Bipolar Disorder

 
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Introduction

Bipolar disorder refers to a type of mental disorders that are most apparent through extremities in mood shifts, from extreme happiness to extreme sadness. Other terms for the disorder are manic-depressive illness and bipolar disaffective disorder. Bipolar affects a person’s ability to carry out daily tasks. In the absence of proper diagnosis and medication, the disorder can result in damaged friendships and even family relationships, job loss from consistently poor performance, and in extreme cases, self-harm and suicide. With proper diagnosis and treatment, the people with the illness can lead fruitful and full lives.

History of Bipolar

Bipolar disorder uses two terms that indicate the extremes of a person’s mood. The origins of the two words are both Greek: melancholy (depression) and mania (Bogousslavsky & Moulin, 2009). However, the modern use of the term ‘bipolar’ has its origins in the nineteenth century, coming from two French scientists Jules Baillarger and Jean-Pierre Falret (Bogousslavsky & Moulin, 2009). In independent investigations, both of them came up with descriptions of the disorder. Baillarger named it a dual-form insanity. Falret, on the other hand, noted that the illness was prominent among certain families, thus indicating it could be genetic (Khouzam & Singh, 2006). German psychiatrist Emil Kraepelin continued the research the two had done and discovered that the patients had periods where they were completely symptom-free (Smith & Wogsland, 2007). Based on this, he differentiated it from schizophrenia and coined the term manic-depressive psychosis (Smith & Wogsland, 2007). Khouzam and Singh (2006) explain that the emphasis on bipolarity and the elevation of moods as the defining characteristic of the disorder dates to the 1960s.

Causes of Bipolar Spectrum of Disorders

There is a variance between individuals who have the condition. Thus, the exact mechanism underlying the disorder is unclear. This uncertainty has led to misdiagnoses over the years (Khouzam & Singh, 2006). Studies of twins, while using small samples, have indicated a genes contribute to the disorder and so is having a first-degree relative with the disorder (Miklowitz & Chang, 2008). Secondly, scientists have also discerned that variance in the structure and function of brains are a feature of people who suffer from the disorder (Khouzam & Singh, 2006). Furthermore, environmental factors also contribute to the development of bipolar disorder (Kaymaz et al., 2006). According to Khouzam and Singh (2006), neurotransmitters also have an influence on the occurrence of the disorder in individuals.

Signs and Symptoms of the Disorder

The most obvious of the symptoms is the intense disparate emotional states in individuals who have the disorder. These occur in dissimilar periods (mood episodes) that lead to a drastic change in a person’s normal mood and behavior (Khouzam & Singh, 2006). The manic episode, whose main characteristic is extreme happiness or excitement, is followed by a depressive state, in which the person is sad or hopeless. In rare instances, there are symptoms of both states at the same time.

During the manic period, one is overly joyful for long periods and is extremely irritable. On the behavioral side, the person talks very quickly, he/she cannot concentrate fully, and he/she is restless, which may lead to sleeplessness (Khouzam & Singh, 2006). Additionally, such people have a false belief in their abilities, and they may engage in what others think are risky behaviors. On the other hand, the depressive episode is characterized by a long period of sadness, hopelessness, or both. Secondly, one loses interest in activities that he/she normally enjoys (Khouzam & Singh, 2006). Behaviorally, the person feels tired and has problems with concentration, and he/she can be indecisive. In the extreme cases, one thinks of death and suicide or attempts self-harm. 

Types of Bipolar Disorder

Bipolar disorder occurs in four major types. The first one is Bipolar I Disorder. Having this type of disorder, the person experiences severe manic or, in some instances, mixed episodes that last for at least a week (Khouzam & Singh, 2006). Depression occurring and lasting, at least, two weeks may follow the manic episodes. The second type of the disorder is Bipolar II Disorder. A pattern of depressive episodes characterizes this type as well as hypomanic episodes. However, unlike in the first instance, there is no full-blown manic and mixed episodes (Khouzam & Singh, 2006). The third one is Bipolar Disorder Not Otherwise Specified (BP-NOS). This occurs when a person’s symptoms are apparently outside his/her normal range of behavior but they do not meet the criteria for the diagnosis of either Bipolar I or Bipolar II (Khouzam & Singh, 2006). Lastly, Cyclothymia occurs when a person experiences hypomania and mild depression for at least two years (Khouzam & Singh, 2006). The symptoms, however, fall below the clinical diagnostic threshold. If the person experiences four or more mood instabilities in the period of a year or less, this is known as rapid cycling (Smith & Wogsland, 2007). Rapid cycling may occur in any of the four types of the disorder.

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Prevention

When a patient has been diagnosed with the disorder, he/she should take measures that could prevent trivial symptoms from being full-blown (Miklowitz & Chang, 2008). Measures such as avoiding drugs and alcohol should be taken seriously to avoid a relapse. He/she should pay attention to the warning signs, for example, calling a doctor when episodes of mania or depression occur. One should take the prescribed medicine as per doctor’s instructions, and if one feels like stopping or changing the medication, it should be under a doctor’s authority. According to Miklowitz and Chang (2008), learning how to deal with traumatic experiences can go a long way towards avoiding the triggers for the disorder.

Treatment Plans

The short-term goals of the treatment are to prevent or, at the very least, manage the various types of acute mania or depression. The long-term goals are to prevent a relapse and ensure that the person recovering reintegrates into society. To deal with bipolar in the short-term, psychiatrists will prescribe lithium, anticonvulsants, and antipsychotic drugs that act as mood stabilizers (Geddes & Miklowitz, 2013). Benzodiazepines are especially useful in the short-term relief from the bipolar disorder. Electroconvulsive therapy is useful in cases where another medication has failed. In the long-term, continuous and, in some cases, lifetime prophylaxis may continue even after the acute episode is under control. This is known as maintenance therapy. The drugs used for maintenance therapy include lamotrigine (Lamictal) and continuing psychotherapy (Geddes & Miklowitz, 2013). These drugs help to keep the patient at a stable level.

Suggestions on How to Overcome Bipolar Disorder

One should seek appropriate medical care as without a proper diagnosis the disorder is likely to spiral out of control. After a doctor has diagnosed and issued prescriptions, one needs to take the medication as prescribed by the doctor. Stopping the prescriptions when one decides he/she feels well is highly discouraged as this has the potential of causing a relapse. Furthermore, one should also seek psychotherapy with a therapist he/she is comfortable with (Miklowitz, 2008). The disorder also tends to make people seem anti-social. Miklowitz (2008) suggests that social support and making the recovering person feel accepted from these close to him like family and close friends, and even workmates, is a good way to help the person recover.

Parenting Skills to Help the Individuals

One may still be a good parent despite the fact that parenting while suffering from bipolar may be immensely challenging. A good support system is important for the parent so that during the episodes the children are well taken care of. One can request relatives and close friends to assist in taking care of the children during the episodes so that the children do not suffer either physically or psychologically as a result of the episodes. One also needs to explain to the children about the condition when the children are at an appropriate age (Neeren, Alloy, & Abramson, 2008). This is to enable the children to understand the disorder that afflicts their parents. 

Evidence-Based Therapies for Bipolar Disorders

Some of the most common evidence-based therapies for the bipolar disorder include psychoeducation, cognitive behavioral therapies, therapies whose focus is the family of the person affected by the condition, and social rhythm therapy (Meyer & Hautzinger, 2012). These therapies are important as medication alone can be ineffective in the treatment of the disorder (Bouwkamp et al., 2013). However, these four and other evidence-based therapies used together with medication are effective as adjunct treatments.

Conclusion

While bipolar disorder is a severe mental disorder, it is possible to manage the condition through short-term and long-term medication coupled with evidence-based therapies. Bipolar disorder afflicts a large number of people in the world. While the specifics of how the disorder occurs are not yet clear to the scientists, there is evidence that points to genes, an imbalance in the neurotransmitters, and environmental factors as the most common contributors to the disorder. In addition, street drugs have the capability of triggering the disorder. The condition manifests in four different ways: Bipolar I, Bipolar II, BP-NOS, and Cyclothymia. In addition to treatment, one can also reduce the risk of suffering from the disorder through the avoidance of stressful situations, street drugs, and proper medication of the early symptoms of the disease.