Abstract
Bipolar disorder (BD) is a mental disease that affects around 1% of all people worldwide. In the US the incidence is at 2.8%. BD affects a person’s mood, forcing them to go through periods of manic anxiety and extreme depression. It may result in suicide attempts, which is the most common cause of death from BD. There is no cure, but treatments are available. Medicine and cognitive-behavioral therapy remain the most popular solutions for the disease.
Keywords: Bipolar Disorder, Depression, Manic anxiety, Suicide.
Introduction
Bipolar disorder (BD), previously known as manic depression, is a type of mental illness characterized by extreme shifts of mood. These can vary between hyper depressive streaks and bouts of hyperactivity. The disease is fairly common – global incidence is estimated at about 1%, with a 0.5% yearly fluctuation (Carvalho et al., 2020, p. 58). In the US, over 2.8% are affected with BD at any given moment (Carvalho et al., 2020, p. 58). The real numbers are likely higher, since many incidents often go undiagnosed by specialists and are not made part of the overall statistics. The disease does not have a cure at this moment, and treatments available are serving only to manage the symptoms with the purpose of improving the quality of life. This paper will cover the key aspects of the disease, its pathology, diagnosis, treatment, and the overall awareness about the issue.
Types of Bipolar Disorder
There are currently three types of bipolar disorder that have been identified. These include Bipolar I, Bipolar II, and Cyclothymia diseases (Magioncalda & Martino, 2022). Bipolar I is typically diagnosed when at least one manic episode occurs in a patient (Magioncalda & Martino, 2022). The pattern of elevation-depression repeats itself before, during, and after major depressive and manic episodes. Bipolar I episodes occur equally in all sexes, with no specific preferences or underrepresentation. Bipolar II is characterized by long depressive episodes followed by shorter experiences of hypomania (Magioncalda & Martino, 2022). Depressive streaks last for at least two weeks, followed by 4-5 days of elated mania. This type of disorder is primarily experienced by women (Magioncalda & Martino, 2022). Finally, there is Cyclothymia, which is characterized by shorter and less severe episodes of mania/depression when compared to Bipolar I and II, with significant pauses between the two (Magioncalda & Martino, 2022). Patients diagnosed with this type of BD may not experience any symptoms for months, before being affected. Overall, the borders between all three types are relatively vague, making identifying them difficult.
Psychopathology
Psychopathology of the disease is characterized irregularities in the body’s dopamine and serotonin systems combined with the brain’s failure to properly regulate emotional responses. Some of the factors that may affect the disease progression and development include psychosocial stressors (including life events and family situations). Others revolve around events that provoke significant duress on the system, facilitating either extremely negative (fear, hate, anger) or positive (joy, elation) responses (Magioncalda & Martino, 2022). The differences in behavior have the potential to put severe psychological stress on the person, resulting in various comorbidities, including suicidal depression (Dome et al., 2019). The latter is one of the most frequent cases when bipolar disorder results in the death of the patient, thus justifying the attention and caution given to the disease.
Diagnosis
The primary means of diagnosing the presence of BD is through detecting at least one episode of mania, hypomania, and depression. In general, the experiences of joy and elation are considered to be less severe than experiences of depression. Nevertheless, mania can affect day-to-day functioning and may disrupt one’s work and family relations, while hypomania usually does not. The gradation to Bipolar I, II, or Cyclothymia happens based on the specifics of patient’s experiences (Rowland & Marwaha, 2018). B I typically feature at least one week-long mania episode, disrupts normal daily functioning, and does not relate to another medical condition or substance use. B II features short periods of hypomania coupled with longer depressive episodes that may last for several weeks (Rowland & Marwaha, 2018). While hypomania does not affect daily functioning, depression patterns may be dangerous.
Cyclothymia is diagnosed over a long period of time, usually up to two years, due to the infrequent nature of the disorder’s appearance. When it does, however, it shows patterns of hypomania and depression coming one after the other, and during this period a patient’s life balance may be severely disrupted (Rowland & Marwaha, 2018). Overall, the most difficulties in diagnosing the disease is generated from B I and B II disorders.
Treatment
Primary treatments for BD include medications, psychoeducation, and cognitive-behavioral therapy (CBT). Medications include mood stabilizers, anti-psychotics, antidepressants, and anti-anxiety drugs to help manage acute or ongoing symptoms of the disease (Vieta et al., 2018). They are, however, associated with numerous side-effects and drug interactions. Psychoeducation allows patients to understand more about the disease, the treatments used, and the support being needed. It is the first step to both medication and non-medication-based treatments. Finally, CBT focuses on understanding thought patterns, reframing distressing emotions, and learning coping strategies that could help address some of the ongoing issues a person experiences (Vieta et al., 2018). It is a good long-term supplement and alternative to medication use, though not as reliable during acute manic or depressive episodes.
Conclusions
BD is a serious mental health disorder that has a relatively high incidence rate. It has the capacity to severely destabilize a patient’s life for prolonged periods of time. Although there is no cure at the moment, there are ways of coping and treating the symptoms to make them more manageable. Recognizing the symptoms early and identifying the type of disease help prevent any significant damage early and allow a person to go on through their life less disrupted by the episodes of mania or depression.
References
Carvalho, A. F., Firth, J., & Vieta, E. (2020). Bipolar disorder. New England Journal of Medicine, 383(1), 58-66.
Dome, P., Rihmer, Z., & Gonda, X. (2019). Suicide risk in bipolar disorder: A brief review. Medicina, 55(8), 403.
Magioncalda, P., & Martino, M. (2022). A unified model of the pathophysiology of bipolar disorder. Molecular Psychiatry, 27(1), 202-211.
Rowland, T. A., & Marwaha, S. (2018). Epidemiology and risk factors for bipolar disorder. Therapeutic Advances in Psychopharmacology, 8(9), 251-269.
Vieta, E., Salagre, E., Grande, I., Carvalho, A. F., Fernandes, B. S., Berk, M., & Suppes, T. (2018). Early intervention in bipolar disorder. American Journal of Psychiatry, 175(5), 411-426.