Abstract
As a psychological disorder, manic and depressive episodes occur intermittently among patients with bipolar disorder. Epidemiology shows bipolar mainly affect adults, and the global prevalence rate is 2.4% while the prevalence rates of the United States and South America are 4.4% and 2.3% respectively. Major causes of the disorder are genes, neurological malfunction, and pre-existing psychological conditions. Apparently, manic and depressive moods are major symptoms of the disorder. As the early diagnosis is key to the treatment and management of the disorder, psychiatrists normally use DSM, family history, imaging techniques, and blood test in the diagnosis of the bipolar disorder. The combination of chemotherapy and psychotherapy has proved to be effective in the treatment bipolar disorder.
Introduction
Bipolar disorder is a unique and serious psychological disorder characterized by intermittent high and low episodes of mood. Individuals with bipolar disorder do not have a stable mental condition because they transition from low mood to high mood. The state of low mood represents depressive episode while the state of high mood represents manic episode. The transition of manic-depressive episodes affects the functioning of the brain because it distorts rational thoughts and incites emotions. Merikangas et al. (2011) explain that bipolar disorder is a burdensome disease because it contributes significantly to the loss of daily-adjusted life years when compared to other diseases such as epilepsy, cancer, and Alzheimer’s disorder. In this view, bipolar disorder is a serious psychological disorder that has disabling effects on patients. Therefore, this essay examines bipolar disorder by focusing on epidemiology, causes, symptoms, diagnosis, and treatment.
Epidemiology
Epidemiology indicates that bipolar disorder is a global psychological disorder. The prevalence rates of bipolar disorder vary from one country to another, which means that predisposing factors are unique to each country. Epidemiological studies show that the prevalence rate of bipolar across the world is 2.4%, and it is increasing with time (Merikangas et al., 2011; Simeonova, Chang, Strong, & Ketter, 2005). Although the increasing prevalence rate of bipolar disorder may be due to improved diagnostics, increased prevalence of comorbid factors can also account for the same trend. A recent comparative epidemiology shows that the prevalence rates in the United States and South America 4.4% and 2.3% respectively (Holtzman, Lolich, Ketter, & Vazquez, 2015). The difference in the prevalence rates points out that people in the United States and South America have unique social and genetic predisposing factors. Moreover, the occurrence of bipolar disorder is common among adults when compared to children.
Causes
Physiological conditions, genes, and pre-existing mental disorders are some of the causes of bipolar disorder among individuals. The imaging analysis shows that the abnormal pattern of the brain among people with bipolar disorder resembles that of people with multi-dimensional impairment. The abnormal pattern of brain influences physiological functions, for example, by reducing secretion of neurotransmitters and influencing functions of neurons. Genes also determine the occurrence of bipolar disorder among individual, which means that it is an inheritable disorder. Juli, Juli, and Juli (2012) state that parents with bipolar are five to ten times more likely to have children with bipolar disorder when compared to normal parents. Thus, the statement confirms that bipolar disorder is a genetic disorder that follows family lineage. Furthermore, pre-existing mental disorders contribute to the occurrence bipolar disorder. Simeonova et al. (2005) note that people with mental disorders such as post-traumatic stress syndrome, social phobia, schizophrenia, obsessive-compulsive disorder, and other anxiety disorders are likely to experience bipolar disorder than those without these mental conditions. In this perspective, it means that the interaction of diverse mental disorders contributes to the occurrence of bipolar disorder among people.
Symptoms
Major symptoms that characterize bipolar disorder are the intermittent occurrence of manic and depressive episodes. In the manic episode, a patient exhibits increased activity due to high energy levels. The major symptoms that are common during the manic episode are increased activity, high energy, extreme irritability, aggressiveness, insomnia, deprived judgment, disturbed thoughts, and other symptoms, which show enhanced level excitement. When these symptoms occur daily and persist for two weeks, they manifest manic episode. Fundamentally, the enhanced activity stems from a high energy generated by the body. In the manic episode, the patients exhibit a varied degree of mania, which can be severe mania, moderate mania, and hypomania.
In the depressive episode, a patient exhibits reduced activity and diminished interests in daily activities owing to low mood. The major symptoms that are common during the depressive episode are diminished interest in activities, sleep disturbance, fatigue, suicidal ideation, irritability, and chronic pain among other depressive symptoms. These symptoms persist for two or more months among adults, but they can only last for few hours among children. Depending on the degree of the depression, a patient with bipolar disorder can experience mild depression, moderate depression, or severe depression. Mild and moderate forms of depression do not have major effects on individuals, but severe depression has major effects because it results in a psychotic condition where a patient experiences hallucinations and delusions.
Diagnosis
Early diagnosis of bipolar disorder is central to its treatment and management.
Family members and psychiatrists play a significant role in the diagnosis of bipolar disorder. Since symptoms that a patient exhibits can be at times subtle or confused with other mental disorders, psychiatrists require ample information from the family members to undertake effective diagnosis. In this view, family members should keenly observe symptoms exhibited by patients and present them to psychiatrists. Given that bipolar disorder is a genetic disorder, family members are the ones who should inform psychiatrists regarding the existence of bipolar disorder or other mental disorders within the family. In most cases, psychiatrists use Diagnostic and Statistical Manual of Mental Disorders (DSM) in the diagnosis and classification of bipolar disorder (Angst, 2013). However, to confirm the existence of bipolar disorder, psychiatrists need to perform brain scan and blood test so that they can eliminate misdiagnosis of cancer.
Treatment
The major methods involved in the treatment of bipolar disorder are chemotherapy and psychotherapy. Chemotherapy entails the utilization of drugs called mood stabilizers to stabilize intermittent manic and depressive moods. Although drugs such as Valproate, Carbamazepine, and Lamotrigine are available, Nolen (2015) recommends Lithium as a first-line drug that psychiatrists should use in the long-term treatment of bipolar disorder. Ample evidence indicates that Lithium is safe and effective in stabilizing moods among patients with bipolar. Psychotherapy is also a helpful method of treating bipolar disorder. Interpersonal therapy and social rhythm therapy are suitable in the management of depressive episode while cognitive behavioral theory and family-focused therapy are appropriate in boosting outcomes during chemotherapy.
Conclusion
Bipolar disorder is a unique and serious psychological disorder, which has a global prevalence of 2.4% and mainly affects adults. Its uniqueness is due to the intermittent occurrence of manic and depressive episodes. Physiological conditions, genetics, and pre-existing psychological disorders predispose individuals to bipolar disorder. Critical analysis of symptoms and historical information are central to diagnosis and treatment of bipolar disorder. Usually, psychiatrists combine chemotherapy and psychotherapy in the treatment of patients with bipolar disorder.
Annotated bibliography
Angst, J. (2013). Bipolar disorders in DSM-5: Strengths, problems, and perspectives. International Journal of Bipolar Disorders, 1(12), 1-3.
The author asserts that DSM-IV is not effective in the diagnosis of bipolar disorder because it does not define sub-threshold groups of manic and depressive episodes. In this view, the author recommends the use of DSM-5 since it is more detailed and effective than DSN-IV. Specifically, DSM-5 can perform sub-diagnosis of manic and depressive episodes, hence, improving the determination of severity.
Holtzman, J., Lolich, M., Ketter, T., & Vazquez, G. (2015). Clinical characteristics of bipolar disorder: A comparative study between Argentina and the United States.” International Journal of Bipolar Disorders, 3(8), 1-20.
With the understanding that bipolar disorder has diverse symptoms, the authors investigated symptoms that manifest severe illness. The authors carried out a comparative study of patients in the United States (n = 503) and South America (n = 499). The findings revealed that North America and South America have distinctive prevalence and outcomes of bipolar disorder.
Juli, G., Juli, M., & Juli, L. (2012). Involvement of genetic factors in bipolar disorders: Current status. Psychiatria Danubina, 24(1), 112-116.
The authors examine genetic factors that contribute to the occurrence of bipolar disorder. Through meta-analysis, the study identified genes that code for serotonin transporter, catechol-o-methyl transferase, brain-derived neurotrophic factor, tyrosine hydroxylase, and neuregulin as specific genes that contribute to the occurrence of bipolar disorder.
Merikangas, K., Jin, R., He, J., Kessler, R., Lee, S., Sampson, N.,… Zarkov, Z. (2011). Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey Initiative. Archives of General Psychiatry, 68(3), 241-251.
The article focuses on the global prevalence of bipolar disorder with a view of establishing important patterns. The authors performed extensive global survey where they selected 61,392 adults and examined diverse DSM parameters. The findings revealed that patterns, comorbidity, and severity of bipolar were the same in spite of the difference in the prevalence rates.
Nolen, W. (2015). More robust evidence for the efficacy of Lithium in the long-term treatment of bipolar disorder: Should Lithium be recommended as the single preferred first-line treatment? International Journal of Bipolar Disorders, 3(1), 1-3.
The author did a meta-analysis to establish the efficacy of Lithium in the treatment of bipolar polar when compared to placebo and other treatment regimens. The findings of the study show that Lithium is effective in the long-term treatment bipolar disorder. Hence, the article recommends the use of Lithium as a first-line drug that is effective in long-term treatment of bipolar among patients.
Simeonova, D., Chang, K., Strong, C., & Ketter, T. (2005). Creativity in Familial Bipolar Disorder. Journal of Psychiatric Research, 39(1), 623-631.
Authors argue creativity and bipolar disorder have some relationships among individuals. To confirm their argument, the authors correlated the creativity and bipolar by comparing parents and their children with bipolar disorder. The findings show that bipolar disorder correlates positively with creativity among individuals.