The Bipolar Disorder In Early Years

Bipolar affective disorder has been a mystery since the 16th century. History has shown that this affliction can appear in almost anyone. According to an article on bipolar disorder by, David E. Cohen, Some research suggests that highly creative people such as artists, composers, writers, and poets, show unusually high rates of bipolar disorder, and that periods of mania fuel their creativity.

Famous artists and writers who might have suffered from bipolar disorder include poets Lord Byron and Anne Sexton, novelists Virginia Woolf (who did suffer from bipolar disorder) and Ernest Hemingway. (Encarta Encyclopedia) Despite the fact that many people suffer from bipolar disorder, we still wait for clear explanations for the causes as well as the cure. The one fact of which we are painfully aware of is that bipolar disorder severely weakens its” victims ability to obtain and maintain social and occupational success.

Manic and Depressive Symptoms of Bipolar Disorder Bipolar disorder or manic depression is characterized by many symptoms that can be broken into manic and depressive episodes. The depressive episodes are characterized by intense feelings of sadness, despair, hopelessness, and helplessness. guilt, crying spells, disturbances in sleep and appetite, loss of energy, feelings of worthlessness, difficulty thinking, indecisiveness, and recurrent thoughts of death and suicide. (National Depressive and Manic-Depressive Association).

The manic episodes are characterized by elevated or irritable mood, increased energy, decreased need for sleep, poor judgment and insight, and often reckless or irresponsible behavior, grandiose delusions, inflated sense of self-importance, racing speech, racing thoughts, flight of ideas, impulsiveness, poor judgment, distractibility, reckless behavior and in the more severe cases, delusions and hallucinations. (NDMDA )(Encarta Encyclopedia) Bipolar disorder affects approximately one percent of the population (approximately two million people) in the United States.

It usually begins in a person”s late teens or 20s. Men usually experience mania as the first mood episode, and women usually experience depression first. Episodes of mania and depression usually last from several weeks to several months. On average, people with untreated bipolar disorder experience four episodes of mania or depression over a ten-year period. Many people with bipolar disorder function normally between episodes. Still, in “rapid-cycling” bipolar disorder a person experiences four or more mood episodes within a year and may have little or no normal functioning in between episodes.

Often times bipolar patients report that the depressions are longer and increase in frequency as they age. Bipolar disorder is diagnosed if an episode of mania occurs whether depression has been diagnosed or not. Many times bipolar states and psychotic states are misdiagnosed as schizophrenia. Fortunately, Speech patterns help distinguish between the two disorders. This devastating disease causes disruptions of families, loss of jobs as well as millions of dollars in cost to society(Encarta Encyclopedia). (NIMH)

Other Forms of Bipolar Disorder & Stages of Mania In another type of bipolar disorder, a person experiences major depression and hippomanic episodes, or episodes of milder mania. In a related disorder called cyclothymic disorder, a person”s mood alternates between mild depression and mild mania. (Encarta Encyclopedia) The three stages of mania begin with hippomania, in which patients report that they are energetic, extroverted and assertive. The hippomania state has led observers to feel that bipolar patients are “addicted” to their mania.

Hippomania progresses into mania and the transition is marked by loss of judgment. Often, overjoyed grandiose characteristics are displayed, and paranoid or irritable characteristics begin to manifest. The third stage of mania is when the patient experiences delusions with often paranoid ideas. Speech is generally rapid and hyperactive behavior sometimes becomes violent when frustrated ((NIMH) (Encarta Encyclopedia) The genes that a person inherits seem to have a strong influence on whether or not the person will develop bipolar disorder.

Studies of twins provide evidence for this genetic influence. Among genetically identical twins where one twin has bipolar disorder, the other twin has a 50 percent chance of also having the disorder. Conversely, among pairs of fraternal twins, who have about half their genes in common, brothers, sisters and children have a 5-10 percent chance. The amount of genetic similarity seems to explain for the difference between identical and fraternal twins. Further evidence for a genetic influence is apparent in the study of adopted children with bipolar disorder.

This study shows that children who develop bipolar disorder are more likely to have had biological relatives with this disorder rather than adoptive relatives. Although research has shown an apparent linkage to genes on many chromosomes, researchers have been unable to locate a specific gene linked to the disorder. (Kalat 434) (Encarta Encyclopedia) Lithium salts has been the primary treatment of bipolar disorder which continues to be used since it accidental discovery by J. F. Cade. (Kalat 434) It is main function is to stabilize the mood of bipolar disorder patients.

The drug usually takes two to three weeks to become effective. People with bipolar disorder may take lithium during periods of normal mood to delay or prevent later episodes of mania or depression. Common side effects of lithium include nausea, increased thirst and urination, dizziness, loss of appetite, and muscle weakness. Unfortunately, 20- 40% of bipolar patients are either unresponsive to lithium or can”t stand the side effects. (Encarta Encyclopedia) For those 20 to 40 percent of people who do not respond to lithium therapy, two anticonvulsant drugs may help calm severe manic episodes.

The first one is carbamazepine (Tegretol) and valproate (Depakene). These drugs are useful as anti-manic agents, especially in patients with mixed states. Both of these medications can be used in combination with lithium or in combination with each other. Valproate is especially helpful for patients who are unresponsive to lithium, experience rapid cycling, or have alcohol or drug abuse problems. (Encarta Encyclopedia) (NDMDA) Newer antipsychotic medications such as olanzapine, risperidone and quetiapine appear to help with manic episodes.

Also, anticonvulsant or antiepilepsy drugs such as lamotrigine, topiramate and gabapentin may help stabilize patient”s mood when other medications are ineffective. (psychology today, 87) Yet other drugs used are antidepressants. They include, selective serotonin reuptake inhibitors (SSRI”s), fluovamine and amitriptyline which been used by some doctors as treatment for bipolar disorder.

However, research shows that SSRI”s and other antidepressants can actually trigger high manic episodes especially when used alone. Antidepressants are useful when used in together with mood stabilizing medications such as lithium. NIMH) (Psychology Today, 87) In addition to the mentioned medical treatments of bipolar disorder, there are several other options available to bipolar patients, most of which are used together with medicine. One such treatment is light therapy. Which is actually used to treat another form of depression known as seasonal affective disorder (SAD). Patients are treated with very bright lights (2500lux) for an hour or more each day.

This bright light treatment is equally effective in the morning, afternoon, or evening, but according to research it is most effect during the day. Kalat 436) Yet another popular treatment for bipolar disorder is electro-convulsive shock therapy.

ECT is usually the recommended treatment for severely manic patients who are homicidal, psychotic, catatonic, severely suicidal, or for those who were unresponsive to drugs. (Kalat 433) (Encarta Encyclopedia) A final type of therapy is outpatient group psychotherapy. According to The National Depressive and Manic Depressive Association, the value of support groups, has challenged mental health professionals to take a more serious look at group therapy for people with bipolar depression.

Research shows that group participation may help increase lithium compliance, decrease denial regarding the illness, and increase awareness of both external and internal stress factors leading to manic and depressive episodes. Group therapy for patients with bipolar disorders responds to the need for support and reinforcement of medication management, and the need for education and support for the personal difficulties that arise during the course of the disorder. Cognitive and behavioral treatments focus on recognizing early warning signs, interrupting unrealistic thoughts and maintaining positive activities. (Psychology Today, 87)