History of the Mental Illness: Bipolar Disorder - Assignment Example

History of the mental illness: Bipolar disorder Bipolar disorder also known as manic depression is a of mood disorders in which the person experiences states or occurrence of depression or mania, hypomania, or mixed states which severely disabling psychiatric condition. The difference between bipolar disorder and unipolar disorder, also called major depression, is that bipolar disorder involves energized or activated mood states in addition to depressed mood states. Mood swings cause impairment not only in ones mood, but also in ones energy level, sleep pattern, activity level, social rhythms and thinking abilities (Wikipedia, 2006). Estimates for the lifetime risk of developing bipolar disorder range from 0.6 per cent to 1.2 per cent. Bipolar disorder is a serious mental illness distinguished by repeated episodes of despair, mania, along with mixed symptom states. These episodes cause unusual and severe shifts in mood, energy, and behavior that interfere drastically with normal, healthy functioning. Manic symptoms include: Severe changes in mood, overly-inflated self-esteem, and improved energy, able to go with very little or no sleep for days without tiring, increased talking, attention moves constantly from one thing to the next, hyper sexuality and increased goal-directed activity (National Institute of Mental Health, 2000). Bipolar disorder is rare in young children, but more common in adolescents. Detection can be problematic, particularly given that the presentation is similar to major depression. As a result, youth with bipolar disorder may not be diagnosed accurately until they reach a psychiatric inpatient unit (Burns, et al. 1999). Bipolar disorder affects more than two million Americans. Bipolar disorder can also badly affect spouses, family members, friends, and people in the workplace. It usually begins in late adolescence though it can start in early childhood. An equal number of men and women develop this illness and it is found among all races, ethnic groups and social classes (DBSA, 2006). A brief history of bipolar disease Bipolar disorder is perhaps one of the oldest known illnesses. It was first noticed as far back as the second century. Aretaeus of Cappadocia (a city in ancient Turkey) first recognized some symptoms of mania and depression, and felt they could be linked to each other. His findings went unnoticed and unsubstantiated until 1650, when a scientist named Richard Burton wrote a book, The Anatomy of Melancholia, which focused specifically on depression. His findings are still used today by many in the mental health field, and he is called the father of depression as a mental illness.  Jules Falret in 1854 coined term "folie circulaire" (circular insanity), and established a link between depression and suicide. His work led to the term bipolar disorder, as he was able to find a distinction between moments of depression and heightened moods. He recognized this to be different from simple depression, and finally in 1875 his recorded findings were termed Manic-Depressive Psychosis, a psychiatric disorder. Since Falret found the disease seemed to be found in certain families he was the first person to recognize very early that there was a genetic link (caregiver.com, 1995). The scientific revolution of the 18th century, the 19th century laid the groundwork for modern views of bipolar disorder. Falret and Baillarger suggested (independent of each other) that mania and depression were part of the same disease. Subcategories of bipolar disorder were also identified: Mendal (1881) described "hypomania" as "that form of mania that typically shows itself only in the mild stages abortively, so to speak" (quoted in Goodwin and Jamison, 1990), and a year later Kahlbaum re-described cyclothymia as episodes of both mania and depression that did not end in dementia (Holman, 2006). Francois Baillarger believed there was a major distinction between bipolar disorder and schizophrenia. He characterized the depressive phase of the disease. It was this achievement that allowed bipolar disorder to receive its own classification from other mental disorders of the time.  In 1913, Emil Krapelin established the term manic-depressive, with an exhaustive study surrounding the effects of depression and a small portion about the manic state. Within fifteen years, this approach to mental illness was fully accepted and became the prevailing theory of the early 1930’s (caregiver.com, 1995). Kraepelin was also the first to separate bipolar disorder from what he called "dementia praecox," which we now know as schizophrenia. He believed that schizophrenia had a "deteriorating course" in which mental function continuously declines, and bipolar disorder (which he termed "manic depression," which is now seen as comprising a variety of mood disorders, including bipolar disorder) patients experienced the illness in severe episodes followed by symptom-free intervals (Wikipedia, 2006). Later, in 1924, Eugen Bleuler suggested that manic depression and dementia praecox were on a continuum or spectrum, and that a person could be at different points on that spectrum at different times. He also extended Kraepelins category of manic depression into subcategories that would lead to the future classification of subtypes within bipolar disorder (Holman, 2006). Treatments for bipolar disease Mental illness was believed to be caused by loss of status or money during the early Egypt.  The recommended treatment was to "talk it out", and to turn to religion and faith.  Suicide was accepted at this time. In the Old Testament, despair and cognition was the accepted cause of mental illness; faith the cure.  Homer believed that mental illness was caused by Gods taking a mind away.  He offered no treatment. Demon possession was the theory of Aeschylus to explain Mental illness and exorcism the cure. Socrates believed that mental illness was heaven-sent and not shameful in the least.  He believed it to be a blessing, and therefore no treatment was required. According to Aristotle, Melancholia was the cause of mental illness, and music was the cure. It was the belief of Hippocrates that both melancholia and natural medical causes contributed to mental illness.  He advised abstinence of various types, a natural vegetable diet and exercise as treatment. Celsus believed mental illness to be a form of madness to be treated with entertaining stories, diversion and persuasion therapy. Psychic functions of the brain were considered by Galen to be the foremost cause of mental illness.  Treatment consisted of confrontation, humor and exercise.  During the 18th and 19th centuries, hospitals and asylums assumed the care of the mentally ill.  The first hospital to accept and treat mentally ill patients was the Pennsylvania Hospital founded by the Quakers in 1752.  Treatment there was the same as for other patients…clean surroundings, good care and nutrition, fresh air and light…in short the mentally ill were treated as human beings. The real work on treatments started only in the 1940s and 50s. During this time medication was discovered that helped the severely mentally ill.  Great hope was placed in these drugs, though they did not offer a complete cure for the disorder, they were quite successful at ameliorating some of the symptoms.  These medicines, the anti psychotics, are still in use today.    ECT and insulin therapy was also discovered, and went a long way to helping especially those in depression.  ECT, in a refined and safer mode is also practiced today. The stigma of mental illness has not been eradicated, though the move to equate mental illness with physical illness has resulted in greater understanding on some fronts.  We still have a long way to go in this area (Bloom and Schafer, 1998). The modern day treatment s include mood stabilizer treatment that can dramatically halt the turbulent course of bipolar disorder, reduce the risk of suicide, increase life expectancy, increase productivity and functioning and 40-75% of patients who respond to mood stabilizers achieve a reasonable occupational status and ability to live independently (Goldberg et al, 1995; Tsuang et al, 1979). Lithium is a tried and tested medication, efficacious in acute mania, prophylaxis of classical bipolar disorder (Groff et al, 1993) and when the disorder has a mania/hypomania-depression euthymia course (Faedda et al, 1991). It has proven, significant antidepressant properties when compared with Divalproex and Carbamazepine. However the high frequency of non-adherence to lithium treatment (30-50%) is often associated with adverse effects, particularly in the early stages of treatment. Cognitive impairment, tremor, acne, polyuria and polydipsia, muscle weakness and weight gain can be associated with noncompliance, particularly in adolescents, young adults and the elderly. (Gitlin et al, 1984). Divalproex Sodium (DVPX) has emerged as an effective broad-spectrum alternative to Lithium. It is effective in acute mania (Bowden et al, 1994), rapid cycling and mixed states, with comorbid substance abuse and in secondary bipolar disorder (Calabrese et al, 1996). Gastrointestinal, sedative and hematological (thromobocytopenia and leucopenia) side-effects with Divalproex (DVPX) appear to be associated with serum levels above 700 mmols/l (Bowden et al, 1993). There are several other treatments present today such as Carbamazepine (CBZ), ECT, Typical neuroleptics, Benzodiazepines, Antidepressants etc. and it has definitely advances from the earlier treatments. These treatments have definitely made their impression in medical science today and have helped many who suffer from it. When compared to the earlier days when these diseases were left to the action of God, treatments today has advanced a lot. Still there is a long way to go in case of treatments for bipolar disorder. With the present day advancement in medical sciences and genetics, in future it would be possible that such disorders are diagnosed and treated at a very early stage even before the symptoms are shown. Medical science and its advancement has helped many of the dreaded diseases under control, it is proposed that the future research in the field of mental health will also be helpful for patients to diagnose and treat the disease and also find a complete cure for the disease. References Bloom, A. and Schafer, D. (1998) History of Mental Illness and Early Treatment in a Nutshell. Retrieved on 4 October 2006 from http://www.bipolarworld.net/Bipolar%20Disorder/History/history.html Bowden, C.L., May, R.B., Sunder, T.R. (1993) Hematological Manifestations of Long-Term Valproate Therapy. Epilepsia. 34. 1098-1101. Bowden, C.L., Brugger, A.M., Swann, A.C., Calabrese, J.R. et al. (1994). Efficacy of Divalproex vs Lithium and Placebo in the Treatment of Mania. JAMA. 271:12. 918-924. Burns, B.J., Hoagwood, K., and Mrazek, P.J. (1999) Effective Treatment for Mental Disorders in Children and Adolescents, Clinical Child and Family Psychology Review, Vol. 2, No. 4,:199-254. Calabrese, J.R., Fatemi, S.H., Kujawa, M., Woyshville, M.J. (1996). Predictors of Response to Mood Stabilizers. J Clin Psychopharmacology. 16. 2. Suppl 1. 245-305. caregiver.com, (1995). Brief History of Bipolar Disorder. Retrieved on 4 October 2006 from http://www.caregiver.com/channels/bipolar/articles/brief_history.htm. DBSA, Frequently Asked Questions February 07, 2006, Depression and Bipolar Support Alliance. Retrieved on 4 October 2006 from http://www.dbsalliance.org/FAQs.html Faedda, G.L., Baldessarini, R.J., Tohe, M., Strakowski, S.M., Waternaux, C. (1991) Episode Sequence In Bipolar Disorder and Response to Lithium Treatment.. Am J Psychiatry. 148. 1237-1239. Gitlin, M.J, Jamison, K.R. (1984). Lithium Clinics: Theory and Practice. Hosp Comm Psychiatry. 35:363-368. Goldberg, J.F., Harrow, M., Grossman, L.S. (1995) Course and Outcome in Bipolar Affective Disorder: A Longitudinal Follow-Up Study. Am J Psychiatry. 152: 379-384. Grof, P., Alda, M., Grof, E., Fox, D., Cameron, P. (1993). The Challenge of Predicting Response to Stabilizing Lithium Treatment: the Importance of Patient Selection. Br J Psychiatry. 163:16-19. Holman, M. (2006) Bipolar Disorder/Manic Depression: History, Symptoms, Effects and Treatments. Retrieved on 4 October 2006 from http://www.associatedcontent.com/article/24666/bipolar_disordermanic_depression_history.html National Institute of Mental Health, “Child and Adolescent Bipolar Disorder: An Update from the National Institute of Mental Health”, August 2000, National Institute of Mental Health, National Institutes of Health, US Department of Health and Human Services: 1-4, Retrieved on 4 October 2006 from http://www.nimh.nih.gov/publicat/NIMHbipolarupdate.pdf Tsuang, M.T, Woolson, R.F, Fleming, M. (1979). Long-Term Outcome Of Major Psychosis - I. Schizophrenia and Affective Disorders Compared with Psychiatrically Symptom-Free Surgical Conditions. Wikipedia, Bipolar disorder, 12 July 2006, Wikimedia Foundation, Inc., Retrieved on 4 October 2006 from http://en.wikipedia.org/wiki/Bipolar_disorder Read More