Bipolar Disorder – Causes, Symptoms & Treatment

Bipolar DisorderBipolar disorder encompasses much more than the normal mood swings that everyone is affected by from time to time. By contrast, bipolar disorder can have devastating effects on one’s personal life and their profession. Bipolar is characterized by manic depression commonly referred to as the shifting of one’s personality from states of highs and lows. The profound symptoms of bipolar disorder lead to a complicated, yet, manageable life.

Throughout the United States, estimates have anywhere from 1-2 million people who (University of Maryland Medical Center, 2007) suffer with bipolar disorder to over 2 million people or 1% of the population over age 18 with the disorder (NIMH, 2007). The onset of the disorder generally begins in late adolescence to early adult-hood. One problem with having a definite count is that some people will go through their entire life without seeking treatment and as such are not diagnosed with bipolar disorder. Bipolar disorder is as much an illness as high blood pressure or diabetes. One must learn to respect this disorder and make adjustments in daily life in order to cope with the illness. Presently bipolar disorder cannot be diagnosed by medical tests such as a brain scan or blood test; rather it is diagnosed by a clinician with the aid of the DSM-IV describing the conditions and symptoms of the disorder.

Studies reveal that environmental stressors play an important role in bipolar disorder. The effects of family conflict, job related stress or job loss, sleep deprivation, and some medications such as over-the-counter cold medications, caffeine, appetite suppressants, corticosteroids, and thyroid medications can produce profound distortions to one affected with bipolar disorder and can trigger an onset. Life stressors effect people with bipolar disorder to a much higher degree than the general population (Ruggero, 2006).

Types of bipolar disorder

The types of bipolar disorder are bipolar I, bipolar II, rapid cycling, and cyclothymia. Bipolar I is the most common form of bipolar disorder and possess the classic symptoms of recurring mania and depression, hence manic depression. Bipolar II on the other hand consists of milder mania symptoms of hypomania with frequent bouts of major depression. Rapid cycling is having four or more episodes within a 12-month period. One with rapid cycling may undergo several episodes in a single day. Women are more likely to experience rapid cycling compared to men. Cyclothymia is the less severe of the disorder.

Bipolar disorder symptoms

Bipolar disorder symptoms include manic and depressive episodes, hypomania, and depression. The manic symptoms of the disorder are feelings of grandiosity, a superego, a feeling of euphoria, sleeplessness, more talking than normal, easily distracted, increased risky behavior, and deficient in judgment. The depressive episode symptoms include feeling depressed, loss of normal interests, sleep irregularities, slowed speech and motor skills, to talk down about oneself, and the inability to focus. Hypomania is a milder form of mania. People with hypomania have an elevated self-esteem, feel somewhat euphoric, possess an abundance of energy, and are more productive, yet with less intensity than that of mania. The symptoms of depression are feelings of great sadness, loss of hope, and feelings of worthlessness.

Bipolar is often diagnosed with axis I anxiety disorders such as panic disorder. One with bipolar disorder is 6 times more likely to suffer from panic disorder than the general population. When bipolar disorder is accompanied by an anxiety disorder, there is a likelihood of more severe episodes and an increase risk of suicide.

The symptoms of bipolar disorder can be tricky to distinguish from other similar disorders. The patient may not be able to distinguish the difference between happiness and mania. Hypomania is the less severe variant of mania and lasts for at least 4 days. Patient’s with hypomania are usually very talkative, easily distracted, and have a difficult time with daily functioning. A correct diagnosis is important in getting the correct medication. If one is diagnosed as only depressed when in fact they have mania as well, they may only be given an antidepressant for depression and neglect the mania that can cause another relapse. Severe episodes of mania including delusions can be mistaken for schizophrenia. Mania or hypomania symptoms will be present in bipolar disorder but not with schizophrenia. Moreover, patients with schizophrenia are generally flat in their actions and responses whereas patients with bipolar disorder in a mania state will be very talkative and active.

Substance abuse is approximately 60% by patients with bipolar disorder. Substance withdrawal symptoms can look very similar to a manic or depressive episode. The erratic behavior of a heavy cocaine user may have the appearance of bipolar disorder.

Other causes of mood swings to rule out before determining bipolar disorder are thyroid disorder, adrenal disorders such as Cushing’s syndrome and Addison’s disease, vitamin B12 deficiency, neurologic disorders such as epilepsy, Huntington’s disease, brain tumors, and multiple sclerosis. Medications such as corticosteroids, and drugs to treat Parkinson’s, and anxiety disorders may also cause mood swings.

There are new and intriguing studies with regard to children and bipolar disorder. An important question being asked is whether a child can accurately be diagnosed with bipolar disorder. What complicates this is that children are going through various stages of physiological and mental development during these early years. Another hindrance in correctly diagnosing bipolar disorder in children is that too often it is confused with ADHD. Furthermore, it is possible to have a child with bipolar disorder and ADHD at the same time.

Those affected with bipolar disorder were born with a predisposition of having the disorder. Genetics play a significant role in bipolar disorder. The extent that bipolar disorder runs in families is 60%. Other research is looking at neurotransmitter imbalance specifically serotonin, dopamine, and norepinephrine. With the use of a brain imaging, such as a PET scan or MRI the differences in brain activity can be seen. The normal brain shows equal activity across both sides of the brain, by contrast the bipolar affected brain will consist of only certain areas with activity. High levels of the stress hormone cortisol and abnormal levels of thyroid hormone are also believed to be the causes of manic and depressive episodes. Another theory to the cause of bipolar disorder is the biological clock theory. These theorists believe that the biological clock that regulates sleep-wake cycle is faster for those with the disorder.

Family members of those suffering with bipolar disorder have a higher propensity than that of the general population to have a mental disorder. The most common disorders are major depression, ADHD, axis II anxiety disorders, schizoaffective disorder, and schizophrenia.

Males and females are equally susceptible to having bipolar disorder. Studies show that 60% of those with bipolar disorder inherited Women have a higher incidence of cyclothymia and rapid cycling. Symptoms are noticed as early as childhood, 59% from a survey (University of Maryland Medical Center, 2007).

Bipolar disorder often can be debilitating and even deadly. One out of five individuals diagnosed with bipolar disorder will commit suicide (Increases in Manic Symptoms, 2000). The suicide rate for individuals suffering from bipolar disorder is similar to that of major depression. The annual suicide rate for those with bipolar disorder is roughly 400 out of 100,000 or .4%. Furthermore, approximately 15% of premature deaths are directly linked suicide. As compared to the general population, those who suffer from bipolar disorder are 20 times more likely to commit suicide. Individuals with bipolar disorder have a 5 to 1 rate of success than 18 to 1 in the general population when it comes to completing suicide (Citizen’s Petition, 2005).

Treatment

Successful treatment for bipolar disorder came in the 1960’s with the introduction of lithium. Studies demonstrate that suicide attempts have dropped 80% with the use of lithium. Lithium is the only known treatment for any disorder to have such an effect on suicide. The FDA concedes that the long-term use of lithium reduces the number of recurrences of the illness and the number of days hospitalized (Citizen’s Petition, 2005).Moreover, 60% of those suffering from bipolar disorder respond well to the use of lithium (Family-Focused Treatment, 2003).

Further treatment for the individual lies with the treatment of the family – family-focused treatment. Studies show that family-focused therapy lead to fewer relapses and re-hospitalizations. Individuals have a 60% propensity to relapse compared to 28% who had family participation. Concerning re-hospitalizations, family therapy made a significant difference in that 12% were re-hospitalization in contrast to 60% for individual-based therapy (Family-Focused Treatment, 2003). One study ascertained that on medication alone one would tend to relapse 37% more often in a year and 73% would relapse within 5 years (Family-Focused Treatment, 2003). Moreover, it is also documented that after one has been treated and returns to an ill-prepared family one is more likely to relapse within 9-12 months.