Bipolar Disorder: Causes, Symptoms, And Prevention Every human being is susceptible to mood changes, sometimes feeling happy and energetic, and other times feeling melancholic and miserable. However, a persistent feeling of sadness and hopelessness is a mood disorder, known as depression, which is very common and requires medical attention. In the nineteenth century, Abraham Lincoln was so depressed that he described himself as "the most miserable man living" (Leonard and Jovinelly, 2012). Leonard and Jovinelly go on to describe Bipolar Disease, also referred to as manic depressive illness, as the most complex type of depression. According to National Institute of Mental Health, NMIH (2015), nearly six million American adults suffer from this disorder. Bipolar Disease (BD) is a condition that is characterized by drastic changes in energy and moods which are often not related to the prevailing circumstances. The condition makes a person's moods alternate between two extreme emotional states: mania and depression (Leonard and Jovinelly, 2012). Depression makes the person feel low and become withdrawn from others, while a manic state makes them extremely active - both physically and mentally. However, BD patients struggle with depressive symptoms more than they struggle with symptoms caused by elevations in their mood (Ketter, 2012). This text looks at Bipolar Disorder in detail and examines its causes, symptoms, diagnosis, treatment, and prevention in both children and adults.

Causes of Bipolar Disorder

The functioning and structure of the brain

For a long time, scientists have tried to establish the causes of BD. Most recent brain imaging technology, including, but not limited to, magnetic resonance imaging (MRI) and positron emission tomography (PET) has made it possible for doctors to monitor bipolar disease in the brain. They established that the structure and functioning of the brain of a BD patient is different from that of a normal person. For example, one MRI revealed that there were similarities in the development of the brain between children with multi-dimensional impairment and children with BD, which makes symptoms overlap and leads to mood swings (NIMH, 2015). The prefrontal cortex, the brain structure used in decision making and problem solving, has also been found to be smaller in BD patients and functions in a smaller capacity. Preston and White (2009) also note that the brains biochemistry plays a big part in BD due to the unstable transmission of nerve impulses.

Genetics

Studies have found that BD is genetic. Children with a family history of BD are more likely to suffer from the condition as compared to those whose siblings or parents have never had it. However, the National Institute of Mental Health (2015) notes that this is not to say that all children with a history of BD will acquire the condition when they grow up.

Trauma and Stress

The most popular triggers of BD symptoms among adults are stress and lack of sleep. Strenuous activities that are not accompanied by adequate amounts of rest are likely to cause mood elevation. According to Preston and White (2009), trauma experienced in an individual's childhood hastens the start of severe BD.

Signs and Symptoms of Bipolar Disease

The following are the signs and symptoms of BD (White and Preston, 2009; NIMH, 2015):

Mania

Persistent feelings of irritability and denial

Restlessness and high levels of energy without feeling tired

Increased sexual drive

Feelings of great or supernatural abilities

A high sense of irritability and intrusive behavior

Extreme feelings of happiness and joy

Lack of concentration and easy distraction

Impulsive behavior

Depression

Feelings of hopelessness

Suicidal thoughts

Feelings of melancholy and anxiousness

Lack of concentration and changes in sleep patterns and appetite

A pessimistic attitude and loss of interest in once fun activities

Lack of self-worth and feelings of emptiness

Fatigue and feeling delayed or slowed down

Diagnosis

The Diagnostic and Statistical Model of Mental Disorders (DSM) provides guidelines that help doctors diagnose the various types of BD. When a person manic symptoms are very extreme with episodes lasting a whole week, they are diagnosed with Bipolar I disorder (NMIH, 2015; DBSA, 2015). Bipolar II Disorder is characterized by less severe mania and depression. When a person is not acting normally but does not have either Bipolar I or II, they are diagnosed with Bipolar Disorder Not Otherwise Specified (BP-NOS). Milder episodes of BD characterized by depression and hypomania are classified as Cyclothymic Disorders (NMIH, 2015; DBSA, 2015). NMIH also explains a more severe type of BD where a patient experiences more than four episodes of extreme depression and mania in one year. This is known as Rapid Cycling Bipolar Disorder and is rather prevalent in women.

The diagnosis of bipolar disorder involves a thorough evaluation of a patient's family history with tests and examinations to ascertain the type of BD suffered from. Brain scans enable doctors identify the causes of mood changes by checking for tumors. NMIH...

The main aim of treatment is to enable patients become stable and lead normal lives while continually managing episodes that may occur, since it is classified as a life-long illness. Three strategies: education, medication and physiotherapy are used to treat the disease.
Medication

According to Preston and White (2009), medication is applied on a trial and error basis and the medicine that proves successful is chosen for the patient. They go ahead to list the most common medication for both mania and depression. For mania, common drugs prescribed include Zyprexa (olanzapine), Depakote (divalproex), Seroquel (quetiapine), Trileptal (oxcarbazepine), and Tegretol and Equatro (carbamazepine). Frequent drugs prescribed for depression are Symyax (fluoxetine and olanzapuine), Serequel (quetiapine), Lamitcal (lamotrigine), and antidepressants such as Prozac ( fluoxetine). Miklowitz et al. (as cited in White and Preston, 2009), reported that "a recent large scale study found that the average number of medications taken concurrently by bipolar patients is three to four." Leonard and Jovinnely (2012) refer to them as 'medication cocktails', which are combinations of medicines necessary to make the patients accustomed to the drugs, and to make the treatment effective.

Education

BD patients must educate themselves on the causes, symptoms, diagnosis, treatment and prevention of the disease. This enables them to get the right treatment and monitor episodes and symptoms with the help of doctors. Ignorance of the disease makes it hard to identify the first phases of the conditions which may occur in children or teenagers. Pregnant women should learn the medication that is considered harmful for them and their infants. They also face different and unique challenges which can only be addressed by an experienced medical practitioner. Friends and family should also educate themselves in order to provide the support their loved ones need to conquer this condition and to live, learn and work normally.

Physiotherapy

Physiotherapy ensures medication used by patients with BD is effective and prevents patients from falling back to the illness after recovery (White and Preston, 2009). NMIH (2015) also states that the investigation of the effect the social environment has on social behavior, coupled with a mix of medication and physiotherapy, is the best treatment for BD. White and Preston (2009) describe four psychosocial interventions that are applied to patients: group psycho-education, cognitive behavioral therapy (CBT), interpersonal and social rhythm therapy (IPSRT) and family focused psycho-educational treatment - all of which enable socialization, reduce relapses and symptoms, and help patients avoid being hospitalized.

Prevention

Although there are no specific ways to prevent BD, there are some precautions one can take to prevent worsening of the condition. These include:

Maintaining good physical health

Monitoring symptoms and triggers

Taking medication as prescribed by the doctor

Consultation with doctors before taking new medication

Avoiding alcohol and drug use

Continuity in education, consultation and medication

Counseling to deal with trauma

Conclusion

Bipolar Disease is a mental illness that is characterized by depression and mania, with mood changes different from the typical ups and downs most individuals experience. It is a cyclic disorder with alternating high and low moods which may negatively affect a patient's life if not diagnosed and treated. Doctors assess the various symptoms and categorize the condition into any of the five categories explained in the text. Although classified as a life long illness, patients can undertake prevention measures to reduce the severity of symptoms and avoid relapse. Patients must also embrace recovery as a process and not just a one-time event.

References

Depression and Bipolar Support Alliance, DBSA. (2015). What is Bipolar Disorder? Retrieved 26 January 2015 from http://www.dbsahouston.org/what-is-bipolar-disorder/

Ketter T, A. (Ed). (2010). Handbook of Diagnosis and Treatment of Bipolar Disorders. Arlington, VA: American Psychiatric Publishing, Inc.

Leonard, B. & Jovinnely, J. (2012). Understanding Brain Diseases and Disorders: Bipolar Disorder. New York, NY: The Rosen Publishing Group, Inc.

National Institute of Mental Health. (2015). What is Bipolar Disorder? Retrieved 26 January 2015 from http://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml#part5

White, R.C & Preston, J.D. (2009). Bipolar 101: A Practical Guide to Identifying Triggers, Managing Medications, Coping with Symptoms and More. Oakland, CA: New Harbinger…