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Bipolar Disorder: The History, Causes, Symptoms, a

nd Treatments
Caleb Carter
University of Houston

Abstract:
Bipolar disorder is a very serious mood disorder. It is a mental health disease that interferes with a person’s ability to live a healthy life. Although many people go through highs and lows, people with bipolar disorder gothrough major peaks and valleys called “episodes”.They experience happiness, sadness, hope, despair, and many other moods on the opposite ends of the spectrum.Diagnosing bipolar disorder is challenging because many of the people suffering from it don’t realize that their extreme mood swings aren’t normal; and the people who interact with the person suffering from the disorder don’t recognize the symptoms. They simply characterize the person as being moody or temperamental. If a person is pointed in the direction of a doctor, they will receive a psychological assessment that will help determine whether or not they are suffering from bipolar disorder.The treatments for this diseaseconsistmainly of a combination between various medications and psychotherapy.Medications are helpful because they can stabilize the mood of the individual;while psychotherapy is effective because it can help the person better understand their disorder,which will enable them to better deal with it.There is no evidence that shows this disease effects one gender or race over another, but it is believed that people with substandard or stressful home lives are more likely to develop this disease. If properly treated, people can live their entire lives with minimal episodes. But because thereis no cure for bipolar disorder,even the best treatment can’t rid them of some of the symptoms associated with this disease. Dealing with this disease is a full time job that can’t be successfully done without the support of friends and family. It is important for people suffering from this to disease to feel as if they have people to lean on when necessary. Bipolar disorder is a complicated disease that is not easy to explain. Researchers are making strides to continue to broaden their knowledge of the disease. This will help doctors and mental health professionals in treating the disease, which in turn, will improve the lives of the millions of people who suffer from bipolar disorder.

Introduction:
Bipolar disorder is a complex disease that affects people worldwide. In order to understand this disease, one must understand its’ origins, process of diagnosis, and the different types of treatments available for people suffering from it. It is also important tounderstand who it affects. Does it affecta specific race, gender, and age group, or if it’s completely random.A detailed explanation of the components of bipolar disorder will give one a clearer picture of this very complicated disease.
What is Bipolar Disorder:
Bipolar disorder, also known asmanic-depressivedisease(Healy 2008),is a personality disorder that affects the mood, behavior, and energy of the person suffering from it.People have suffered from mood disorders since the beginning of human existence. Theintroduction of theconcept of manic-depressive diseasecan be traced back to the 1850s (Healy 2008)However, in 1957 German psychiatrist Karl Leonhard was the first to use the sub classification “bipolar disorder” (Healy 2008).

People with bipolar disorder have extremechanges in emotions. They alternatebetween opposite ends of the emotional spectrums. They go from being upbeatand happy, to sad and hopeless(Peacock 2000). People with bipolar disorder ride an emotional roller coaster. In moodswings know as “episodes’, people’s emotions fly high, and plunge low. These moods are affected by the level of serotonin in ones system. Their highs and lows are known as mania and depression, respectively.A high level of serotonin in the body corresponds with episodes of mania, and a low level of serotonin in the body corresponds with episodes of depression (Manji & Zarate 2011).How long these episodes last usually depends on how severe the person’s case is. For some, episodes may last for a few days, while forothersit may take months to come out of an episode.People going through mania often feel like they are”on top of the world” (Peacock 2000). Nothing can affect their level of excitement and energy, or their positive attitude.People in mania have so much energy, that they go days without sleeping. They are so optimistic about the world that they have countless ideas of all of the things they want to achieve. Thoughts race through their mind faster than they can even process them.They are irritable and are eager to start fights or arguments.Sometimes people with bipolar disorder can’t remember having a manic episode. When they aretold about an episode, they feel as if someone is playing a trick on them.
While a manic episode is filled with delusions of grandeur, an episode of depression is filled with feelings of inadequacy and hopelessness.Peoplelose interest in everyday activities and have difficulty focusing or making decisions (Peacock 2000).An episode of depression can even have effects on a person’s health. Theyunintentionally gain or lose weight because of their eating habits. They suffer from aches and pains that aren’t the result of any actual injury.During an episode of depression, many people suffering from bipolar disorder will no loner be able to function in daily life. They become unable to go to work or school and spend substantial amountsof time at home (Peacock 2000)Some people episode is so severe that they see suicide as the only way to escape from their emotional pain.

Who does it affect:
Bipolar disorder is a fairly common disease, it affects 1 in 100 people (Aiken 2010).There is no evidence that shows it affects one genderor racemore than the other and it can develop at any age (Peacock 2000). The firsts signs and symptoms usually appear in the late teens or early twenties, with the illness taking many years to fully develop (Aiken 2010).Sometimes a person can go years with an untreated case of bipolar disorder because they don’t realize that their highs and lows aren’t normal. They think it’s something that everyone goesthrough as just a part of life.Because more Hispanics and African Americans live in poverty in the United States, their home conditions are more likely to provide the stress and traumatic experiences that may trigger this disease. However, there isno evidence that supports the thought that bipolar disorder is more prevalent in any one race.

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Bipolar Disorder has been genetically linked with depression. About 80 to 90 percent of people with bipolar disorder are related to someone who suffers from depression (Peacock 2000).
If left untreated, bipolar disorder canseverelyaffecta person’s life. The extreme mood swings can interferewith people’s ability to hold down a job.People with bipolar disorderhavea hard time maintaining relationships with people because they are looked at as narcissistic and unpredictable(Owen 2008)Bipolar disorder also affects a person’s family. The family members of those suffering from bipolar disorder don’t know how to deal with the uncontrollable mood swings.

Diagnosis:
Bipolar disorder is diagnosed based on the criteria found in the most updated edition of the Diagnostic and Statistical Manual for Mental Disorders. In order to be diagnosed with bipolar disorder a patient has tocurrentlyshowor have shownthe majority of the symptoms listed in the manual. There are guidelines that say how recent the symptoms of bipolar disorder must have be present, as well as how long they were present.Another method mental health professions use to diagnose bipolar disorder is by using the Mood Disorders Questionnaire (Soares ; Young2007).If a person responds to more than half of the questions with positive response, they are said to have a level of sensitivity (Baldassano 2005), making it more likely that they suffer from a mental disorder.Because it is a mental illness,bipolar disordercan’t be diagnosed by taking a simple blood test or brain scan. Therefore, a doctor has to go by the existence of symptoms and family history. The fact that most doctors don’t specialize in mentaldisorderssometimes makes it hard for them to actually diagnose patients.
When being diagnosed, the patients first go through an initial assessment. In this assessment,a mental health professional asks patients about their symptoms for information on when they started, howlong they lasted, how prevalent they were, and is this the first time they’ve experienced them. They also ask what type of past treatment the patient was given for these symptoms, if any. As part of the assessment, doctors ask about what type of mental health disorders the patient’s family members suffer from. The patient may also be asked to go through a psychological or physical examination.
Mental health professionals know significantly more about bipolar disorder than we did twenty and even ten years ago. In present day, doctors have a good understanding on how to diagnose and treat bipolar disorder with medication and psychotherapy. Brain imaging techniqueshelp scientists locate the parts of the brain that are associated with mood (Leonard 2012). Scientists regularly make new discoveries about bipolar disorder and new medications are being developed and tested all the time. These developments give hope to the people suffering from bipolar disorder, that they will one day be able to live normal lives.

Symptoms:
Symptoms of bipolar disorder can be changes in the mood or behavior of an individual.One of the main symptoms associated with bipolar disorder is hallucination(Miklowitz 2010).Hallucinations can be visual, auditory, olfactory, and tactile. Visualhallucinations occurwhen someone sees things that are not actually present. An example of an auditory hallucination would be when someone hears voices inside their head. Olfactory hallucinations are when someone smells odors that aren’t present, odors that are most likely unpleasant. Tactile hallucinations occur when someone feels they are being touched, or feels as if bugs are crawling on their skin. Delusion is another symptom of bipolar disorder(Miklowitz 2010).Delusion is a set belief that is false and sometimes irrational. Even with evidence that their beliefs are not accurate, people suffering from bipolar disorder who are delusional, will refuse to accept any belief other than their own. Another symptom of bipolar disorder is suicidal ideation(Miklowitz 2010). This is when a person has regular thoughtsabout suicide, with some thoughts being as deep as actually coming up with a plan to carry out their suicide.Insomnia is also another common symptomof bipolar disorder(Miklowitz 2010).Insomniais characterized as a person having a very difficult time falling asleep, or sleeping through the night. Some people with insomnia even go to sleep for four hours and wake up to start their day, thinking they have slept for a full eight.
Other examples of mood changing symptoms are, long periods of unexplained joy, being overly happy, being irritable, easily agitated, feeling jittery, feeling worried or empty, and a loss in the interest of normal day-to-day activities (Peacock2000).Some other examples of changes in behavior are, being easily distracted, restlessness, impulsive behavior, risk-taking behavior, jumping from idea to idea, feeling tired, or being unwillingto eat(Peacock 2000).


Treatment:
Although there is no cure for bipolar disorder, with treatment, people who suffer from this disease can better control the symptoms associated with it. Themost common treatment for bipolar disorder is medicationprescribed by psychiatrists(Soares & Young 2007).These medications areusuallyin the form of mood stabilizers like Valproic acid, Lithium, Lamictal, Neurontin and Topamax(Soares & Young 2007).The downside to thisform of treatment is thatthese medications often makepatients emotionally numb and zombie like.
An alternative to treatmentby medication is psychotherapy. This type of treatment can be effective in helping the patient and his or her family members cope with the reality of the situation. This type of treatment also educates those affected by this disease, sometimes making it easier to deal with it. The two main types of psychotherapy treatments are Cognitive behavioral therapy, which helps people change their behaviors, and Family focused therapy which helps family members learn how to better handle being in the life of the person affected by teaching them how to recognize the changes in moodsand identify oncoming episodes(Soares & Young 2007).


Causes:
There is no exact cause for bipolar disorder. Scientists believe than many tings come together to cause the disease. Most people believe that a main factor in the disease is a person having a chemical imbalance of some sort. This is because chemicals known as neurotransmitters control the function of the brain and if a person has too many of a certain type of neurotransmitter, it can cause their brain to function abnormally(Peacock 2000).

Genetics also play a major role in the development of bipolar disorder. If an identical twin has the disease, the other twin has a very high chance of also suffering from it(Peacock 2000).However, just because somebody is genetically linked to the disease doesn’t mean they will have it, genetics only increases the chances. The common believe is that some sort of stress or traumatic event, as well as a combination of genetic and environmental factors are needed to bring about the onset of the disorder.
Prognosis:
Because there is no cure for bipolar disorder, people who suffer from it must live with it for the entirety of their lives.Therefore, their only option is to seek treatments that will help them control the symptoms. These treatments help most people function normally in society and in some special cases, these treatments actually prevent some from ever having another episode (Miklowitz2010). What’s most important is having family members who will support the person affected. These family members can learn how to spot the signs of oncoming episodes and get the immediate help that they need in order to prevent a relapse. The people who don’thave supportive family members struggle to overcome oreven cope with the disease(Miklowitz 2010).Their episodes are magnified because of their feelings of loneliness.
Concusion:
Bipolar disorderis a brain disorder that causes uncontrollable shifts in mood. It affects a person’s attitude about life as well as their ability to function normally. The causes of bipolar disorder are not fully understood. It has been linked to genetics but it does not always run in the family. The late teens to early twenties are usually the ages where the symptoms become the most intense. Because of the difficulties with diagnosing bipolar disorder, people can suffer for years before they are finally treated. It is a long term disease that requires a lifetime commitment to fighting it.
References:
Aiken, C. (2010) Family Experiences of Bipolar Disorder: The ups, thedowns and the bits in between. Philadelphia, Pennsylvania: JessicaKingsley Publishers.

Baldassano, C. F. (2005). Assessment tools for screening and monitoringbipolar disorder. Bipolar Disorders, 78-15. doi:10.1111/j.1399-5618.2005.00189.x
Duffy, A. (2010). The Early Natural History of Bipolar Disorder: What WeHaveLearned From Longitudinal High-Risk Research. CanadianJournal OfPsychiatry, 55(8), 477-485.

Healy, D. (2008). Mania: A short history of bipolar disorder. Baltimore:Johns Hopkins University Press.

Leonard, B. (2012). Understanding Brain Diseases and Disorders: BipolarDisorder. New York: The Rosen Publishing Group, Inc.
Manji, H. K., & Zarate, C. A. (2011). Behavioral neurobiology of bipolardisorder and its treatment. Heidlberg: Springer.
Miklowitz, D. (2010). The Bipolar Disorder Survival Guide: What you andyour family need to know. New York :Guilford Press
Peacock, J. (2000). Bipolar Disorder: A roller coaster of emotions.Mankato, Minnesota: Capstone Press.Poon, Y., Chung, K., Tso, K., Chang, C., & Tang, D. (2012). The use ofMood Disorder Questionnaire.Psychiatry Research, 195(3), 111-117.doi:10.1016/j.psychres.2011.07.014
Owen, S. (2008). Bipolar Disorder: The ultimate guide. OneworldPublications.
Soares, J., Young, A. (2007). Bipolar Disorders: Basic mechanisms andtherapeutic implications. New York: Informa Healthcare USA, Inc.


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