The phenomenon of bipolar affective disorder

The phenomenon of bipolar affective disorder has been a mystery since the 16th Century. History has shown that this affliction cornerstone appear in almost anyone. Even the Great painter Vincent Van Gogh is believed to nurture had bipolar disorder. It is clear that in our society many people run low with bipolar disorder however, despite the abundance of people suffering from it, we be still waiting for definite explanations for the causes and cure.The one particular of which we argon distressingly aw be is that bipolar disorder severely undermines its victims ability to obtain and hold on social and occupational success. Because bipolar disorder has such debilitating symptoms, it is irresponsible that we remain vigilant in the quest for explanations of its causes and treatment. Affective disorders atomic number 18 characterized by a smorgasbord of symptoms that shag be broken into manic and depressive episodes. The depressive episodes atomic number 18 characterized by i ntense feelings of sadness and despair that can become feelings of hopelessness and helplessness.Some of the symptoms of a depressive episode include anaerobia, disturbances in sleep and appetite, psychomotor retardent, loss of energy, feelings of worthlessness, guilt, ifficulty thinking, indecision, and recurrent thoughts of death and suicide (Hollandsworth, Jr. 1990 ). The manic episodes are characterized by elevated or testy mood, extendd energy, decreased postulate for sleep, poor judgment and insight, and oft reckless or irresponsible sort (Hollandsworth, Jr. 1990). bipolar affective disorder affects approximately one percentage of the population (approximately deuce-ace million people) in the United States.It is presented by twain males and females. Bipolar disorder involves episodes of passion and feeling. These episodes may alternate with profound epressions 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 (Leiby,1988). nearly commonly, individuals with manic episodes see to it a period of depression.Symptoms include elated, expansive, or irritable mood, hyperactivity, pressure of speech, f settle of ideas, inflated self-esteem, decreased need for sleep, distractibility, and excessive meshing in reckless activities (Hollandsworth, Jr. 1990). Rarest symptoms were periods of loss of every interest and retardation or agitation (Gurman, 1991). As the National Depressive and Manic Depressive connector (MDMDA) turn in demonstrated, bipolar disorder can create substantial developmental delays, married and family disruptions, occupational setbacks, and financial disasters.This devastating disease causes disruptions of families, loss of jobs and millions of dollars in toll 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 isdiagnosed as schizophrenia. Speech patterns help distinguish amongst the two disorders (Turner,1989). The onset of Bipolar disorder usually occurs between the ages of 20 and 30 years of age, with a second peak in the forties for women. A typical bipolar patient may experience octonary 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 hypo mania, in which patients report that they are energetic, extroverted and ssertive (Hirschfeld, 1995). The hypomania state has led observers to feel that bipolar patients are addicted to their mania. Hypo mania progresses into mania and the transition is mark by loss of judgment (Hirschfeld, 1995). Often, euphoric grandiose characteristics are displayed, and pa ranoiac or irritable characteristics begin to manifest.The third stage of mania is spare when the patient experiences delusions with often- paranoid themes. Speech is generally rapid and hyperactive appearance manifests sometimes associated with violence (Hirschfeld, 1995). When both manic and depressive ymptoms occur at the equal time it is called a conflate episode. Those afflicted are a spare risk because there is a combination of hopelessness, agitation, and anxiety that makes them feel equivalent they could jump out of their skin(Hirschfeld, 1995). Up to 50% of all patients with mania have a variety of depressed moods.Patients report feeling dysphonic, depressed, and discontented yet, they exhibit the energy associated with mania. Rapid cycling mania is another foundation of bipolar disorder. Mania may be present with quaternion or more distinct episodes within a 12-month period. There is now indorse to uggest that sometimes rapid cycling may be a passing manifestatio n 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 1960s.It is main function is to modify 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 handle with Lithium was 78% (Turner,1998). Lithium is also the primary drug utilize 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 atomic number 3 or cannot get the side effects.Some of the side effects include thirst, weight gain, nausea, diarrhea, and edema. Patients who are unresponsive to atomic number 3 treatment are often those who experience dysphonic mania, mixed states, or r apid cycling bipolar disorder. One of the problems associated with lithium is the fact the long-term lithium treatment has been associated with decreased hyroid functioning in patients with bipolar disorder. Preliminary evidence also suggest that hypothyroidism may actually go across to rapid-cycling (Gurman,1991).Pregnant women experience another problem associated with the use of lithium. Its use during gestation has been associated with birth defects, particularly Ebsteins anomaly. Based on current data, the risk of a child with Ebsteins 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 (Leiby,1988). There are other telling treatments for bipolar disorder that are use in cases where the patients cannot tolerate lithium, or have been unresponsive to it in the past.The American Psychiatric Associations guidelines suggest the adjacent line of treatment to be Anticonvul sant drugs such as valproate and carbamazepine. These drugs are useful as antimanic agents, especially in those patients with mixed states. Both of these medications can be apply in combination with lithium or in combination with each other. Valproate is especially helpful for patients who are ithium noncompliant, experience rapid-cycling, or have comorbid alcohol or drug abuse. Neuroleptics such as haloperidol or chlorpromazine have also been used to help stabilize manic patients who are highly agitated or psychotic.Use of these drugs is often necessary because the response to them are rapid, but there are risks winding in their use. Because of the often severe side effects, Benzodiazepines are often used in their place. Benzodiazepines can achieve the same results as Neuroleptics for most patients in terms of rapid control of agitation and excitement, without the severe side effects. Antidepressants such as the selective serotonin reup pay off inhibitors (SSRIs) fluovamine and a mitriptyline has also been used by some doctors as treatment for bipolar disorder. A double-blind arena by M. Gasperini, F. Gatti, L. Bellini, R. Anniverno, and E.Smeraldi showed that fluvoxamine and amitriptyline are highly effective treatments for bipolar patients experiencing depressive episodes (Leiby,1988). This subscribe is controversial however, because conflicting research shows that SSRIs and other antidepressants can actually precipitate manic episodes. Most doctors can see the value of ntidepressants when used in conjunction with mood stabilizing medications such as lithium. In addition to the mentioned medical treatments of bipolar disorder, there are some(prenominal) other options available to bipolar patients, most of which are used in conjunction with medicine.One such treatment is fire up therapy. One take compared the response to light therapy of bipolar patients with that of unipolar patients. Patients were free of psychotropic and soporific medications for a t least one month before treatment. Bipolar patients in this study showed an average of 90. 3% improvement in their depressive ymptoms, with no relative incidence of mania or hypomania. They all continued to use light therapy, and all showed a sustained positive response at a three month follow-up (Turner,1998). other study involved a four week treatment of bright morning light treatment for patients with seasonal worker affective disorder and bipolar patients. This study found a statistically significant decrement in depressive symptoms, with the maximum antidepressant effect of light not being reached until week four (Hollandsworth, Jr. 1990). Hypomanic symptoms were experienced by 36% of bipolar patients in this study. Predominant hypo manic symptoms include racing thoughts, deceased sleep and irritability. Surprisingly, one-third of controls also developed symptoms such as those mentioned above.Regardless of the explanation of the emergence of hypo manic symptoms in undiagnosed controls, it is evident from this study that light treatment may be associated with the observed symptoms. Based on the results, careful professional monitoring during light treatment is necessary, even for those without a history of major mood disorders. Another popular treatment for bipolar disorder is electro-convulsive hock therapy. ECT is the preferent treatment for severely manic pregnant patients and patients who are homicidal, psychotic, catatonic, medically compromised, or severely suicidal.In one study, researchers found marked improvement in 78% of patients treated with ECT, compared to 62% of patients treated only with lithium and 37% of patients who received neither, ECT or lithium (Gurman,1991). A final role of therapy is outpatient group psychotherapy. According to Dr. John Graves, spokesperson for the National Depressive and Manic Depressive Association has called attention to the value f affirm groups, and challenged mental health professionals to take a more se rious look at group therapy for the bipolar population.Research shows that group participation may help increase lithium compliance, decrease denial regarding the illness, and increase awareness of both external and inner(a) stress factors leading to manic and depressive episodes. Group therapy for patients with bipolar disorders responds to the need for support and reinforcement of medication management, and the need for education and support for the interpersonal difficulties that prepare during the course of the disorder.