Bipolar disorder: characteristics, diagnosis, and treatment approaches

Bipolar

UNDERSTANDING and MANAGING a MIXED STATE of MIND

Causes and Treatments of Bipolar Disorder

Bipolar disorder, or manic-depressive disorder, is characterized by unusual changes in mood, energy and ability to function (Spearing 2000) at severe proportions. It can injure or destroy relationships, one's job or studies and even lead to suicide. Statistics say that it afflicts 5.7 million American adults or 2.6% of the population aged 18 and over in any given year. It commonly starts at late adolescence or early adulthood. It is a long-term condition, which is not usually recognized as an illness so that the person may suffer from it for years without the proper diagnosis. Its highs and lows of mood are called episodes of mania and depression. Each episode has many signs and symptoms. The most dangerous sign consists of thoughts of suicide or suicide attempts (Spearing).

Causes, Factors

Experts and researchers believe that contributing factors to the development of bipolar disorder include genetic predisposition, environmental influences, and brain chemistry (Spearing 2002, NWHRC Health Center 2005). It is 10-20 times more likely to be genetically inherited, according to the National Institute of Mental Health. Experts, however, note that not all with a family history of the disorder develop it. No single gene has been isolated as a cause or precipitating factor. That factor appears to be genetic in combination with the personality or the environment. Experts say that genes account for only 50% of the risk. Environmental factors can include stress and difficulty at work or in personal relationships. Troubled relationships often result in stress, which disturbs sleep. The lack or loss of sleep, in turn, encourages changes in brain chemistry, which make the person susceptible to bipolar disorder (Spearing, NWHRC).

Of the environmental influences or factors, stress appears to be the most important (Kidd 2004). A long-term study of more than 5,000 subjects born in 1946 linked stressful conditions in the prenatal and perinatal periods to mood disorders later in life. Stress exposes the fetus to chronically high levels of endogenous corticosteroids of the mother, which can lead to behavioral abnormalities, including bipolar disorder. Brain cell loss can occur. Growth factors, such as enzymes and pathways to neuronal maturity and brain plasticity, can be imbalanced. The condition can also increase one's susceptibility to seizures. The infant's stress-coping mechanisms may also be over-activated and inhibit normal nerve development (Kidd).

Bipolar disorder can also grow out or be activated by stressful life experiences, such as death or divorce (Kidd 2004). Stress can also result from struggles to achieve goals, the lack of social support, physical or sexual abuse in childhood or adolescence. Other contributing factors may be an existing medical condition or intervention, head injury, substance abuse and exposure to toxic chemicals or substances in the environment (Kidd).

Treatments

Bipolar disorder is usually managed by medications, psychosocial measures and preventive care (Grisworld and Pessan 2000). Medications include mood stabilizers, especially lithium, flaxseed oil, phospholipids, lecithin, antioxidants, folate, amino acids, multivitamins and minerals (Kidd 2004). Psychosocial measures include a change of lifestyle, a change in diet, the inclusion of dietary supplements, cognitive behavior therapy and therapeutic parenting (Kidd).

A plan that can be devised in treating or managing bipolar disorder can include traditional medications for symptoms, the new electroconvulsant therapy resistant cases, and preventive measures (Kidd 2004). The family must be educated on possible relapses through informational pamphlets, videos or their involvement in advocacy groups. Family physicians, psychiatrists and mental health professionals should be involved in the plan. Family members should be informed about and trained to recognize the warning signs of suicide. They should also be taught how to distinguish between the signs of mania and those of depression. Substance abuse should be discouraged or stopped. Even seemingly modest or "innocent" social drinking should be discouraged as well. Guns should be confiscated or removed from the house. The person afflicted with bipolar disorder and his or her family members should be tested for sexually transmitted disease. Spouses should be informed about their legal rights and where they can take refuge in case of violence. If the person with the disorder shows signs of overspending, help should be solicited from the social services entities and banks to prevent undue withdrawals (Kidd).