Your mind Essay

This essay has a total of 1758 words and 10 pages.


your mind






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 it, we are still waiting for definite explanations for the causes
and cure. The one fact of which we are painfully 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 imperative that
we remain vigilant in the quest for explanations of its causes and treatment.


Affective disorders are characterized by a smorgasbord of symptoms that can be broken into
manic and depressive episodes. The depressive episodes are characterized by intense
feelings of sadness and despair that can become feelings of hopelessness and helplessness.
Some of the symptoms of a depressive episode include anhedonia, disturbances in sleep and
appetite, psychomotor retardation, loss of energy, feelings of worthlessness, guilt,
difficulty thinking, indecision, and recurrent thoughts of death and suicide
(Hollandsworth 178). 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 (Hollandsworth 179). Bipolar affective disorder affects
approximately one percent of the population (approximately three million people) in the
United States. It is presented by both males and females. Bipolar disorder involves
episodes of mania and depression. These episodes may alternate with profound depressions
characterized by a pervasive sadness, almost inability to move, hopelessness, and
disturbances in appetite, sleep, in concentrations and driving.


Bipolar disorder is diagnosed if an episode of mania occurs whether depression has been
diagnosed or not (Goodwin, Guze, 11). Most commonly, individuals with manic episodes
experience a period of depression. Symptoms include elated, expansive, or irritable mood,
hyperactivity, pressure of speech, flight of ideas, inflated self esteem, decreased need
for sleep, distractibility, and excessive involvement in reckless activities
(Hollandsworth, 194). Rarest symptoms were periods of loss of all interest and
retardation or agitation (Weisman 109).


As the National Depressive and Manic Depressive Association (MDMDA) has demonstrated,
bipolar disorder can create substantial developmental delays, marital and family
disruptions, occupational setbacks, and financial disasters. This devastating disease
causes disruptions of families, loss of jobs and millions of dollars in cost to society.
Many times bipolar patients report that the depressions are longer and increase in
frequency as the individual ages. Many times bipolar states and psychotic states are
misdiagnosed as schizophrenia. Speech patterns help distinguish between the two disorders
(Lish 234).


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 succeed each other without a period
of remission (DSM III-R).


The three stages of mania begin with hypomania, in which patients report that they are
energetic, extroverted and assertive (Hirschfeld, 1995). The hypomania state has led
observers to feel that bipolar patients are "addicted" to their mania. Hypomania
progresses into mania and the transition is marked by loss of judgment (Hirschfeld 128).
Often, euphoric grandiose characteristics are displayed, and paranoid or irritable
characteristics begin to manifest. The third stage of mania is evident when the patient
experiences delusions with often paranoid themes. Speech is generally rapid and
hyperactive behavior manifests sometimes associated with violence (Hirschfeld 145).


When both manic and depressive symptoms occur at the same time it is called a mixed
episode. Those afflicted are a special risk because there is a combination of
hopelessness, agitation, and anxiety that makes them feel like they "could jump out of
their skin"(Hirschfeld 145). Up to 50% of all patients with mania have a mixture of
depressed moods. Patients report feeling dysphoric, depressed, and unhappy; yet, they
exhibit the energy associated with mania. Rapid cycling mania is another presentation of
bipolar disorder. Mania may be present with four or more distinct episodes within a 12
month period. There is now evidence to suggest that sometimes rapid cycling may be a
transient manifestation of the bipolar disorder. This form of the disease exhibits more
episodes of mania and depression than bipolar.


Lithium has been the primary treatment of bipolar disorder since its introduction in the
1960's. It is 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%. 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 tolerate 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.
Preliminary evidence also suggest that hypothyroidism may actually lead to rapid-cycling
(Hirschfeld 125). Pregnant women experience another problem associated with the use of
lithium. Its use during pregnancy has been associated with birth defects, particularly
Ebstein's anomaly. Based on current data, the risk of a child with Ebstein's anomaly
being born to a mother who took lithium during her first trimester of pregnancy is
approximately 1 in 8,000, or 2.5 times that of the general population (Hirschfeld 341).


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 line of treatment to be
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