Bipolar Disorder and Bipolar Depression - Coursework Example

Bipolar Disorder and Bipolar Depression Introduction The difference between bipolar disorder and bipolar depression is a common confusion that existsamong people. It is more easy to understand the difference between the two in terms of their symptoms and how they relate to each other. Depression can either exist stand-alone or it may be part of an ongoing disorder, such as bipolar. As such, depression involves the examination of a patient to find out symptoms that either relate the condition with a particular disorder or its conclude its existence as depression itself (Grohol, 2013). Bipolar disorder, in particular, is characterized by excessive mood changes, which is why doctors identify the disease as a mood disorder (Peacock, 2000). As a result, individuals that have bipolar disorder experience extreme changes in their mood, energy, and behavior, constantly switching between two polar emotions. This includes feelings that are paired; high-low, happy-sad, good days-bad days. Individuals may experience period of calmness in between but the larger portion of their mood is taken over by extreme opposites thereby giving the disorder the name bipolar disorder. Thus, bipolar disorder is followed by an uncontrollable change in the mood and behavior, which is most often unavoidable. Bipolar spectrum disorders involve three types of bipolar disorders including type I, type II, and cyclothymic (Thakkar and Collins, 2006). Type I bipolar disorder has often been referred to as manic depression, although this term is not found in DSM-IV. Type I is also the most severe form of bipolar disorders involving manic episodes of mood shifts. These manic moods cause an elevation of the mood, talkativeness, escalated self-esteem, and wakefulness. Rapid thoughts are another attribute of such an elevated state where one may think that they can solve one of the world’s greatest problems. Depression is a prominent presentation in disorders such as bipolar. However, in order to diagnose the condition, the bipolar disorder should have a history of mania or hypomania (Mallakh and Ghaemi, 2006). Often bipolar disorder is marked by an elevation of the mood with frequent episodes of mania or hypomania. Clinicians often find it hard to identify and diagnose whether depression a particular patient has particularly rooted from bipolar disorder or not. The determination of an individual’s depression is quite straightforward during the diagnosis although its connection with unipolar or bipolar disorder, as shown by the patient’s history, is hard. This is why probably the first steps in the diagnosis involves a careful study of the symptoms, causes, and consequences of the bipolar disorder and depression (Evans and Andrews, 2005). Depression today, has been identified as an illness which needs treatment just as any other disease in the world. It is more than blue moods and may be caused by various factors such as academic performance, family life, relationship with friends, drug use, and so on. Bipolar depression, on the other hand, has only little known causes. According to Bressart (2007), several factors including genetic, neurochemical, and environmental factors come into play. A malfunctioning neurotransmitter that interrupts the transference of message thereby causing a biological disorder. Since bipolar disorder and bipolar depression both have different causes, characteristics, and risks, therefore, doctors employ a different methodology of diagnosis and treatment for both the diseases. Bipolar depression, in particular, is considered to be a representation of depression under the bipolar disorder however, bipolar disorder can also exists independently. Diagnosis The diagnostic criteria set by the Diagnostic and Statistical Manual for Mental Disorders are used in the identification of bipolar disorder (Martin, 2006). This procedure involves several criteria pertaining to symptoms, time range for which the symptoms are experienced, extent of symptom implications on life, and family history among many others. Since bipolar disorder is a mental illness, its diagnosis does not involve brain scans or other blood tests but the whole procedure relies on the family history, symptomatic expressions, and the course of the condition. However, the diagnostic procedure for bipolar disorder may involve its own issues and may not be well identified by a family doctor or a general practitioner but the case must be handled by a professional health expert who may have more knowledge about mental disorders. The initial assessment involves a study of the symptoms through a series of questions asking about the initiation, term, severity, history, and previous treatment of the symptoms. In many cases, the doctors even ask for possible family history of the disorder due to bipolar disorder’s possible genetic links. A research by Moreno, Laje, Blanco, Jiang, Schmidt, and Olson (2007) has shown an increase in the diagnosis of bipolar disorder among the youths. Seeing this trend, the health professionals may ask teens and children about their family members and/or friends who are close to them. After a thorough interview to the mental health professional, a psychological evaluation takes place in which the doctor evaluates the symptoms for possible steps to be taken. Usually, the evaluation phase is followed by routine visits to the healthcare provider. Hence, the overall diagnostic process of bipolar disorder is based on the existence of the symptoms over time, absence of medication and any other mental illness that may hint towards bipolar disorder, and most importantly, the family history. While there are generally accepted diagnostic criteria for the identification of bipolar disorder, there is no accepted criteria for diagnosing bipolar depression. Bipolar I disorder is characterized by episodes of mania or hypomania. Mitchell, Goodwin, Johnson, and Hirschfeld (2006) have found that there are no distinct pathognomonic characteristics of bipolar depression as opposed to unipolar depressive disorder, although there are some characteristics that are common to both. Some of the characteristic features of bipolar depression include certain ‘atypical’ attributes such as “hypersomnia, hyperphagia, leaden paralysis; psychomotor retardation; psychotic features, and/or pathological guilt; and lability of mood” (Mitchell, Goodwin, Johnson, and Hirschfeld, 2006). Since the symptomatic representation for bipolar depression and disorder pose a problem for the doctors, Mitchell, Goodwin, Johnson, and Hirschfeld (2006) have proposed a likelihood framework in order identify and distinguish between the two illnesses. Treatment Now that both bipolar disorder and bipolar depression have been well established as illness, they are regarded just as any other disease or illness. Hence, both the disorders also have their own treatment methods and techniques, many of which may involve medication as well. Bipolar disorder, if not treated can also lead to death (Keck and McElroy, 2009) which is why treatment of such a disorder is essential at the right time. Treatment for bipolar disorder involves long-term medication of complex nature which primarily makes use of mood stabilizers, antipsychotic agents, antidepressants, and so on. Treatment for bipolar depression also involve the use of mood stabilizers and Lithium and the anticonvulsants lamotrigine (“Treating Bipolar Depression”, 2014). The treatment for bipolar disorders are complex and long lasting. A combination of medication are administered to the patient that combine mood stabilizers, antidepressants, and other drugs such as benzodiazepines (Moller and Nasrallah, 2003). Although the use of antipsychotic drugs have been a common strategy for the management of bipolar disorder, the study conducted by Moller and Nasrallah (2003) considered the use of “atypical” antipsychotics in order to devise a different approach to treating individuals with bipolar disorders. Treatment of the disorder is generally recommended during the early stages as the full recovery of patient may take quite a while beyond improvements in the symptomatic representations (Keck and McElroy, 2009). Recent studies have suggested that a great fraction of individuals suffering from bipolar disorder spend their times neither in wellness nor in syndromal illness but rather in a depressive state chronic subsyndromal symptoms (Keck and McElroy, 2009). PAtients suffering from bipolar depression have, since many years, been given excessive medication and sedatives that came with plenty of side effects. Fortunately, developments in medical science and psychiatry has allowed the administration of medication and drugs that are relatively less repulsive in nature. Mood stabilizers are among the most common medications given to patients of bipolar depression. Today, symptoms of depression can be relieved by the use of lithium or antipsychotic drugs or a combination of both that work within the body of the patients without stimulating any episodes of mania (“Treating Bipolar Depression”, 2014). The impact of a mood stabilizing drug is that the patient’s interaction and relationship with their peers is stabilized, along with their mood and behavior. The patient feels more calm and the frequent shifts in the mood is mitigated, as a result, leading a reduction in depressive symptoms. Mood stabilization technique is, therefore, known to be an effective treatment and prevention of bipolar depression as it helps the patient to gradually reduce manic episodes and mood swings, gradually returning to normalcy, although this may take a prolonged course. As a result, the change between high and low is stabilized and the frequency of switching between lows of depression and the highs of mania or hypomania. A few studies have shown that using anti-depressants along with mood stabilizers are only as effective as using mood stabilizers alone, pointing towards the use of mood stabilizer as a more effective medication for treating bipolar depression. References Bressert, S. (2007). The Causes of Bipolar Disorder (Manic Depression). [online] Retrieved from: http://psychcentral.com/lib/the-causes-of-bipolar-disorder-manic-depression/000912 [Accessed: 14 Apr 2014]. El-Mallakh, R. S. & Ghaemi, S. N. (2006). Bipolar depression. Washington, DC: American Psychiatric Pub. Evans, D. L. & Andrews, L. W. (2005). If your adolescent has depression or bipolar disorder. New York, N.Y.: Oxford University Press. Grohol, J. M. (2007). What’s the Difference Between Bipolar Disorder and Depression?. [online] Retrieved from: http://psychcentral.com/lib/whats-the-difference-between-bipolar-disorder-and-depression/000906 [Accessed: 14 Apr 2014]. Keck, P. E. & Mcelroy, S. L. (2009). Chapter 54: Treatment of Bipolar Disorder. The American Psychiatric Publishing Textbook Of Psychopharmacology, 4 doi:10.1176/appi.books.9781585623860.443573 [Accessed: 14 Apr 2014]. Martin, B. (2006). How is Bipolar Disorder Diagnosed?. [online] Retrieved from: http://psychcentral.com/lib/how-is-bipolar-disorder-diagnosed/000512 [Accessed: 14 Apr 2014]. Mitchell, P. B., Goodwin, G. M., Johnson, G. F. & Hirschfeld, R. (2008). Diagnostic guidelines for bipolar depression: a probabilistic approach. Bipolar Disorders, 10 (1p2), pp. 144--152. Moller, H. & Nasrallah, H. A. (2003). Treatment of bipolar disorder. The Journal Of Clinical Psychiatry, 64 pp. 9--17. Moreno, C., Laje, G., Blanco, C., Jiang, H., Schmidt, A. B. & Olfson, M. (2007). National trends in the outpatient diagnosis and treatment of bipolar disorder in youth. Archives Of General Psychiatry, 64 (9), pp. 1032--1039. Peacock, J. (2000). Bipolar disorder. Minnetonka, MN: Life Matters. Thakkar, V. and Collins, C. E. (2006). Depression and bipolar disorder. New York: Chelsea House Publishers. Web MD. (2014). Treating Bipolar Depression. [online] Retrieved from: web.archive.org/web/*/http://www.webmd.com/bipolar-disorder/guide/treating-bipolar-medications, an [Accessed: 14 Apr 2014]. Read More