Introduction
Bipolar disorder (formerly manic depression) is a serious and common psychiatric disorder affecting a person’s mood. The moods swing from one extreme to another- feeling very low and weary and feeling very high and overactive. These moods dysfunctions i.e, melancholia and mania have been documented repeatedly in human history. First descriptions were made by Hippocrates, Falret and Baillarger, and Kraepelin in the 19th century (Mason et al. 3). The causes of the condition are unidentified, although several incidences including extreme stress, overpowering problems, and life-changing events have been associated with it.
Epidemiology
The disorder is recognized as a neuroprogressive abnormality with a cumulative risk of relapse for every new episode and with increasing cognitive disabilities during the course of illness. It affects nearly 1% of the population globally and is the chief cause of hospitalizations, health care expenditures, and suicide (Oedegaard et al. 2). The onset of bipolar disorder is projected to be 25 years, and roughly 34% individuals have an inception under the age of 19 years. Studies have found a “bimodal distribution of age onset, with a peak in late teenage and a minor, but yet substantial, peak in mid-life” (Kessing et al. 544). It affects people from all races and backgrounds equally.
Signs and Symptoms
The symptoms of bipolar disorder depend on the mood being felt and may last several weeks. Early prognostic signs include depression, which is accompanied by a sense of worthlessness, hopelessness, and suicidal thoughts. The manic phase of the disorder is portrayed by extreme feelings of happiness, invigorated, having aspiring plans and big ideas.
Bipolar Disease and Pregnancy
The condition is likely to occur or worsen during or after pregnancy. It is imperative that any sign of depression and manic episode be diagnosed and treated accordingly. Risks of untreated perinatal bipolar disorder comprise preterm labor, underweight children, raised levels of fetal stress hormones, alterations in neurobehavioral function of the newborn, and effect on mother-infant binary exchanges. Careful examination is essential to distinguish between depression due to unipolar disorder and that due to bipolar disorder.
Treatment
The disorder is a highly treatable and manageable condition. Baldessarini and Tarazi note that “the backbone of clinical management of bipolar disorder is stabilization and prophylaxis by use of mood-stabilizing pharmacological agents to minimize both manic and melancholic symptoms” (1245). However, these therapeutic agents are more effective in the manic phase of the illness. Lithium is the mainstay of treatment with the strongest data for both efficacy and suicide prevention, even though reports of non-response to this medication among some patients have been documented (Mason et al. 4). In addition, a number of patients are intolerant to prolonged use of lithium due to side effects such as weight gain, acne, thyroid suppression, and renal impairment (Oedegaard et al. 3). Hence, efforts aimed at finding different antimanic and mood stabilizing agents have increased and borne fruits. Other mood stabilizers, developed as a result, include some anticonvulsants e.g., valproate, carbamazepine, and lamotrigine.
Atypical antipsychotics such as olanzapine, risperidone, aripiprizole and quetiapine are also efficacious. These drugs have been found to generate their mood-stabilizing effects through their actions on various biochemical pathways. For instance, they inhibit cAMP and cGMP production by catecholamines, inhibit inositol signalling mechanisms and other pathways involved in cell survival, and repress gene expression of several proteins involved in the pathogenesis of bipolar disorder.
Other forms of treatment include talking therapy that can help one to deal with depression, and provide advice on better socializing. In addition, lifestyle advice, i.e., regular exercise, improved diet and getting more sleep is helpful.
Conclusion
Even though bipolar disorder has many debilitating effects on the life of a patient, a good treatment program can curb mood swings and provide symptom relief. A combination of medication and psychotherapy is effective. Ongoing treatment, rather than dealing with problems as they arise, is preferable.
Works Cited
Baldessarini, Ross and Frank Tarazi. Pharmacotherapy of Psychosis and Mania: Goodman & Gilman’s the Pharmacological Basis of Therapeutics. McGraw- Hill, 2006.
Kessing, Lars Vedel, et al. “Life Expectancy in Bipolar Disorder.” Bipolar Disorders: An International Journal of Psychiatry and neurosciences, vol. 17, no. 1, 2015, pp. 543-548.
Mason, Brittany, et al. “Historical Underpinnings of Bipolar Disorder Diagnostic Criteria.” Behavioral Sciences, vol. 14, no. 6, 2016, pp. 1-19.
Oedegaard, Ketil, et al. “The Pharmacogenomics of Bipolar Disorder study (PGBD): Identification of Genes for Lithium Response in a Prospective Sample.” BMC Psychiatry, vol. 129, no. 16, 2016, pp. 1-15.