Bipolar Disorder: Symptoms, Diagnosing and Treatment

Introduction

The mental state is a topic of concern for many people worldwide. As psychological health became more researched, the real tendency of such illnesses has been revealed. Currently, there is one of four people who experienced mental disorders at some point in their lives. Bipolar disorder appears to be a part of the issue. Nowadays, approximately 1% of the worldwide population struggles to overcome such a state (Grande et al., 2016). Bipolar disorder is a severe mental illness characterized by extreme mood swings, and among people with this particular disorder, suicide is the number one cause of death.

Symptoms

Similar to the majority of mental illnesses, there is a variety of bipolar disorder types. Moreover, there are several related disorders such as mania, hypomania and depression. These symptoms can cause erratic mood and behavior swings, which usually result in lifelong hardships. Bipolar disorder of the first type is characterized by one manic episode followed by hypomanic or depressive episodes (Grande et al., 2016). In certain circumstances, the separate attacks can trigger a disconnection from reality called psychosis (Grande et al., 2016). Manic-depressive illness of the second type characterizes by having depressive and hypomanic episodes without experiencing a manic episode.

Furthermore, there is a cyclothymic disorder related to the illness mentioned earlier, and it is characterized by having at least two years of hypomania and depressive symptoms. However, they are less severe than in the case of two types of bipolar disorder. Other types of this mental disease include maladies related to substance abuse or specific medical conditions. Bipolar afflictions of two kinds are separate diagnoses since manic episodes of the first type possess more dangerous qualities (Grande et al., 2016). However, bipolar disorder of the second type can cause mental deterioration due to the more extended depressive periods.

Although some people think that mania and hypomania are the same symptoms of bipolar disorder, these are two distinct and different states, which have the same symptoms. However, mania is a more severe condition since it causes more noticeable issues with relationships or social events such as school, work, and others (Grande et al., 2016). Moreover, it usually triggers psychosis, which in most cases finalizes in the ill patient’s hospitalization. Psychosis makes one lose the touch with the reality, affecting the way the brain processes information.

Both episodes include some of these symptoms: increased energy levels, euphoria, decreased urgency to sleep, high levels of distractibility, poor decision-making, logorrhea. Nevertheless, the opposite episodes – major depressive ones can occur so severely that it negatively impacts a person’s life. Some of these symptoms can characterize this episode: dreary moods, hopelessness, emptiness, loss of interest in the previously appalling activities, either constant sleepiness or insomnia, increased fatigue levels, feeling constant guilt, suicide thoughts, inability to concentrate (Grande et al., 2016).

Treatment

Unless the person is treated appropriately, the symptoms of bipolar disorder are going to become more severe. Mania could last for 3 to 6 months, while depression – 6 to 12 months (López-Muñoz et al., 2018). However, with suitable treatment, the severity of episodes decreases, making the illness more manageable. People who have bipolar disorder usually receive some of the following treatment: stabilizing medicine to reduce the durability of the opposite episodes, antidepressants. Patients also get other pills to treat the main symptoms as they are occurring, therapy sessions, and some lifestyle changes, such as eating healthier foods and adding regular exercise.

Most people affected by this particular disorder usually do not need to stay in medical facilities since they can receive all the necessary treatment outside of hospitals. However, if one’s symptoms are severe enough to fall under the Mental Health Act, there is a high probability that this person would be taken to hospital. Several medicines are aimed to stabilize the mood swings. For example, lithium, an anticonvulsant medication, the antipsychotic medication must be taken strictly under the doctor’s care. Depressive episodes tend to be treated slightly differently from actual depression since taking antidepressants can worsen a patient’s state in some cases.

Additionally, suppose a bipolar disorder should take lithium as the primary treatment, which is usually prescribed for six months. In that case, the lithium treatment has to be consistent, which is why a person should stick to the prescribed dose and not stop taking it without consulting a doctor first (López-Muñoz et al., 2018). For the practical usage of such medicine, the dosage has to be precise. While taking this drug, one should be careful and mind any side effects, and do regular blood tests to ensure that the organism did not have any damage.

Furthermore, there are medicines explicitly designed for manic episodes called anticonvulsant medication, including valproate, carbamazepine, lamotrigine. These drugs are often used to treat dangerous states such as epilepsy, but they also prove to be effective mood stabilizers (López-Muñoz et al., 2018). If the person does not respond to lithium alone, anticonvulsant medicines can be used as a practical addition (López-Muñoz et al., 2018). However, it is essential to note that women who take oral birth control should consider other contraception methods since these pills often contradict each other resulting in the loss of effectiveness for both.

As for antipsychotic medicines, they are used to treat manic episodes, and they include aripiprazole, olanzapine, quetiapine, risperidone. These medicines are used for severe symptoms of bipolar disorder that affect a person’s behavior negatively. These drugs can cause some inconvenient side effects, which include blurred vision, a dry mouth, weight gain, and in some cases sweating (López-Muñoz et al., 2018). Those who are prescribed these medicines usually need regular checkups, especially if one suffers from more than one health conditions that can deteriorate one’s health.

Effect on Day-to-day Function

This psychological disorder can bring distress into one’s day to day function since it affects relationships, workplace, school, and university functioning. A person with bipolar disorder suffers from extreme sadness during depressive episodes, leading to suicidal thoughts and actions. Moreover, while a person develops such a mental condition, one can experience excessive fatigue levels, which can ruin their productiveness at work, school, or relationships (Rowland & Marwaha, 2018). Additionally, during manic episodes, an individual could find it difficult to fall asleep, which can severely affect one’s responsibilities.

During the period of hyperactivity, one can potentially experience increased heart palpitations, high levels of energy. Therefore, during active episodes, a person with bipolar disorder can be extremely irritable, restless, resulting in ruining relationships due to not careful words or phrases. Nevertheless, depressive episodes can result in guilt, concentration difficulties, hardships in memorizing things, oversleeping. These mood swings can have a severe impact on one’s ability to function.

Etiology. Typical Age of Onset

The etiology of bipolar disorder can affect all genders, races, and social classes since there is little knowledge about the exact reasons this illness occurs and the main risk factors. The typical age of onset is between 15 and 25, but some people can start developing the first symptoms later in life, in their 30s or even 40s (Rowland & Marwaha, 2018). Bipolar disorder has a chance of occurring due to other conditions or traumas occurring in life. Bipolar disorder of the second type is more common among women; however, the bipolar disorder of the first type is equally prevalent both in men and in women (Rowland & Marwaha, 2018).

There are some correlations between thyroid hormones malfunctioning and depression, bipolar disorder. The reason for this correlation is in the hypothyroidism, or underactive thyroid, which has occurred within people with bipolar disorder.

Prognosis, What Is Thought to Be Happening in the Brain of the Individual of the Disorder

Bipolar disorder of the first type (BPD1) is hereditary in most cases. The neurological pathology, although it reveals itself in adolescence or later, starts developing before adolescence. The patients with confirmed BPD1 often engage in reward-seeking behaviors, which can lead to unhealthy obsessions and brain dysfunction called amygdala and ventral prefrontal cortex (PFC) (Rowland & Marwaha, 2018).

Amygdala is the brain’s reaction center, which tends to respond to outside threats and could be associated with quick emotional responses (Rowland & Marwaha, 2018). Dysfunctions of the PFC can include hyperactive emotional expressions within manic episodes, ventral PFC hypofrontality, hypersensitivity to external stimulations such as overreaction to rewards. During the depressive periods, patients with bipolar disorder showcase a striking change in their brain function. Due to the rapidness of changing, the mood and the state of a patient can become extremely unstable, which can end up in suicide. The inability to live with extreme and rapid mood swings is not a weakness; those people desperately need help and support.

Health Care Issues/Challenges to Providing Healthcare to Individuals with This Disorder

The essential part of treating the bipolar patient is in acknowledging the disease and treating them respectfully. Moreover, some pills tend to cancel the effects of antidepressants and mood stabilizers and vice versa. For example, as stated earlier, oral birth control and antidepressants tend to overlap, canceling both pills’ effects. Furthermore, it is vital to determine whether a person with bipolar disorder is having a manic or depressive episode, since both of these states tend to be treated differently.

What Should Healthcare Providers Keep in Mind

Moreover, it is important not to trigger the patient’s adverse reaction and be kind towards them and understand their particular situation. It could be a challenge since healthcare providers can possess a lack of knowledge of a specific person’s mental state, which can lead to inevitable consequences. Additionally, a healthcare professional has to keep in mind that these people can be over-talkative during manic periods, which should be treated respectfully. As for the depressive episodes, medical workers have to showcase support and understanding.

Conclusion

To conclude, mental health issues should be taken seriously since malfunctions in one’s brain cause them. Moreover, the patient has no control over the mood swings during bipolar disorder, which is why a medical professional has to be respectful and treat the patient with kindness and determination. Bipolar disorder is a common issue within the Earth’s population since it affects many of its inhabitants. It is a severe mental illness that should be treated with medicines, psychotherapy, and some changes within a person’s lifestyle.

References

Grande, I., Berk, M., Birmaher, B. & Vieta, E. (2016). Bipolar disorder. The Lancet, 387(10027), 1561-1572. Web.

López-Muñoz, F., Shen, W., D’Ocon, P., Romero, A. & Álamo, C. (2018). History of the pharmacological treatment of bipolar disorder. International Journal of Molecular Sciences, 19(7), 2143. Web.

Rowland, T. & Marwaha, S. (2018). Epidemiology and risk factors for bipolar disorder. Therapeutic Advances in Psychopharmacology, 8(9), 251-269. Web.

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