Manic–Depressive Illness: Bipolar Disorders
Bipolar Disorder Research
Bipolar disorder was previously called manic depression, currently it is used to identify a mental disorder, which leads to the periods of depression, followed by the periods of abnormally elevated state of mood. The state of elevated mood also received the names of mania or hypermania, depending upon the fact of presence of psychosis symptoms. In the state of mania a person tends to feel energetic, irritable and even abnormally happy, he is inclined towards committed actions without proper consideration of the consequences. The manic phases are also characterized by lack of sleep. Depression periods are characterized by negative perception of life, by poor establishment of eye contact with other individuals and in some cases by crying. People, suffering from bipolar disorder might commit suicide or do self-harm. There are also other mental health problems, including substance use disorder or anxiety disorder, which are associated with bipolar disorder by some patients. Bipolar disorder is a serious mental health problem, experienced by individuals in various countries of the world and characterized by mood swings between depression and mania.Manic–Depressive Illness: Bipolar Disorders
Historically the cases of mood swings and variations of energy states were met quite often. Such concepts as mania or melancholia date back to the times of Ancient Greece. “The word melancholia is derived from melas (μέλας), meaning “black”, and chole (χολή), meaning “bile” or “gall”, indicative of the term’s origins in pre-Hippocratic humoral theory” (Liddell & Scott, 1980, p. 158). Mania was considered to result from the excess of yellow bile or the combination of black and yellow bile. There is no concrete data about the source of the concept of mania, but most probably it came from the term “manos”, used by Roman physician, when he described the state of excessive relaxing of human mind. The term “manic-depressive reaction” was for the first time mentioned in 1952. (Goodwin & Jamison, 2007, p. 8). Later, German psychiatrists Karl Leonhard and Karl Kleist worked out the concepts of unipolar and bipolar disorders, suggesting that these are two separate conditions.Manic–Depressive Illness: Bipolar Disorders
The major signs and symptoms of bipolar disorder include disruptions of normal functioning and mood of an individual, problems with his cognitive functions, circadian rhythm, and psychomotor activity. “Mania can present with varying levels of mood disturbance, ranging from euphoria that is associated with “classic mania” to dysphoria and irritability. The core symptom of mania involves an increase in energy of psychomotor activity. Mania can also present with increased self-esteem or grandiosity, rapid speech, the subjective feeling of rapid thoughts, disinhibited social behavior, or impulsivity.” (Akiskal, 2017, p. 182).
The causes of bipolar disorder could vary by different patients, and till the moment there is no universally accepted research results regarding the exact mechanism of development of bipolar disorder. Most of the researchers are convinced that genetic influences play important role for development of bipolar disorder. Statistically the heritability of the bipolar spectrum is estimated as 0.71. (Edvardsen, et. al., 2008, p. 230). Thus the family members of an individual with bipolar disorder have an increased risk of development of it as well. At the same time at the moment there is no information about any gene, which could be considered responsible for bipolar disorder. One more cause of bipolar disorder is considered to be chemical imbalance in the brain. Noradrenaline, dopamine and serotonine are the neurotransmitters, which bear the responsibility for managing and control of functions of human brains. The lack of balance by one or several of them leads to development of bipolar disorder. In some cases stressful life situations and circumstances could also become triggers for the symptoms of bipolar disorder. The basic prevention strategies for bipolar disorder include focusing upon stress, which forces those individuals, who are biologically and genetically vulnerable towards bipolar disorder, be at risk.Manic–Depressive Illness: Bipolar Disorders
Treatment of bipolar disorder could be performed with pharmacological and psycho therapeutic techniques. Sometimes patients are motivated to use self-help approach. Hospitalization is applied in cases of manic episodes in bipolar I, it could be either voluntary or involuntary. “Following (or in lieu of) a hospital admission, support services available can include drop-in centers, visits from members of a community mental health team or an Assertive Community Treatment team, supported employment and patient-led support groups, intensive outpatient programs. These are sometimes referred to as partial-inpatient programs.” (McGurk, et. al., 2007, p. 440). Psychotherapy is applied for treatment of bipolar disorder in order to alleviate the symptoms, help to manage negative emotional expressions and episode triggers. Interpersonal and cognitive-behavioral therapies proved to be the most effective in treating depressive symptoms. Medications are also used for treatment of bipolar disorder. The best one at the moment is considered to be lithium, which is effective in treatment of acute manic episodes and bipolar depression. It is also known for its ability to prevent relapses and reduction of suicide risks or self –harm intentions. “Lithium and the anticonvulsants carbamazepine, lamotrigine, and valproic acid are used as mood stabilizers to treat bipolar disorder. These mood stabilizers are used for long-term mood stabilization but have not demonstrated the ability to quickly treat acute bipolar depression. Lithium is preferred for long-term mood stabilization” (Post, 2016, p. 22). Manic–Depressive Illness: Bipolar Disorders Antidepressants are not used alone for treatment of bipolar disorder and are said to bring less benefits in comparison to mood stabilizers. Only few studies accept alternative medicine methods for treatment of this kind of mental health disorder on the basis of the suggestions that omega 3 fatty acids have the potential of reducing of depressive syndromes. Important is to note that they are useless for manic symptoms.Bipolar disorder is considered to be one of the severe health problems in the whole world due to the increased rates of disability and mortality cases. The situation is worsened by under diagnosis, leading to delays in adequate treatment interventions. The health care specialists are challenged first by correct and timely diagnostics of this disorder and then by complete remission of all symptoms of it, as they tend to become stronger and more severe with time. Early diagnosis and treatment interventions allow making better prognosis for the patients with bipolar disorder.
Overall, bipolar disorder is one of the serious mental health problems worldwide, it is characterized by significant mood swings, the states of depression and mania, leading such risky behaviors as self-harm or even suicide.Manic–Depressive Illness: Bipolar Disorders