Manic-Depressive Illness - Essay Example

? Bipolar Depression The following paper looks into Bipolar Disorder which is a mental disorder manifested by episodes of depression and mania. The paper begins by giving an introduction of bipolar disorder and its history which goes way back in the second century. The paper also identifies the causes of the disorder ranging from certain forms of medication, neurotransmitters, environmental and genetic factors. The risk factors associated with bipolar disorder are also discussed and they include age, gender and family history. The conditions that are prone to occur with the disorder such as ADHD, substance abuse and physical problems are highlighted. Individuals with bipolar disorder go through different phases. This paper gives an in-depth discussion of the signs and symptoms that are linked to such phases and concludes by advocating for more research on the disorder. Introduction Bipolar Disorder is also known as Manic-Depressive illness. It is a mental disorder that leads to out of the ordinary energy shifts, the capability of doing chores, activity level and moods (Havens & Ghaemi, 2005). The symptoms exhibited by the disorder are severe in nature and can lead to suicide, poor school and job performance as well as damaged relationships. According to Angst & Marneros (2001), Bipolar Disorder frequently arises in a person’s late teenage years or the early adult ones. Not less than half of every reported case begins even before an individual turns 25. For other individuals, the first symptoms are experienced during childhood, although there are others who may develop symptoms later on in life. This disorder is hard to spot in the beginning stages since the symptoms may look like separate problems (Angst & Marneros, 2001). The objective of this paper is to identify what Bipolar Disorder is by describing its history, causes, signs and symptoms, risk factors and effects on an individual. History of Bipolar Disorder Bipolar Disorder is possibly among the oldest known mental illnesses. According to a review of research works by Angst & Marneros (2001), medical records from as early as the 100 AD have cited symptoms similar to those of patients with Bipolar Disorder. The first time it was detected dates back to the 2nd century. In a city in ancient turkey, some symptoms of depression and mania were made out by Aretaeus of Cappadocia who sensed they might have a connection with each other. Until 1650, his findings went unsubstantiated and unnoticed. This is when a scientist by the name Richard Burton wrote a book titled The Anatomy of Melancholia (Angst & Marneros, 2001). This book focused on depression to a great extent. A large number of those in the mental health field today still utilize his findings. He is given credit as being the one who first considered depression to be a mental illness. In 1854, Jules Falret made up the expression ‘folie circulaire’ which means circular insanity (Angst & Marneros, 2001). He also found a relation between depression and cases of suicide. The term Bipolar Disorder came about from his work as he observed the difference between instants of depression and heightened moods. He identified that this differed from the case of simple depression and his findings were named name Manic-Depressive Psychosis which is a psychiatric disorder. Falret also realized the genetic connection at a very early stage since the illness seemed to be detected in certain families (Angst & Marneros, 2001). Sedler (1983) analyzed the genetics that brought about the disorder and revealed the probability that manic depression was experienced in families affected by the disorder. Many individuals having the disorder were placed in institutions in the 1960s. They however received little financial aid since congress refused to recognize that manic depression was a legitimate sickness. It is in the 1970s that standards were established and laws enacted to help the afflicted. In 1979, an organization known as the National Association of Mental Health (NAMI) was founded (Sedler, 1983). The term Bipolar Disorder replaced the expression manic-depressive disorder in 1980. In the 1980s era, research was eventually successful in differentiating the childhood from adult Bipolar Disorder. However, even in present times, studies are required to discover the probable causes of the illness (Sedler, 1983). Causes of Bipolar Disorder Even though Bipolar Disorder’s main cause is not yet well known, there are a number of factors that appear to cause and trigger the bipolar episodes. As per Ketter (2010), genetic factors play a major role. Bipolar Disorder has a tendency of running in families whereby approximately half of the individuals having Bipolar Disorder also have a family member who has a mood disorder for example, depression. There is a fifteen to twenty-five percent chance of an individual having the condition if he/she has one parent with the disorder (Ketter, 2010). An individual whose both parents have the disorder has a 25% chance of illness same as a person whose non-identical twin has the illness. On the other hand, an individual with and identical twin having the disorder is at a much greater risk of acquiring the condition (Ketter, 2010). Environmental factors also play a role in causing the condition (Havens & Ghaemi, 2005). A particular life event may act as a trigger to a mood episode if a person has a genetic tendency for Bipolar Disorder. Significant loss, abuse, stress or other traumatic occurrences may play a part in causing the disorder. Hormonal problems, substance or alcohol abuse, or altered health habits may act as a trigger to an episode even without clear genetic factors (Havens & Ghaemi, 2005). An imbalance in neurotransmitters also appears to have a key role in causing the disorder as well as other mood disorders. Neurotransmitters are naturally occurring brain chemicals. Bipolar Disorder might stay dormant and later be activated by itself or by external factors like social circumstances and psychological stress. There are also some medications that may set off a manic or depressive episode. However, the individual goes back to their normal after stopping the medication. It is therefore advisable that one notifies their physician if they have a history of the disorder (Havens & Ghaemi, 2005). This will be helpful in the avoiding of medication-induced episodes. Risk Factors According to Ketter (2010), there are various factors that may add onto the risk of developing Bipolar Disorder. The first one is family history whereby the disorder is often found within families. The family members of persons having the disorder are prone to exhibiting some other disorders that are psychiatric. Some of these include: Major Depression, ADHD, Anxiety Disorders, Schizoaffective Disorder and Schizophrenia (Ketter, 2010). The other risk factor is gender. Even though Bipolar Disorder has an equal effect on people from both sexes, there are higher incidences of cyclothymia, mixed states and rapid cycling in women. On the other hand, the early-onset Bipolar Disorder has a tendency of occurring to a greater extent in men and is connected to a more severe condition. Ketter (2010) believes that men having Bipolar Disorder also have a tendency of exhibiting higher rates of alcohol and substance abuse as compared to women. Havens & Ghaemi (2005) identified age as a risk factor. The first occurrences of Bipolar Disorder are usually experienced between ages 15 to 30 years. However, the average age of onset is at 25 years. This disorder can however affect individuals of all ages and children are included. The Bipolar Disorder that comes about later in life is frequently accompanied by neurological and medical problems especially cerebrovascular diseases such as stroke (Havens & Ghaemi, 2005). The one that comes later on in life is less probable to have a connection to a family history of the disorder as compared to the earlier-onset Bipolar Disorder. Conditions that Occur with Bipolar Disorder If an individual suffers from Bipolar Disorder, he/she may have other health conditions that may be diagnosed either before or after the Bipolar Disorder diagnosis (Ketter, 2010). Such conditions ought to be detected early enough to avoid worsening of the disorder. These conditions include; physical health problems whereby individuals diagnosed with the disorder have a more likelihood of having other health problems like obesity, thyroid problems and heart disease. According to Ketter (2005), addiction or substance abuse is another condition in that many individuals with the disorder are known to also have drug, tobacco and alcohol problems. Alcohol or drugs may appear to ease the symptoms but they instead can worsen, prolong or trigger mania or depression. Havens & Ghaemi (2005) states that ADHD (Attention-Deficit/Hyperactivity Disorder) is also another condition that may occur with Bipolar Disorder. The symptoms of ADHD coincide partially or wholly with those of Bipolar Disorder. It can therefore be difficult to differentiate between ADHD and Bipolar Disorder due to this reason. One can be mistaken for the other at times and an individual might be diagnosed with both conditions in some cases (Havens & Ghaemi, 2005). Signs and Symptoms of Bipolar Disorder Persons with Bipolar Disorder go through phases known as mood episodes. These are unusually acute emotional states that take place in separate periods. An excessively hopeless or sad state is called a depressive episode whereas an extremely overexcited/joyful state is called a manic episode (Furukawa, 2010). Furukawa (2010) argues that there are times when a mood episode is inclusive of the symptoms of both depression and mania. Such a time is known as a mixed state. During such a state, frequently experienced symptoms include major changes in appetite, agitation, suicidal thinking and trouble sleeping. Individuals in a mixed state might feel really hopeless or sad while at the same time feeling extremely energized. Persons with Bipolar Disorder might also be cranky and volatile throughout a mood episode. Alterations in behavior, sleep, activity and energy that are extreme go hand in hand with the changes in moods. It is possible for a person having Bipolar Disorder to experience a long lasting episode of moods that are unstable instead of separate phases of mania or depression. A person might be going through an episode of Bipolar Disorder if he/she exhibits for most parts of the day several depressive or manic symptoms, almost daily, for at least one or two weeks. The symptoms may at times be a hindrance to a person’s normal functioning at home, school or work if they are very severe (Angst & Marneros, 2001). There are times when an individual going through severe phases of depression or mania also has psychotic symptoms like delusions and hallucinations (Ketter, 2010). These psychotic symptoms have a tendency of reflecting the individuals extreme mood whether it is a depressive or manic one. Persons with Bipolar Disorder having psychotic symptoms are as a result wrongly diagnosed at times. They may be thought to have Schizophrenia, which is another severe mental illness associated with delusions and hallucinations. Also, behavioral problems like performing poorly at work or in school, relationship problems and abuse of alcohol or substances may be exhibited by individuals with the disorder. It is difficult to at first identify these problems as being symptoms linked to a major mental illness (Ketter, 2010). Effects of Bipolar Disorder on an Individual In most cases, this disorder lasts a whole lifetime with phases of depression and mania generally recurring as time goes by. However, in between episodes many individuals having Bipolar Disorder don’t have any symptoms but some may experience lingering symptoms (Sedler, 1983). Mental illnesses are usually diagnosed by doctors following guidelines found in the Diagnostic and Statistical Manual of Mental Disorders (DSM) (Sedler, 1983). According to Sedler (1983), the basic kinds of Bipolar Disorder are four in number. The first one which is primarily characterized with mixed or manic episodes which last for 7 days at least or by severe manic symptoms which require prompt hospital attention is known as Bipolar I Disorder. Also, the individual usually experiences depressive episodes that last for at least two weeks. These symptoms of depression or mania must have a huge difference from the normal behavior of the person. The second one which is characterized by a series of depressive episodes taking turns with hypomanic (less severe manic) episodes but not fully blown manic or mixed periods is called Bipolar II Disorder. The third one which is diagnosed when an individual’s symptoms are not up to the diagnostic standards for bipolar I or II is BP-NOS (Bipolar Disorder Not Otherwise Specified). A person might have either have too few symptoms or they may last for not long enough, but are however out the range of the individual’s normal behavior. The fourth one, Cyclothymia or Cyclothymic Disorder, is a form of the disorder that is mild where individuals experiencing it have hypomania episodes that take turns with mild depression for at least two years. As per Angst & Marneros (2001), the symptoms however, are not up to the diagnostic criteria for any other form of Bipolar Disorder. Some individuals might be found to have rapid-cycling Bipolar Disorder which occurs when a person experiences up to four or even more episodes of mixed symptoms, mania, hypomania or major depression in one year. It often may be more common in individuals whose first episode occurs at a younger age and appears to be more common in individuals with severe Bipolar Disorder. It affects more women in comparison to men (Angst & Marneros, 2001). Conclusion It is clear that Bipolar Disorder has been in existence for quite a long time given that its symptoms were detected as far back as the second century. In the earlier years many people with the disorder were institutionalized but they did not get sufficient medical assistance. This was because congress did not recognize the disorder as a legitimate illness. This situation improved over the years due advancements in research as well as the establishment of the National Association of Mental Health (NAMI). However, studies are still required even today so as to determine all the possible causes of the disorder. Although it is not clear as to what mainly causes the disorder there are some factors that seem to cause and trigger the episodes. They include; genetic factors, environmental factors, neurotransmitters and some types of medication. The risk factors associated with Bipolar Disorder include; the family history, gender and age. An individual suffering from the disorder may also have conditions such as physical health problems, substance abuse and ADHD. This disorder causes people to go through various phases that are known as mood episodes which can either be manic or depressive. These episodes may be accompanied by psychotic symptoms like delusions and hallucinations. Bipolar Disorder lasts a lifetime in a majority of cases and it is therefore important that it is detected early so that the symptoms can be controlled. References Angst, J. & Marneros, A. (2001). ‘Bipolarity from ancient to modern times: Conception, birth and rebirth’. Journal of Affective Disorders, 67 (1–3), 3–19. Furukawa, T. A. (2010). ‘Assessment of mood: Guides for clinicians’. Journal of Psychosomatic Research, 68 (6), 581–589. Havens, L. L. & Ghaemi, S. N. (2005). ‘Existential despair and Bipolar Disorder: The therapeutic alliance as a mood stabilizer’. American Journal of Psychotherapy, 59 (2), 137–147. Ketter, T. A. (2010). ‘Diagnostic Features, Prevalence, and Impact of Bipolar Disorder’. The Journal of Clinical Psychiatry, 71 (6), e14. Sedler, M. J. (1983). ‘Falret's discovery: The origin of the concept of bipolar affective illness. Translated by M. J. Sedler and Eric C. Dessain’. The American Journal of Psychiatry, 140 (9), 1127–1133. Read More