Term Paper on Bipolar Disorder

This essay has a total of 1576 words and 9 pages.


Bipolar Disorder




Bipolar affective disorder has been a mystery since the 16th century. History has shown
that this disorder 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 amount of people suffering from it, we
are still waiting for explanations for the causes and cure. The one fact of which we are
aware is that bipolar disorder severely undermines its' victims ability to obtain and
maintain social and occupational success. Because bipolar disorder has such debilitating
symptoms, it is important that we keep looking for explanations of its causes and for more
ways to treat this disorder.

Bipolar has a large variety of symptoms, divided in two categories. One is the manic
episodes, the other is depressive. The depressive episodes are characterized by intense
feelings of sadness and despair that can turn into feelings of hopelessness and
helplessness. Some of the symptoms of a depressive episode include disturbances in sleep
and appetite, loss of energy, feelings of worthlessness, guilt, difficulty thinking,
indecision, and reoccurring thoughts of death and suicide. The manic episodes are
characterized by elevated or irritable mood, increased energy, decreased need for sleep,
poor judgment and insight, and often reckless or irresponsible behavior. These episodes
may alternate with profound depressions characterized by a deep sadness, almost inability
to move, hopelessness, and disturbances in appetite, sleep, problems with concentrations
and driving.

Bipolar affective disorder affects approximately one percent of the population
(approximately three million people) in the United States. It occurs in both males and
females. Bipolar disorder is diagnosed if an episode of mania occurs whether depression
has been diagnosed or not. Most commonly, individuals with manic episodes do experience a
period of depression. Symptoms include elated, excited, or irritable mood, hyperactivity,
pressure of speech, flight of ideas, inflated self-esteem, decreased need for sleep,
distractibility, and excessive involvement in reckless activities.

As the National Depressive and Manic Depressive Association (MDMDA) has found out in their
research, bipolar disorder can create marital and family disruptions, occupational
setbacks, and financial disasters.

Many times, bipolar patients report that the depressions are longer and increase in
frequency as the person ages. Many times's bipolar states and psychotic states are
misdiagnosed as schizophrenia.

The onset of Bipolar disorder usually occurs between the ages of 20 and 30 years of age,
with a second peak in the mid-forties for women. A typical bipolar patient may experience
eight to ten episodes in their lifetime. However, those who have rapid cycling may
experience more episodes of mania and depression that follow each other without a period
of remission.

The three stages of mania begin with hypomania, in which patients report that they are
energetic, extroverted and assertive. Hypomania progresses into mania and the transition
is marked by extreme loss of judgment. Often, euphoric grandiose characteristics are
displayed, and paranoid or irritable characteristics begin. The third stage of mania is
evident when the patient experiences paranoid delusions. Speech is generally rapid and
hyperactive behavior sometimes turns into violence.

Sometimes both manic and depressive symptoms occur at the same time. This is called a
mixed episode. Those affected are at special risk because there is a combination of
hopelessness, agitation, and anxiety that make them feel like they "could jump out of
their skin". Up to 50% of all patients with mania have a mixture of depressed moods.
Patients report feeling dysphoric, depressed, and unhappy; yet, they have the energy
associated with mania. Rapid cycling mania is another form of bipolar disorder. Mania
may be present with four or more episodes within a 12 month period. This form of the
disease has more episodes of mania and depression than bipolar disorder, although this is
believed to be a branch of actual bipolar disorder.

Lithium has been the primary treatment of bipolar disorder since its introduction in the
1960's. Its main function is to stabilize the cycling characteristic of bipolar disorder.
In four controlled studies by F. K. Goodwin and K. R. Jamison, the overall response rate
for bipolar subjects treated with Lithium was 78% (1990). Lithium is also the primary
drug used for long- term maintenance of bipolar disorder. In a majority of bipolar
patients, it lessens the duration, frequency, and severity of the episodes of both mania
and depression.

Unfortunately, as many as 40% of bipolar patients are either unresponsive to lithium or
can not handle the side effects. Some of the side effects include thirst, weight gain,
nausea, diarrhea, and edema. Patients who are unresponsive to lithium treatment are often
those who experience dysphoric mania, mixed states, or rapid cycling bipolar disorder.

One of the problems associated with lithium is the fact the long-term lithium treatment
has been associated with decreased thyroid functioning in patients with bipolar disorder.
Evidence also suggests that hypothyroidism may actually lead to rapid-cycling. Pregnant
women experience another problem associated with the use of lithium. Its use during
pregnancy has been associated with birth defects.

There are other effective treatments for bipolar disorder that are used in cases where the
patients cannot tolerate lithium or have been unresponsive to it in the past. The
American Psychiatric Association's guidelines suggest the next best treatment to be
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