Causes

     Bipolar is mostly caused by genetic factors. If a person has a parent with Bipolar they have a 10% chance of being Bipolar themselves. It affects children, adolescents and adults. However stresses such as family or relationship problems, changing jobs, or changing place of residence, having a baby or the death of a close friend or family member could trigger the onset of Bipolar Disorder. Bipolar Disorder can also be triggered by physical health issues, such as childbirth, hormonal problems or cancer.

                    

Reasons

                            Bipolar Disorder is a biological brain disorder and is classified according to the severity of the symptoms of the disorder:

Bipolar I is characterized by a least one manic episode, with or without major depression. Untreated mania lasts a least a week and can end in hospitalization. Depressive episodes tend to last six to twelve months if untreated. However, untreated manic episodes last three to six months.

Bipolar II is characterized by at least one episode of hypomania and at least one episode of major depression. With hypomania the symptoms of mania are milder and last a shorter time than those of mania. Hypomania does not usually require hospitalization.

Cyclothymic Disorder is not as severe as either Bipolar Disorders I and II. However the condition is more chronic. The disorder can last for two years, with single episodes persisting for more than two months. It could possibly lead onto either Bipolar I or Bipolar II.

In pure mania either euphoria or irritability are present along with other symptoms of mania and there are no indications of depression at the same time. However, with mixed mania depressed mood and manic symptoms occur for a least a week. Depression is present most of the day and nearly every day. Symptoms of mania are also present to a significant degree.

Bipolar disorder can be mild with infrequent episodes or it can be severe and long-term. The usual pattern of bipolar is one of increasing intensity and duration of symptoms that progress slowly over many years. However, patients can experience symptoms in very different ways.

Some suffers of Bipolar Disorder, about 15% can have a phase of rapid cycling in which the manic and depressive episodes alternate at least four times a year and in severe cases can progress to several cycles a day.

In the context of mental illness, a Mixed State (also known as dysphoric mania or agitated depression) is a condition during which symptoms of mania and depression occur simultaneously (e.g.)agitation anxiety fatigue, guilt, impulsiveness, insomnia, irritability, morbid and/or suicidal ideation, panic, paranoia, pressured speech and rage). Typical examples include tearfulness during a manic episode or racing thoughts during a depressive episode. Mixed States can be the most dangerous period of mood disorders, during which substance abuse, panic disorder suicide attempts, and other complications increase greatly.

 

The Effects

                                                   Bipolar causes unusual and dramatic shifts in a person’s mood, their energy level and their ability to function. They can go from an overly high (mania) or irritable state to one of being sad and hopeless (depressed) and back again. Often there are periods of normal mood in between the highs and lows.

It can cause problems in relationships, at school or at work. Unfortunately suicide can sometimes come as a result of the disorder, this includes adults as well as children. Bipolar Disorder is a long-term illness and one, which needs to be managed throughout the person’s life.

In a manic phase the person has insomnia as a result of their high energy levels and therefore they require less sleep. They will have an increased intensity in their goals, which interferes with their social behavior, sexual activity, their school and their work. They are not able to pay attention to any activity for very long. They will talk excessively, have flights of ideas, their thoughts will literally race. They would be thoughtless of others, such that they can damage their job, or impair their relationships with others. They may require hospitalization to avoid them harming themselves as a result of their risk taking activities. Or they may harm others.

In the depressive phase the person is in a sad mood, has sleep problems, is fatigued or lacks energy, their weight can change, they are not able to concentrate well or make decisions, and they maybe agitated or behave sedentarily, or feel guilty, worthless. They will also lose interest or pleasure in life. They may have thoughts of suicide or attempt suicide.

 

Treatment

                          While there is no currently known cure for Bipolar Disorder, medications offer the best assistance. While therapy may not be the usual treatment, it can help to person to recognize their mood changes and is helpful in providing support, education and guidance to the person with Bipolar Disorder and their families. This can lead to increased mood stability, less hospitalization and improved functioning.

While medications can be prescribed by local General Practioners, it is better for a person with Bipolar Disorder to see a psychiatrist for treatment.

In most cases bipolar disorder is much better controlled if treatment is continuous rather than on and off. Unfortunately those who suffer from Bipolar Disorder are inclined to put themselves on medication and take themselves of it at a whim. Staying on their treatment plan even when they are well can keep the disorder under control and result in less episodes.

Even so, if there are no breaks in treatment, mood changes can occur, and should be reported to the doctor. The doctor may be able to prevent a full-blown episode by making adjustments to the person’s treatment. The doctor may require the patient to keep a daily mood chart, on which the patient records their mood and their sleep patterns. As people with bipolar disorder can often have abnormal thyroid gland function, which can lead to mood and energy changes, their thyroid levels should be monitored by a physician.

There are two basic types of medications. They are mood stabilizers and anti psychotic medications.

Mostly people with Bipolar Disorder will remain on a mood stabilizer for long periods of time; this could be years. They may have other medications to treat mania or depression, which can occur in spite of the mood stabilizer. Lithium and valproate are the most commonly used mood-stabilizing drugs today.

Antipsychotics were introduced in the 1950’s such as Chlorpromazine, fluphenazine perhenazine and haloperidol. Due to the hasher side effects of these older type antipsychotics, doctors are more inclined to prescribe the newer atypical antipsychotic medications such as clozapine, olanzapine, risperidone and quetiapine.

Should medication or psychosocial treatment prove ineffective or are too slow then electroconvulsive therapy (ECT) may be considered. It may also be considered if the person is pregnant as medication maybe considered too risky. ECT is an effective treatment for severe depressive, manic or mixed episodes. The possibility of long lasting memory problems, which were a concern in the past have been significantly reduced with modern ECT techniques.

The person with Bipolar may have comorbid disorders. Such as Anxiety Disorder, Post-traumatic Stress Disorder or Obsessive-compulsive Disorder. And it can be comorbid with ADHD- C. If this is the case: it is difficult to diagnose, as to whether the person has both of these disorders. This is due to the similarities of the two disorders. However it is possible to differentiate between the two. Some researchers have put forward the theory that ADHD with comorbid Bipolar may be another subtype of ADHD. Usually the Bipolar symptoms are treated first and then any residual disorders or symptoms are treated. Due to the symptoms of ADHD-I being close to the opposite of Bipolar Disorder it is highly unlikey that a person with ADHD-I could have comorbid Bipolar Disorder.