Compare and Constrast Essay on Bipolar Disorder

This essay has a total of 3340 words and 16 pages.

Bipolar Disorder

Abstract
Bipolar Disorder is a mental illness in which a person's mood alternates between extreme
mania and depression. Bipolar disorder is also called manic-depressive illness. In a
related disorder called cyclothymic disorder (sometimes called Bipolar III), a person's
mood alternates between mild depression and mild mania. Some people with cyclothymic
disorder later develop full-blown bipolar disorder. Rates of bipolar disorder are similar
throughout the world. At least fifteen percent of people with bipolar disorder commit
suicide. Bipolar disorder is much less common than depression. Many people with bipolar
disorder function normally between episodes. Medications known as "mood stabilizers" are
usually prescribed by psychiatrists to help control bipolar disorder. In general, people
with bipolar disorder continue treatment with mood stabilizers for extended periods of
time. One of the most important thing family and friends can do for a person with bipolar
disorder is learn about the illness. Never ignore remarks about suicide. It is important
to note that most people with bipolar disorder—even those with the most severe forms can
achieve substantial stabilization of their mood swings and related symptoms with proper
treatment.




Bipolar Disorder is a mental illness in which a person's mood alternates between extreme
mania and depression. Bipolar disorder is also called manic-depressive illness. When
manic, individuals with bipolar disorder feel intensely elated, self-important, energetic,
and irritable. When depressed, these individuals experience painful sadness, negative
thinking, and indifference to things that used to bring them happiness


Bipolar disorder is much less common than depression. In North America and Europe, about
one percent of people experience bipolar disorder during their lives (J). Rates of bipolar
disorder are similar throughout the world. In comparison, at least eight percent of people
experience serious depression during their lives. Bipolar disorder affects men and women
about equally and is somewhat more common in higher socioeconomic classes. At least
fifteen percent of people with bipolar disorder commit suicide. This rate roughly equals
the rate for people with major depression, the most severe form of depression (E).


Some research suggests that highly creative people—such as artists, composers, writers,
and poets—show unusually high rates of bipolar disorder, and that periods of mania fuel
their creativity. Famous artists and writers who probably suffered from bipolar disorder
include poets Lord Byron and Anne Sexton, novelists Virginia Woolf and Ernest Hemingway,
composers Peter Ilyich Tchaikovsky and Sergey Rachmaninoff, and painters Amedeo Modigliani
and Jackson Pollock. Critics of this research note that many creative people do not suffer
from bipolar disorder, and that most people with bipolar disorder are not especially
creative (E).


SYMPTOMS
Bipolar disorder usually begins in a person's late teens or twenties. Men usually
experience mania as the first mood episode, whereas women typically experience depression
first (E). Episodes of mania and depression usually last from several weeks to several
months. On average, people with untreated bipolar disorder experience four episodes of
mania or depression over any ten-year period. Many people with bipolar disorder function
normally between episodes. In rapid-cycling bipolar disorder, however, which represents
five to fifteen percent of all cases, a person experiences four or more mood episodes
within a year and may have little or no normal functioning in between episodes (H). In
rare cases, swings between mania and depression can occur over a period of days or hours.
The term ultra-rapid cycling may be applied to those who cycle through episodes within a
month or less. If this pattern is demonstrated within a twenty-four hour period, the
person's diagnosis could possibly be phrased ultra-ultra-rapid cycling or ultradian.
Ultradian cycling is often difficult to differentiate from a mixed state, when a person
experiences aspects of both depression and mania or hypomania at the same time. Sometimes
mania is prominent, sometimes depression (A).


Bipolar I can have some very frightening characteristics of psychosis (loss of contact
with reality). These may include: hallucinations (hearing or seeing things that are not
there), delusions (persistent beliefs in things that are not true), and paranoia
(believing that a person or group is actively working to harm you, without any basis in
fact). These psychotic features are also characteristic of schizophrenia, a mental illness
where the patient is out of touch with reality, but without mood swings. Bridging the
space between bipolar disorder and schizophrenia is schizoaffective disorder. What
distinguishes schizoaffective disorder from Bipolar I with psychotic features is that
sometimes (for at least two weeks) the patient has only psychotic symptoms, without mania
or depression (A).


In another type of bipolar disorder (Bipolar II), a person experiences major depression
and hypomanic episodes, or episodes of milder mania. In a related disorder called
cyclothymic disorder (sometimes called Bipolar III), a person's mood alternates between
mild depression and mild mania. Some people with cyclothymic disorder later develop
full-blown bipolar disorder. Bipolar disorder may also follow a seasonal pattern (Seasonal
Affective Disorder), with a person typically experiencing depression in the fall and
winter and mania in the spring or summer (A).


People in the depressive phase of bipolar disorder feel intensely sad or profoundly
indifferent to work, activities, and people that once brought them pleasure. They think
slowly, concentrate poorly, feel tired, and experience changes—usually an increase—in
their appetite and sleep. They often feel a sense of worthlessness or helplessness. In
addition, they may feel pessimistic or hopeless about the future and may think about or
attempt suicide.


In the manic phase of bipolar disorder, people feel intensely and inappropriately happy,
self-important, and irritable. In this highly energized state they sleep less, have racing
thoughts, and talk in rapid-fire speech that goes off in many directions. They have
inflated self-esteem and confidence and may even have delusions of grandeur. Mania may
make people impatient and abrasive, and when frustrated, physically abusive. They often
behave in socially inappropriate ways, think irrationally, and show impaired judgment. For
example, they may take airplane trips all over the country, make indecent sexual advances,
and formulate grandiose plans involving indiscriminate investments of money. The
self-destructive behavior of mania includes excessive gambling, buying outrageously
expensive gifts, abusing alcohol or other drugs, and provoking confrontations with
obnoxious or combative behavior.


The most dangerous aspect of manic depression, however, is the danger of suicide. The
suicide rate among people with bipolar disorder has been given as high as twenty percent,
which means a staggering number of bipolar people make unsuccessful and/or repeated
attempts on their own lives, and even more than that consider suicide without acting on
the urge. Yet people with manic-depressive illness are often highly intelligent,
extraordinarily gifted, marvelously talented people whose brilliance makes the world a
better place while they themselves are struggling every day to cope, to function, and to
stay alive (A).


CAUSES
A newly published study in the American Journal of Psychiatry reports "in those with
bipolar disorder, two major areas of the brain contain thirty percent more cells that send
signals to other brain cells." This report theorizes that "the extra signal-sending cells
may lead to a kind of over stimulation, which makes sense considering the symptoms of
bipolar disorder" (P).


According to Durand and Barlow, most scientists believe that "psychological disorders are
always the products of multiple interacting causal factors" (D). As it relates to bipolar
disorder, these causal factors are usually divided into biological and psychological
explanations. Psychopathology is the study of significant causes and processes in the
development of mental illness, which means there are physical and mental, and
environmental and emotional causes for mental illnesses.


In considering the biological explanations, the first issue is inheritability. This
question has been researched via multiple family, adoption, and twin studies. In families
of persons with bipolar disorder, first-degree relatives (parents, children, siblings) are
more likely to have a mood disorder than the relatives of those who do not have bipolar
disorder (C). Twin studies indicate that "if one twin presents with a mood disorder, an
identical twin is approximately three times more likely than a fraternal twin to have a
mood disorder" (D/H). In considering bipolar disorder specifically, the concordance rate
(when both twins have the disorder) is eighty percent for identical twins, as compared to
only sixteen percent for fraternal twins (D). "Overwhelming evidence suggests that such
disorders are familial and almost certainly reflect an underlying genetic vulnerability"
(D).


However, exactly what is inherited? The neurotransmitter system has received a great deal
of attention as a possible cause of bipolar disorder. Researchers have known for decades
that a link exists between neurotransmitters and mood disorders, because drugs which alter
these transmitters also relieve mood disorders (B). Some studies hypothesize that a low or
high level of a specific neurotransmitter such as serotonin, norepinephrine, or dopamine
is the cause. Others indicate that an imbalance of these substances is the problem in
other words, that a specific level of a neurotransmitter is not as important as its amount
in relation to the other neurotransmitters (D). Still other studies have found evidence
that a change in the sensitivity of the receptors on nerve cells may be the issue (B). In
short, researchers are quite certain that the neurotransmitter system is at least part of
the cause of bipolar disorder, but further research is still needed to define its exact
role.


The primary psychological culprit implicated in the manifestation of bipolar disorder is
stressful life changes (G p. 91). These can range from a death in the family to the loss
of a job, from the birth of a child to a move. It can be anything, but it cannot be
precisely defined, due to personality traits such as hardiness, since one person's stress
may be another person's piece of cake. With that in mind, research has found that
stressful life changes can lead to the onset of symptoms in bipolar disorder. However,
once the disorder is triggered and progresses, "it seems to develop a life of its own.
Once the cycle begins, a psychological or pathophysiological process takes over and
ensures that the disorder will continue" (D).


When we look for the cause of bipolar disorder, the best explanation via the research
available at this time is what is termed the "Diathesis-Stress Model." Diathesis means, in
simplified terms, a bodily condition that make a person more than usually susceptible to
certain diseases. Thus the Diathesis-Stress Model says that "each person inherits certain
physical predispositions that leave him or her vulnerable to problems that may or may not
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    Bipolar Disorder2 Bipolar Disorder The phenomenon of bipolar affective disorder has been a mystery since the 16th century. History has shown that this affliction can appear in almost anyone. Even the great painter Vincent Van Gogh is believed to have had bipolar disorder. It is clear that in our society many people live with bipolar disorder; however, despite the abundance of people suffering from the it, we are still waiting for definite explanations for the causes and cure. The one fact of whi