Bipolar Disorder, also known as manic-depressive illness, is a psychiatric mood disorder characterized by cycles of unusually elevated moods and severe depression. Mania, or manic episodes, cause a sense of hyper energy, insomnia, racing thoughts, and decreased focus. Individuals with the disorder make impulsive and irrational decisions without considering the consequences of their actions. On the other hand, the depressive phase of the disorder involves hopelessness, major depression, and a higher risk of self-harm and suicide. The cause of the disease is unknown, however, there are environmental and genetic factors that are thought to be involved [1]. This article will investigate the signs and symptoms, causes, and current therapies to treat bipolar illness.
There are three types of bipolar illness: Bipolar I Disorder, Bipolar II Disorder, and Cyclothymic Disorder.
Bipolar I is characterized by severe and long episodes of mania and depression. This unstable form is defined by extreme mania and oftentimes, immediate hospitalization is necessary for the safety of the patient and others around them.
Bipolar II is classified by hypomania, a milder form of mania that usually does not require immediate hospitalization. Hypomania does not present any psychotic symptoms such as hallucinations or volatile behavior. As a result, this form is much more difficult to diagnose as it does not present severe and accentuated mania that Type I depicts. [2][4].
Cyclothymic Disorder is the third type and is distinguished by its milder and more chronic symptoms. In cyclothymia, there are repetitive cycles of emotional highs and lows that persist for at least two years. Essentially, during the elevated state, one’s senses are elevated but not to a level where it can be diagnosed as a hypomanic episode. Despite its far milder symptoms as compared to Type I, cyclothymia still interferes with day-to-day activities as well as significantly increasing the chances to develop Bipolar Disorder Type [3].
Manic Symptoms
During the energetic manic or hypomanic phase, patients go into a hyper-energetic state lasting longer than one week. Generally, this phase is primarily characterized by unusually high levels of activity, inflated self-esteem (grandiosity), intense pleasure (euphoria), an inability to fall asleep (insomnia), and risky behavior. Mania can be measured through the Young Mania Rating Scale, a system of questions that gauges the severity of symptoms that a patient experiences [6]. Manic episodes can also trigger psychosis, a disconnection from reality, and require immediate psychiatric care [2][4]. Mania can also be deadly not only due to its mental toll on the afflicted, but also on their physical self. For instance, higher risk-taking can potentially involve substance abuse, unprotected sex, and more unsafe activities [1][5]. It is quite evident that mania is deadly in multiple aspects and can destroy a person physically, emotionally, and socially.
Depressive Symptoms
The other half of bipolar involves major depression, a disease that tens of millions have experienced in the past year. Key features of depression include a feeling of emptiness, hopelessness, lack of interest (apathy), insomnia, and feeling overtired (fatigue) [4]. More critically, a substantial aspect of the disorder is the vastly increased risk of suicide. According to a meta-analysis and review of bipolar-related suicide attempts, “between 25% and 60% of individuals with bipolar disorder will attempt suicide at least once in their lives and between 4% and 19% will complete suicide,”[7]. As a result, it is clear that bipolar has devastating effects on a person’s mental health. Another complication of bipolar is misdiagnosis. Since a diagnosis requires both mania and depression symptoms, a person in the depressive stage can be misdiagnosed with major depression instead of bipolar [2]. This can cause even more damage if they are incorrectly prescribed with incorrect antidepressants. Unlike the plethora of symptoms, bipolar has few plausible causes.
Genetic Causes
Although there are possible genetic or hereditary causes, researchers and scientists are yet to truly find a proper cause for bipolar disease [4]. People with depression could be at a higher risk if they have relatives with bipolar or other psychiatric illnesses such as schizophrenia [1]. In many singular studies, variants within genes have been identified as being associated with bipolar, “including BDNF, DAOA, DISC1, GRIK4, SLC6A4, and TPH2,” [8]. Despite there being numerous hereditary and genetic discoveries about those with bipolar, there is no singular gene or factor that is a direct cause of the illness.
My references:
[1] Wnuk, Alexis, et al. (2018). BrainFacts a Primer On the Brain and Nervous System. Psychiatric Disorders. Page 79-80. Retrieved: 24/06/2020.
[2] National Institute of Mental Health. (01/2020). Bipolar Disorder. National Institute of Health. https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml. Retrieved: 24/06/20
[3] Cagliostro, Dina. (03/03/2020). Cyclothymia. Psycom. https://www.psycom.net/depression.central.cyclothymia.html. Retrieved: 25/06/20
[4] (31/01/2018). Bipolar Disorder. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955. Retrieved: 25/06/2020
[5] Cagliostro, Dina. (21/10/2019). Bipolar Disorder. Psycom. https://www.psycom.net/depression.central.bipolar.html. Retrieved: 25/06/2020
[6] Furukawa, Toshi. (06/2010). Assessment of mood: Guides for clinicians. ScienceDirect. https://doi.org/10.1016/j.jpsychores.2009.05.003. Retrieved: 26/06/2020
[7] Novick, Danielle. (24/01/2010). Suicide attempts in bipolar I and bipolar II disorder: a review and meta‐analysis of the evidence. Wiley Online Library. https://doi.org/10.1111/j.1399-5618.2009.00786.x. Retrieved: 26/06/2020
[8] Barnett, Jennifer. (24/11/2009). The genetics of bipolar disorder. Science Direct. https://doi.org/10.1016/j.neuroscience.2009.03.080. Retrieved: 27/06/20
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