Etiology of Bipolar Disorder - Essay Example

? Bipolar Disorders: Etiology, Facts, Symptoms, Diagnosis, and Treatment 15 November Bipolar Disorders: Etiology, Facts, Symptoms, Diagnosis, and Treatment One of the recent films about bipolar disorder is Silver Linings Playbook, directed by David O. Russell and produced by Bruce Cohen in 2012, a film where two people with different degrees of symptoms of bipolar disorder fall in love with each other. Both Pat (Bradley Cooper) and Tiffany (Jennifer Lawrence) demonstrate dramatic shifts in moods and behaviors throughout the day and night, which are some of the symptoms of bipolar disorder. They have some differences, where Tiffany, despite being cynical, is more accepting of her disorder, while Pat lives in a delusional optimist state. These different symptoms accurately show that bipolar disorders are complex and even have several kinds. The American Psychiatric Association (2013) determined that bipolar disorders include “Bipolar I Disorder (BD I), Bipolar II Disorder (BD II), Cyclothymia, and Bipolar Disorder Not Otherwise Specified” (p.350).This paper describes the etiology, facts, symptoms, diagnosis, and treatment of these bipolar disorders. Etiology of Bipolar Disorder Bipolar disorder (BD) is a chronic mental disorder that has general characteristics of alternating periods of depression, euthymia, (hypo)mania, and mixed emotional and cognitive states (Oostervink et al., 2009, p.176). BD may be an outcome of severe functional impairment that disrupts relationships and behaviors at work, school, and home, and is also correlated with a high risk for suicide (Pinto, Schub, & Pravikoff, 2013, p.1). BD is considered treatable, but some patients relapse, which lead to poor quality of life (QOL) (Pinto et al., 2013, p.1). The causes of BD are not yet determined by the medical community, although different factors are believed to lead to it, including genetic, bio-chemical (e.g., neurotransmitter levels), neurophysiological (e.g., alterations in regions of the brain that control emotional responses), and environmental factors (e.g., external stressors) (Palsson et al., 2013; Pinto et al., 2013, p.1; Price & Marzani-Nissen, 2012, p.485). Children of parents with bipolar disorders have a 4 to15 percent risk of developing the same illness compared to 0 to 2 percent risk for children who do not have bipolar parents (Oostervink et al., 2009, p.176). Environmental conditions have been strongly related with inheritance patterns, as well as stressful life happenings, such as suicide of family member, problems in sleeping, and family members with high expressed emotion that can be described as over-involved, hyper critical or violent (Oostervink et al., 2009, p.176). Several studies pointed out that some genes and loci may be related with bipolar disorders, such as glycogen synthase kinase-3 (Oostervink et al., 2009, p.176). Facts on Bipolar Disorders BD frequently begins at the age of 30 years old, but the mean age is 21, and it is approximated that around 90% of bipolar patients become severely ill by the time they reach 50 years old (Oostervink et al., 2009, p.176; Pinto et al., 2013, p.1). This means that around 10% of the population may have bipolar disorder for the first time in their fifty years of life (Oostervink et al., 2009, p.176). In the United States, the approximation of lifetime prevalence of BD is 1 to 1.6%, and BD 1 affects women and men in equal numbers (Pinto et al., 2013, p.1). BD II, however, is more prevalent among women than men, and women tend to experience rapid cycling of emotions more rapidly than men too (Pinto et al., 2013, p.1). In addition, women are more likely to ask for treatment than men (Pinto et al., 2013, p.1). For patients with BD I who take in lithium, 50–60% were able to control their symptoms, while for 7% of these patients, symptoms do not reappear (Pinto et al., 2013, p.1). Symptoms of Bipolar Disorders Depending on the kind of BD, the number and degree of BD symptoms can be different (Galione & Zimmerman, 2010, p.764), although Palsson et al. (2013) noted from their cross-sectional study that they found no strong neurocognitive differences between BD I and BD II. The main symptoms of people with BD are mania, hypomania, and major depression, even for children with BD (Birmaher, 2013, pp.141-142). The criteria used for diagnosing mania are the following: 1) must exceed expectations of normal development for children and adults, especially when observing the symptoms of elation and grandiosity; 2) must occur during episodes, though some scholars question the need for episodes for mania to be diagnosed; 3) must not be accounted for other kinds of disorders, such as ADHD, although when other illnesses are present, mood symptoms are clearly worse off during manic episodes; 4) cannot be explained by cultural or environmental or medicinal factors; and 5) must affect performance in school, home, and/or work (Birmaher, 2013, p.141). The symptoms of hypomania are not as long or intense as those for mania, but it can range until four days according to DSM-IV (Birmaher, 2013, p.142). Major depression is another symptom of BD, but such a symptom may be difficult to diagnose among children who tend to have less vegetative or melancholic behaviors when depressed (Birmaher, 2013, p.142). Other symptoms of BD are dramatic influx and movement of thoughts, poor judgment, risk-taking behavior (such as substance abuse, reckless driving, and promiscuity), distractibility, less need for sleep, psychomotor anxiety, and pressured speech (i.e. use of fast and/or incoherent speech) (Pinto et al., 2013, p.1). Diagnosis of Bipolar Disorders There are several ways to diagnose bipolar disorders. Taking patient history and conducting physical examination can help diagnose BD (Pinto et al., 2013, p.2). When taking patient history, it should also have “medical and mental health conditions, substance abuse, current medications, sleep patterns, and past/current reckless behaviors” (Pinto et al., 2013, p.2). Clinicians must also observe client for abnormalities in mood, physical appearance, physical status, emotions, speech, thought processes, judgment methods, and assess patients for impulsive, irritable, and agitated conditions (Pinto et al., 2013, p.2). Clinicians must also assess patients for risks of suicide and violence, and if such levels are high, they should mandate inpatient management (Pinto et al., 2013, p.2). Some laboratory tests may also be done, such as thyroid function tests to test if hypothyroidism causes depression and if hyperthyroidism causes mania, studying CBC for abnormalities, such as high dosage of lithium and other depressants, urinalysis for detecting substance abuse, pregnancy test to know if pregnancy may trigger BD, and other diagnostic tests such as electrocardiograhy and blood glucose (Pinto et al., 2013, p.2; Price & Marzani-Nissen, 2012, p.486). EEG and EKG may also be done to assess neurologic and cardiac dysfunction (Pinto et al., 2013, p.2). Treatment of Bipolar Disorders Treatment of BD can be more effective through early diagnosis and treatment of acute mood episodes, because they will lessen the risk of relapse and increase the chances of responding to medications (Price & Marzani-Nissen, 2012, p.487). Medicine depends on the phase and severity of illness (Price & Marzani-Nissen, 2012, p.487). Treatment should continue also despite showing signs of improvement because a third of patients and more than 40% of patients relapse in five years (Price & Marzani-Nissen, 2012, p.487). Comanaging the illness with a psychiatrist is important because the latter can help in avoiding relapse, decreasing treatment resistance, managing comorbid psychiatric conditions, and lessening the risk of patients harming themselves or others (Price & Marzani-Nissen, 2012, p.487). They can also help educate family members about emotional and social support that can help BD manage their symptoms (Pinto et al., 2013, p.2). Conclusion BD is a life-debilitating illness, but it is not something that cannot be controlled. With the right treatment, it can help people with BD to have better quality of living conditions, where they can manage symptoms and live like others without their disorders. BD patients need social, emotional, and psychological support, apart from medicinal treatment too. With these factors, BD can reduce its negative effects on human functioning and quality of life. References American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5) (5th ed.). Retrieved from http://dsm.psychiatryonline.org//content.aspx?bookid=556§ionid=41101746 Birmaher, B. (2013). Bipolar disorder in children and adolescents. Child & Adolescent Mental Health, 18(3), 140-148. Retrieved from CINAHL Complete. Cohen, B. (Producer), & Russell, David O. (Director). (2012). Silver Linings Playbook [Motion Picture]. United States: Weinstein Company. Galione, J., & Zimmerman, M. (2010). A comparison of depressed patients with and without borderline personality disorder: Implications for interpreting studies of the validity of the bipolar spectrum. Journal o Personality Disorders, 24 (6), 763-772. Retrieved from Medline Complete. Oostervink, F. (2009). Bipolar disorder in the elderly; different effects of age and of age of onset. Journal of Affective Disorders, 116(3), 176-183. Retrieved from AgeLine. Palsson, E., Figueras, C., Johansson, A.G., Ekman, C.J., Hultman, B., Ostlind, J., & Landen, M. (2013). Neurocognitive function in bipolar disorder: A comparison between bipolar I and II disorder and matched controls. BMC Psychiatry, 13, 165-174. Retrieved from Medline Complete. Pinto, S., Schub, T., & Pravikoff, D. (2013). Bipolar Disorder. Cinahl Information Systems, 1-2. Retrieved from CINAHL Complete. Price, A.L., & Marzani-Nissen, G.R. (2012). Bipolar disorders: A review. American Family Physician, 85(5), 483-493. Retrieved from Medline Complete. Read More