- Bipolar Disorder -

Bipolar disorder is a mental disease that affects millions of people around the world. This particular disorder is characterized by an alternating pattern of highs and lows in a person’s mood. These can be mild to severe emotional mood swings, ranging from deep depression to extreme elation. Bipolar is characterized by one or more depressive episodes and at least one episode of mania. It affects thoughts, feelings, perception, behavior, and the way a person feels physically.

Risk factors include age, gender, accompanying neurological or emotional disorders, family history, seasons, socioeconomic status, and even the loss of a parent. Bipolar affects over two million American adults, which is about one percent of the population age eighteen and older. Bipolar occurs in approximately one percent of all age groups. Thirty-three percent of children who had major depression developed bipolar by age twenty-one; bipolar usually sets in around eighteen years of age. Another common age for the onset of bipolar is at age forty, for women in particular. Twenty-five percent of children that were diagnosed with ADHD when they were young develop bipolar by the time they are eighteen, and fifty-nine percent of bipolar patients began showing symptoms when they were younger.

Genetics factor in to bipolar disorder in about sixty percent of cases. Usually if the patient’s parents, one or both, had bipolar, the patient will have it as well. Families with a history of bipolar also tend to have a higher incidence of other psychological problems, like schizophrenia, anxiety disorders, ADHD, and depression, all of which can contribute to bipolar symptoms and effects. Anxiety disorders play a common role in bipolar patents. Researchers have associated anxiety and bipolar to have a direct correlation to longer, more sever bipolar depressive episodes and a higher risk of suicide. Studies have shown that children with ADHD are very prone to developing bipolar later in life.

Bipolar disorder is characterized by the manic and depressive states, both varying from mild to extreme. The patient is always either at one end or the other…there is no middle ground. The flare-ups of these stages could last for weeks, even months at a time. Signs of the manic phase could include the patient feeling as if he can do anything, even if it is unsafe or illegal. They tend to need very little sleep, but never seem to be tired; they dress extravagantly and throw their money away, living recklessly. Many people, while in the manic stage of bipolar, will experience hallucinations or delusions, feel as if they are filled with energy, and even have increased sexual desires.

On the other end of the spectrum is the depression, or depressive, stage. This stage can be identified when the patient refuses to budge from bed for days on end, sleeps a lot more than usual, is constantly tired but unable to sleep, and feels hopeless, helpless, and worthless. Depressed bipolar subjects may have bouts of uncontrollable crying, feel an intense desire to die, become completely disinterested in everything they once enjoyed, and even shirk daily duties and be unable to perform simple decisions.

There is also a stage of bipolar disorder called hypomania. Hypomania is a lesser degree of mania that presents many of the same symptoms as mania. This state of being is characterized by restlessness, racing thoughts, high energy and the desire to do a lot of different things. They may find a lot of joy in spending money, which is also a characteristic of the manic stage. Patients in the hypomania stage can be treated with anti-depressants, which will calm them down and get them back on track on their regular life.

These symptoms can occur in cycles. The episodes of either mania or depression can occur with days, weeks, or even months between cycles. Frequency of occurrences depend mainly on the lifestyle of the person affected by bipolar, although because of the severity of bipolar disorder, some patients may not have any control whatsoever on their mood swings. Rapid cycling occurs in five to fifteen percent of bipolar patients; this is the occurrence of either a manic or a depressive episode no longer than every twenty-four hours. People that are caught in rapid cycling have mood swings so often between mania and depression that there is often no identifiable normal mood to establish a base with to determine when the patient is not rapid cycling. It is a very difficult thing to determine.

Bipolar is very unpredictable, though it is often recurrent. There are many types of treatments available, but at the time there is no total cure. There are possible ways to reduce the severity of episodes of mania or depression, and ways to reduce the frequency of episodes. There are ways to keep from cycling so rapidly from one cycle to the other, and to help the person with bipolar function as well as possible between the episodes. A physician can determine the severity of the symptoms and what brought on the attack. From that point the doctor can determine what treatments can be employed.

The recurring symptoms of bipolar can occur for many different reasons, including things as trivial as seasons, socioeconomic status, and even the loss of a parent or other loved one. Interestingly enough, there appears to be a correlation between bipolar disorder and patients that are born in the winter, and also those whose births were more difficult than normal. Also, the manic stage is said to occur more often in summer, while the depressive state occurs in the “darker” months, mostly October through May, according to recent research.

In addition, the higher up on the social chain a person is, the more likely they are to exhibit symptoms of bipolar disorder. Bipolar is much more prevalent, from ten to twenty percent, in people with a high socioeconomic status that perform in creative arts, as opposed to the general population. Another interesting factor that could be attributed to the development of bipolar later in life is the loss of a parent as a child. Again, there is a correlation between the a child losing a parent early in life and the development of bipolar as an adult.

There are a lot of challenges to treating bipolar in patients, mainly because the disorder is so unpredictable. The mood variations make it difficult to tell if a patient is responding to the treatment, or just cycling from one phase to the next. Another difficulty is that because of the moods and the affects bipolar has on a patient’s mind; they may or may not report their state of mind and illness to their physician. There is also the possibility that the patient would need more than one medication, which could increase the risk of conflicting side effects. Lack of understanding of the disease can also create a problem, because if the patient is not educated about bipolar, he could undercut the seriousness or treatment of the disease.

No single cause may be found that singularly can take on full responsibility for causing bipolar. The disorder is, instead, a combination of biologic, genetic, and environmental factors that are thought to trigger chemical imbalances in the brain that in turn create bipolar. Research and image scanning has given scientists accurate information on what they believe is the cause of bipolar disorder. Among these factors are the oversecretion of cortisol, which is a stress hormone, excessive influx of calcium into the brain cells, and abnormal activity in the emotional and movement coordination parts of the brain that are associated with concentration, attention, inhibition, and judgment. A very fast biological clock that regulates the person’s circadian rhythm and includes waking and sleeping is a factor that greatly attributes to bipolar.

A lot of different types of drugs have come on the market to treat bipolar. Since this paper is specifically about the bipolar disorder, it will not cover the medications to a significant length. Listed as follows are the most common medications to treat bipolar disorder.

Lithium is the most well-known drug that has been used for many years to treat the disorder. It is the best medication for people that have a pure form of the disease, going from one major extreme to the other, from pure mania to pure depression. Although the drug is still imperfect, as many drugs are, it is effective as a long-term drug for many patients.

Anti-seizure agents are used to treat people that have a lot of manic episodes and rapid cycling problems. This works well for people that are substance abusers as well. Valproate, Carbamazepine, Lamotrigine, Neurontin, Zonisamide, and Topiramate are some of the common anti-seizure drugs used for treatments. At this present time in research, it is not yet clear if these newer drugs are helpful in the treatment of acute mania.

Atypical antipsychotics are used for mood stabilizing. Clozapine, Risperdal, Zyprexa, Seroquel, and Zeldox are just a few examples of this type of drug. The agents can be used in combination with each other, but bipolar patients must be very careful to make sure that any additional drugs they are taking do not interfere with their treatment or disrupt its effects in any way.

There are other types of therapy available for bipolar patients other than the typical medication. A lot of people don’t want to have to be dependent of drugs or any other types of chemicals, so they turn to alternative forms of treatment therapy. Because bipolar consists of chemical imbalances in the brain, the classical form of psychological therapy is useless to bipolar patients. However, trained professionals can give psychological support that is essential to all victims of bipolar. This could include educating them on the disorder and treatments, monitoring their progress and episodes, help them adjust to the severity and reality of the illness, and deal with the guilt and remorse that can occur in response to the ramifications of their manic or depressive stage.

Cognitive-behavioral therapy could turn out to be particularly helpful for a lot of people suffering from bipolar. CBT is a structured method that tries to help patient recognize negative thoughts and behaviors and to change them to positive ones.  This therapy helps with depression and anxiety as well as those with bipolar. Studies have shown that patients with bipolar that underwent this program experienced fewer, shorter episodes and improved their socioeconomic status than those that didn’t take the program.

In addition to therapy and/or medication, bipolar patients can change their lifestyle to better accommodate their illness and improve its affects on their lives. One of these includes getting a fair amount of exercise, which not only helps manage weight gain, but also increases feelings of well-being. Sleep management is another important part of controlling the severity of bipolar. The better sleep a patient gets, the less mood cycling they experience as a result of the disorder. Diet is an important part of any person’s life, but people with bipolar must be sure to maintain a regular healthy diet. If they are on medication that makes them gain weight, they must be even more careful. There is research going on that is working to prove that the vitamin B complex may have a positive effect on depression.

Living with bipolar disorder is certainly no walk in the park. Even the economic burden of bipolar is significant; in 1991, the National Institute of Mental Health estimated the bipolar cost the country forty-five billion dollars of patient care, suicides, insitutionalization, lost productivity, and the involvement of the criminal justice system. Despite this obvious need for professional health, patients with bipolar cannot always gain access to medical therapy. In a major survey done, thirteen percent of patients had no insurance at all, and fifteen percent were unable to afford medical treatment of any kind.

Several myths are commonly circulated about bipolar disorder. One such misunderstanding is the rumor that bipolar patients almost always commit suicide. Although suicide is more common among bipolar patients than in other mental diseases, not all patients commit suicide. Some of them will stop taking their medicine during the manic stage in order to enjoy the high, and as a result end up falling even deeper into depression, sometimes to the point of entertaining suicidal thoughts. Another myth is that bipolar people cannot find or hold down a job. This is a fallacy, in that being diagnosed with a mood disorder does not render a person incompetent to handle a job. Often a bipolar patient will feel as if they are incapable of doing something, though, when they are actually quite capable of performing the tasks on hand.

Victims of bipolar are still capable of caring for themselves, but must be very careful with the way they go about doing so. Some useful tools in tracking their mood cycles would include a wellness checklist, figuring out what triggered mania and depression, and removing harmful objects from the vicinity. Coping with bipolar is a very distinct possibility. Those who choose to overcome the disorder can indeed rise above it. It may take a lot of time for both the patient and the family of the patient to accept and adjust to such a disruption of life, but it is very possible, as evident by the numerous people who have done so.