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Exploring the concepts of Bipolar Disorder/Manic-Depression, and its causes, symptoms, treatment, and symptoms. What are the causes of Manic-depression (Bipolar Disorder).What are the many symptoms of this Disorder and what are the various treatments for Bipolar Disorder. How does Manic-Depression affect the lives of those who have this Disorder?

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What is Bipolar-Disorder?

Bipolar-Disorder which is also known as manic depression is a brain disorder illness that can cause alternating periods of elation and depression. This mental disorder is marked as causing unusual fluctuations in energy, mood, and ability to think clearly and affects the ability to function in day to day activities which can result in hurting job or school performance as well as damage family and social relationships. Some people develop bipolar disorder in childhood, but it usually presents in people predisposed to this mental disorder in late adolescence and as early adults and some present symptoms later in life. “More than 2 million American adults, (Narrow WE.: NIMH ECA prospective data July 1 1998) or about 1 percent of the population from the age of 18 and older present bipolar disorder yearly.” (Regler DA, Narrow WE., Rae et al. 1993).

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Manic Depression is not always seen as a mental illness, and many people have it for many years before it is recognized and diagnosed before they can get treated for it.  When this mental illness presents in a person they can go from one emotional extreme to another is a very short period of time, i.e. from hypomania to mania (emotional highs) to a deep depression (lows).Manic Depression is not always seen as a mental illness, and many people have it for many years before it is recognized and diagnosed before they can get treated for it.  When this mental illness presents in a person they can go from one emotional extreme to another is a very short period of time, i.e. from hypomania to mania (emotional highs) to a deep depression (lows).

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The emotional highs can present as feeling of euphoria (high state of happiness) with an increased boost of energy. Then an acute bout of depression (emotional lows) which gives feelings of hopelessness and a loss of interest in activities that once gave pleasure. These symptoms may last from a few times a week to several times a year, each person and case varies.

 

What are the Causes of Bipolar Disorder?

Much research have been done to find out what exactly are the causes of the mental illness, and many studies have been done, however there seems to be no single one cause for manic depression, but rather many internal and environmental factors presenting at once to manifest this disorder. Research studies have shown that this illness can be genetic or triggered in one’s external environment, as well as a combination of both. Genetically no one gene is responsible for bipolar disorder, but could be many genes acting at once to present the disorder. (NIMH Genetics Workgroup, 1998). Also a chemical imbalance of bio-chemicals in the brain called neurotransmitters can play a significant role in mental disorders, but the truth is that which actually causes bipolar disorder in still unknown.

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The Symptoms of Bipolar Disorder

The symptoms of bipolar disorder are manifold but are classified in The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is published by the American Psychiatric Association, and lists the criteria for diagnosing bipolar and related disorders. According to the DSM-5 classification and criteria for the diagnosis of manic and hypomanic episodes, the criteria for the diagnosing based on the particular “type” or related disorder is as follows.

Bipolar I disorder:  At least one or more manic episode. The manic episodes may be preceded by or followed by hypomanic or major depressive episodes. Mania symptoms cause significant impairment in a person’s life and may trigger a sense from reality called psychosis.

Bipolar II disorder: At least one major depressive episode lasting at least two weeks and at least one hypomanic episode lasting at least four days, but did not have a manic episode. Extreme depressive episodes or the unpredictable changes in mood and behaviors that cause distress and difficulty in areas of your life.

Cyclothymic disorder: At least a two year period of hypomania symptoms (milder than a hypomanic episode or bipolar 2 disorder) and periods of depressive symptoms (less severe than a major depressive episode). Symptoms can cause significant distributions in many important areas of your daily life.

The DSM-5 has a specific classification and criteria for the diagnosis of manic and hypomanic episodes:

 

Manic Episode:  is a marked period of abnormally high and persisting irritable mood that lasts at least one week. The episode presents increased goal-driven activity and or energy.

Hypomanic episode: is a distinct period of an abnormally burst of energy and very extreme, overbearing or irritable mood that lasts at least four continuing days.

 

The Symptoms and or Signs of a manic episode or Mania:

  •   A sudden increase in activity or energy and marked restlessness.
  •   Ballooned self esteem
  •   Very highly irritable
  •   Overly high euphoric mood
  •   Thoughts racing and moving from one thought to the next very rapidly
  •   Lack of need to sleep
  •   Elevated sex drive and sexual indiscretions
  •   Overly talkative
  •   Self-denial

(If three or more of the other symptoms are present along with euphoric mood for a large portion of the day, almost every day for a seven days or more than it is diagnosed as a manic episode. There must be at least four more symptoms present with an irritated mood)

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Symptoms and or Signs of Depression:

(The DSM-5 Criteria for a major depressive episode are as follows):

  •   Chronic anxious or sad mood (feeling empty)
  •   High reduction of feeling joy or pleasure in activities most days almost all of the day
  •   Marked reduction of energy (feeling slow, fatigue)
  •   Sleeping to much or marked insomnia
  •   Contemplating suicide, or attempts
  •   Abnormal appetite (gaining or losing weight)
  •   Increased lack of concentration
  •   (If five or more of these symptoms are present almost all day every day for two weeks or more the diagnosis is a depressive episode.)Symptoms and or Signs of Depression:(The DSM-5 Criteria for a major depressive episode are as follows):
    •   Chronic anxious or sad mood (feeling empty)
    •   High reduction of feeling joy or pleasure in activities most days almost all of the day
    •   Marked reduction of energy (feeling slow, fatigue)
    •   Sleeping to much or marked insomnia
    •   Contemplating suicide, or attempts
    •   Abnormal appetite (gaining or losing weight)
    •   Increased lack of concentration
    •   (If five or more of these symptoms are present almost all day every day for two weeks or more the diagnosis is a depressive episode.

 

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Disorder Treatments

The treatments available for patients with Bipolar disorder are assessed by a psychiatrist and can include mood balancing medications like mood stabilizers, antipsychotics, antidepressants, and or anti-anxiety in tandem with psychotherapy depending on the needs of patient. Psychotherapy is a most important part of treatment and can be done in different settings such as family, group or individual setting to fit the needs of the client. A few type of psychotherapy are, cognitive behavioral therapy, interpersonal and social rhythm therapy, art therapy and psycho-education. Bipolar disorder is a chronic and lifelong disorder so it is important to seek ongoing treatment, trying different methods recommended by your doctors to achieve the best results, overall management and care over the course of your life

 

References:

Bipolar and related disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed Dec. 13, 2013

Narrow, WE. One-year prevalence of depressive disorders among adults 18 and over in the U.S.; NHMH ECA prospective data. Population estimates based on U.S. Census estimated residential population age 18 and over on July 1, 1998. Unpublished.

Bipolar and related disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed Dec. 17, 2015.

Culpepper L. The diagnosis and treatment of bipolar disorder: Decision-making in primary care. The Primary Care Companion for CNS Disorders. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195640/. Accessed Dec. 14, 2016.

NIMH Genetics Workgroup. Genetics and mental disorders. NIH Publication No. 98-4268, MD: National Institute of mental Health, 1998.

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