Highs and Lows The Rollercoaster Reality Behind Bipolar Disorder
Thea Brisbane, Edgar Rodriguez, Isabella Rojas March 18, 2019
Table of Contents: Page 3- What is Bipolar Disorder? Page 5- The Chemical Makeup of Bipolar Disorder Page 7- A Case of Bipolar Disorder Page 9- Cures to Bipolar Disorder? Page 10- Summary Page 11- Trends in Bipolar Diagnoses Page 12- References
What is Bipolar Disorder? Bipolar disorder is a burden for about 5.7 million American adults or about 2.6% of the U.S population. Essentially, Bipolar disorder causes mood swings, affects energy, lowers activity levels, and limits the ability to carry out regular tasks. Bipolar disorder is divided into 4 different types: Bipolar 1 Disorder, Bipolar 2 disorder, cyclothymic disorder, and other unspecified Bipolar and Related Disorders. All of the types showcase similar symptoms. People with Bipolar depression tend to be extremely happy and full of energy or depressed and sad. An elated episode is considered a manic episodes while down periods are referred to as depressive episodes. Hypomanic episodes are manic episodes that are not as intense. During manic episodes, people become delusional and don't have the ability to come to their senses. Manic Periods can last anywhere from a few days to multiple moths. Sometimes depression comes after the manic episodes. This kind of cycle leaves people hopeless. Victims are faced with an unstable personality that unfortunately drives them to the ground. Those who are affected by Bipolar 1 have had at least one Manic episode in their lifetime. Bipolar 1 disorder usually comes with depression. Manic episodes and depressive episodes often cycle each other in Bipolar disorder. During manic periods people describe their moods as feeling high. With Manic episodes come Increased energy, excessive spending, and substance abuse. Bipolar 1 disorder tends to be genetic. Everyone that has Bipolar 1 disorder develops it by age 50. Symptoms come to light in the late teens to early '20s. Bipolar 2 disorder is quite similar to Bipolar 1 disorder. The difference is that Bipolar 2 disorder never gives people the extremely intense manic episodes. These episodes are referred to as hypomanic episodes. People that have Bipolar 2 disorder can usually live normal lives when they aren't mid episode. Similar to Bipolar 1 disorder, symptoms of Bipolar 2 disorder include: Flying from one idea to the next, having extreme self-confidence, loud speech,
increased energy, and lack of need of sleep. People that suffer from bipolar 2 and are mid hypomanic episode tend to be fun to be around and the life of the party. Unfortunately, those who have bipolar 2 disorder spend more time in depressive states than in hypomanic. Cyclothymic disorder, a type of Bipolar disorder consist of mild mood swings. The cyclothymic disorder comes with short periods of manic and depressive episodes. The mood swings never tend to reach extreme levels, people can live a normal life as the episodes don't last as long as Bipolar 1 and 2 disorders. Very few people are affected by this disorder. Symptoms begin in teens and young adults. These symptoms include mild depression and more serious mood disorders. No one is completely sure what causes Cyclothymic disorder and Bipolar disorder. Genetics tend to be a factor that determines who will have these types of disorders. Treatments for Bipolar depression are vigorous. Bipolar disorder is treated with three main types of medications. These medications include mood stabilizers, antipsychotics, and antidepressants. Treatment plans consist of a combination of different medications. A commonly used combination of drugs is lithium carbonate and valproic acid. Lithium carbonate shows significant results when dealing with mania. The lithium also shows remarkable results when limiting the occurrence of depression episodes. Valproic acid, a mood stabilizer, is also helpful in treating manic or mixed phases. People on these drugs need to be precisely monitored through clinical assessments and blood tests by doctors. When doses get too high the drug can be toxic to the human body which is why users need to be monitored. Antidepressants are controversial when it comes to treating bipolar depression due to their unreliable effects. Some antidepressants can trigger manic episodes induce depression, therefore, doctors tend to stay away from them when they aren’t in need.
The Chemical Makeup of Bipolar Disorder
Bipolar Disorder isn’t a personality disorder where it’s characterized by certain thought patterns and traits that can be overcome by oneself. It is a something that affects a person’s mood, motivation, energy, and ability to function like other people who do not suffer the disorder. People diagnosed with this Bipolar
Disorder go through intense and extreme mood changes that happen at different time periods and often work in a cycle. These intense and extreme mood changes are often called mood episodes. Mood episodes can be considered either manic or depressive (manic being the high and depressive being the low). People with Bipolar Disorder, other known as manic depression, have very fast paced minds along with mood swings that change very abruptly from mania to depression. The exact cause of Bipolar Disorder is unknown but many believe that it is caused by a chemical imbalance in the brain along with other factors such as genetics and the person’s environment. The brain uses countless numbers of chemicals that act as messengers to communicate with different parts of the brain and nervous system. The main chemicals that are responsible for controlling the brain’s functions are known as neurotransmitters which include serotonin, dopamine, and norepinephrine.
In the brain, serotonin helps regulate mood, social behaviour, appetite and digestion, sleep, memory, sexual desire, and function. Low levels of serotonin are often connected to depression, anxiety, panic attacks, insomnia, obesity, and many other problems. Dopamine is often considered the “feel good” hormone and is associated with the feelings of euphoria, bliss, motivation, and concentration. Increased levels of
dopamine can cause the feelings that people describe as the “mania” or “high” part of bipolar disorder. Norepinephrine is the neurotransmitter that is important to for attentiveness, emotions, sleeping, dreaming, and learning. A decreased level of this chemical in the brain can also be associated with major depression and the depressive episodes in manic depression which are considered the “lows”. These three neurotransmitters work together to create a balanced mood but if either one of these or all three of them were to increase or decrease, the person would experience the sensations of the “high and lows” that come from Bipolar Disorder
A Case of Bipolar Disorder Susie, a 20-year-old college student from the Midwest, grew up with overprotective and strict parents. She described her household as a “traditional Irish home”. Being the youngest of 5 children, Susie claims that she was very obedient and respectful. Growing up, the topics of boys, menstruation and sex were forbidden. She has never dated or had a steady boyfriend throughout her lifetime. Diagnosed with Bipolar I Disorder, Susie experiences mania and exhibits grandiose ideas. In 2011, she declared that the reason she did not menstruate was because she was of “a third sex, a gender above the human sexes”. She then told her friends that she is a “superwoman” who does not require pleasure and can procreate without having sexual intercourse. Another one of Susie’s “episodes” is that she believes she had switched bodies with the senior senator of her state. She would go around campus and lecture people about her theories and how she saved the world from nuclear destruction. Susie is so deep in her maia that she went as far as campaigning for an election that wasn’t even scheduled around this time. She says that her next step is running for U.S presidency. Clearly, college has taken a toll on Susie’s mental health. She suffers from
insomnia and depression, and most days is unable to bring herself to class. She has had a poor appetite, difficulty concentrating, and has even contemplated suicide. Worried that she might forget her thoughts, Susie has begun writing notes everywhere including her dorm walls. Even her friends and family have noticed the change in Susie’s behavior. However, college is not the only factor contributing to Susie’s disorder. Depression runs in both the maternal and paternal sides of her family. Her grandfather was even treated with electroconvulsive therapy (ECT) which aids with depression. The first step to Susie’s diagnosis is figuring out what she is suffering from. Her ongoing episodes, as stated in the above paragraphs, are believing she is a superwoman without sexual tendencies, swapping lives with the senior senator, and campaigning for a nonexistent presidency. Bipolar I Disorder entails extreme mania, depression, or a combination of both that lasts for over a week. Having an astute amount of mania that leads to instant hospitalization is also classified within Bipolar I. Susie’s psychologist, Tabetha Cooper, advises her to work with the McLean hospital. They are known for their studies on neurotransmitters related to brain disorders. Cooper believes that the McLean hospital can gain insight from Susie’s psychotic episodes and ultimately help cure her bipolar disorder.
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Cures to Bipolar Disorder?
Medical professionals have yet to find the cure for bipolar disorder. However, there are certain treatments and medications to suppress it. Prescription drugs such as mood stabilizers, antidepressants, and antipsychotics all treat manic, depressive, and mood episodes. Psychotherapy is the first resource that doctors suggest. This is also known as talking therapy or counseling and can take forms of cognitive behavioral or family therapy. Outpatient treatment takes the forms of support groups, interventions, etc. Inpatient treatment happens inside a hospital or facility where the patient is monitored for mood instability. Dual drug treatment coincides with bipolar disorder and substance abuse. This treatment is most necessary amongst those who have substance abuse running in the family.
https://www.everydayhealth.com/bipolar-disorder/guide/treatment/
Summary
Bipolar Disorder is a mental health issue that involves a constant cycle of periods of mania and depression. The periods of mania include feelings of euphoria, excess energy, poor judgment, risk taking activities, reduced need for sleep and other out of the ordinary actions/emotions. The depressive episodes include feelings of sadness, anxiety, loss of interest in normal day to day activities, no motivation, either no appetite or too much eating, and many other negative side effects. The periods of time for each of these episodes depends on the person but typically they can last from days to weeks or to even months. Depending on the severity of someone’s mood episodes and the duration of these episodes, a person can be diagnosed with 4 different types of Bipolar Disorder . This disorder comes from an unbalance of chemicals in the brain but it can also result from genetics and depending on the person, their environmental factors. There is no cure to this manic depression but there are treatments such as different types of therapies, medication to balance the levels of serotonin, dopamine, and norepinephrine in the brain, supportive care, and seeking help from specialists.
Trends in Bipolar Disorder Diagnoses
In the graph above we see who is affected by Bipolar disorder. Overall 2.8 percent of the United States population is affected. Of the 2.8 percent, there is a relatively equal number of men and female, meaning that Bipolar disorder does not affect one gender specifically. However, Bipolar disorder is relative to age. The graph depicts how Bipolar disorder is more prevalent in young adults ranging in ages from 18-29 years old. The older a person is the least likely it will be for them to develop Bipolar disorder.
References Bipolar Disorder. (n.d.). Retrieved from https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml “Bipolar Disorder.” National Institute of Mental Health, U.S. Department of Health and Human Services, www.nimh.nih.gov/health/statistics/bipolar-disorder.shtml. “Bipolar Disorder Treatment.” WebMD, WebMD, www.webmd.com/bipolar-disorder/guide/understanding-bipolardisorder-treatment#1. “Collection of Messy Room Cliparts (40).” Free Messy Room Cliparts, Download Free Clip Art, Free Clip Art on Clipart Library, clipart-library.com/messy-roomcliparts.html. Doheny, K. (n.d.). 8 Bipolar Myths: Symptoms, Mania, Diagnosis, Statistics, and More. Retrieved from https://www.webmd.com/bipolar-disorder/features/8-myths-aboutbipolar-disorder#1 “Ethnomedical Approach.” Bipolar Disorder, anp204-peter947.weebly.com/ethnomedical-approach.html. Hall, Elizabeth. “The Case Study of Susie: Bipolar I Disorder.” Criminology & Justice, 1 Jan. 1970, criminologyjust.blogspot.com/2011/08/case-study-of-susie-bipolar-idisorder.html#.XI6edShKjIU.
Harvard Health Publishing. “Bipolar Disorder.” Harvard Health, www.health.harvard.edu/newsletter_article/Bipolar_disorder. Team, Spine. “Bipolar Disorder: Are You (or Is Someone You Love) at Risk?” Health Essentials from Cleveland Clinic, Health Essentials from Cleveland Clinic, 25 July 2018, health.clevelandclinic.org/bipolar-disorder-are-you-or-is-someone-youlove-at-risk/. Verywell mind. (2019). Bipolar Disorder. Retrieved from https://www.verywellmind.com/bipolar-disorder-4157274
What Are Bipolar Disorders?, www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolardisorders.