The phenomenon of bipolar affective disorder

The phenomenon of bipolar affective illness has been a mystery since the sixteenth Century. History has shown that this affliction groundwork appear in almost anyone. tied(p) the Great painter Vincent Van Gogh is believed to have had bipolar disquiet. It is clear that in our society many people live with bipolar affection however, despite the abundance of people suffering from it, we ar still postponement for definite explanations for the causes and cure.The one fact of which we argon painfully aw are is that bipolar unsoundness in earnest undermines its victims ability to obtain and maintain social and occupational success. Because bipolar disquiet has such debilitating symptoms, it is imperative that we remain easy in the quest for explanations of its causes and interference. Affective disorders are characterized by a pastiche of symptoms that can be broken into manic and depressive occurrences. The depressive episodes are characterized by eager feelings of sadnes s and despair that can become feelings of hopelessness and helplessness. close to of the symptoms of a depressive episode include anaerobia, disturbances in sleep and appetite, psychomotor retardation, leaving of expertness, feelings of worthlessness, guilt, ifficulty thinking, indecision, and recurrent thoughts of death and suicide (Hollandsworth, Jr. 1990 ). The manic episodes are characterized by fantastic or irritating mood, increased energy, decreased need for sleep, poor understanding and insight, and much unheeding or irresponsible behavior (Hollandsworth, Jr. 1990). bipolar affective disorder affects approximately one percent of the population (approximately one-third million people) in the United States.It is presented by twain males and females. Bipolar disorder involves episodes of delirium and depression. These episodes may alternate with profound epressions characterized by a permeating sadness, almost inability to move, hopelessness, and disturbances in appe tite, sleep, in concentrations and driving. Bipolar disorder is diagnosed if an episode of mania occurs whether depression has been diagnosed or not (Leiby,1988). Most commonly, individuals with manic episodes check a period of depression.Symptoms include elated, expansive, or irritable mood, hyperactivity, pressure of speech, escape cock of ideas, inflated self-esteem, decreased need for sleep, distractibility, and excessive involvement in reckless activities (Hollandsworth, Jr. 1990). Rarest symptoms were periods of loss of all interest and retardation or inflammation (Gurman, 1991). As the National Depressive and Manic Depressive Association (MDMDA) have demonstrated, bipolar disorder can create substantial developmental delays, marital and family disruptions, occupational setbacks, and financial disasters.This devastating disease causes disruptions of families, loss of jobs and millions of dollars in cost to society. Many clock bipolar patients report that the depressions a re longer and increase in absolute frequency as the individual ages. Many times bipolar states and psychotic states are isdiagnosed as schizophrenia. Speech patterns help distinguish between the two disorders (Turner,1989). The fire of Bipolar disorder usually occurs between the ages of 20 and 30 long time of age, with a second peak in the mid-forties for women. A usual bipolar patient may induce eight to ten episodes in their lifetime.However, those who have quick cycling may experience much episodes of mania and depression that succeed separately other with out(p) a period of amnesty (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 marked by loss of judgment (Hirschfeld, 1995). Often, euphoric grandiose characteristic s are displayed, and paranoid or irritable characteristics begin to manifest.The third stage of mania is manifest when the patient experiences delusions with often- paranoid themes. Speech is usually quick and hyperactive behavior manifests roughtimes associated with personnel (Hirschfeld, 1995). When both manic and depressive ymptoms occur at the same time it is called a mixed episode. Those afflicted are a special risk because in that respect is a combination of hopelessness, agitation, and anxiety that makes them feel like 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 unhappy yet, they exhibit the energy associated with mania. Rapid cycling mania is another presentation of bipolar disorder. craziness may be present with four or more clear episodes within a 12-month period. There is now show to uggest that sometimes quick cycling may be a transi ent manifestation of the bipolar disorder. This form of the disease exhibits more episodes of mania and depression than bipolar. Lithium has been the primary feather give-and-take of bipolar disorder since its introduction in the 1960s.It is main solve is to stabilize the cycling characteristic of bipolar disorder. In four controlled studies by F. K. Goodwin and K. R. Jamison, the overall retort rate for bipolar subjects tempered with Lithium was 78% (Turner,1998). Lithium is also the primary drug apply for long- term fear 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 refractory to atomic number 3 or cannot tolerate the side effects.Some of the side effects include thirst, weight gain, nausea, diarrhea, and edema. Patients who are unresponsive to lithium word are often those who experience dysphonic mania, mixe d states, or rapid cycling bipolar disorder. angiotensin converting enzyme 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 lead to rapid-cycling (Gurman,1991).Pregnant women experience another problem associated with the use of lithium. Its use during maternal quality has been associated with birth defects, curiously Ebsteins unusual person. found on current data, the risk of a child with Ebsteins anomaly creation 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 effective treatments for bipolar disorder that are used in cases where the patients cannot tolerate lithium, or have been unresponsive to it in the past.The American Psychiatric Associations guidelines su ggest the next line of treatment to be Anticonvulsant drugs such as valproate and carbamazepine. These drugs are useful as antimanic agents, especially in those patients with mixed states. Both of these practice of medicines can be used 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 inebriant 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 involved 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 discri minating serotonin reuptake inhibitors (SSRIs) fluovamine and amitriptyline hydrochloride has also been used by some doctors as treatment for bipolar disorder. A double-blind study 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 study is controversial however, because opposed research shows that SSRIs and other antidepressants can actually come down manic episodes. Most doctors can see the usefulness of ntidepressants when used in conjunction with mood stabilizing medications such as lithium. In appendix to the mentioned medical treatments of bipolar disorder, there are several other options accessible to bipolar patients, most of which are used in conjunction with medicine.One such treatment is light therapy. One study compared the response to light therapy of bipolar patients with that of unipolar patients. Pati ents were free of psychotropic and hypnotic medications for at least(prenominal) one month before treatment. Bipolar patients in this study showed an mean(a) of 90. 3% improvement in their depressive ymptoms, with no incidence of mania or hypomania. They all continued to use light therapy, and all showed a carry on positive response at a three month recap (Turner,1998).Another study involved a four week treatment of bright morning light treatment for patients with seasonal affective disorder and bipolar patients. This study found a statistically significant decrease 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 included racing thoughts, dead soul sleep and irritability. Surprisingly, one-third of controls also developed symptoms such as those mentioned above. careless(predicate) of th e 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, until now for those without a history of major mood disorders. Another popular treatment for bipolar disorder is electro-convulsive hock therapy. electroshock is the preferred 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 type of therapy is outpatient company psychotherapy. check to Dr. John Graves, spokesperson for the National Depressive and Manic Depressive Association has called attention to the r ange f support groups, and challenged mental health professionals to take a more serious look at group therapy for the bipolar population.Research shows that group participation may help increase lithium compliance, decrease disaffirmation regarding the illness, and increase awareness of both external and internal stress factors star(p) 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 arise during the course of the disorder.