After completing an abnormal psychology course, I walked away knowing that there were two mental disorders I would definitely not want: schizophrenia and bipolar disorder. Although there exists a wide spectrum of mental disorders which are unfavorable, many have far superior treatments. Bipolar and schizophrenia still have great lengths to achieve adequate treatment. Here is some information on the former:
Basic Overview: In the disorder formerly called manic depression, the person experiences altering stages of mania and depression.
Mania is a state where the person feels very energetic and “high on life”. Depending on the level of mania, this state can cause a person to become in trouble with their work, family, or the law. Symptoms include:
- Increased energy and restlessness
- Excessively “good” or euphoric mood
- Extreme irritability
- Racing thoughts and speech patterns, jumps quickly
- Inability to concentrate
- Reduction or complete elimination of sleep
- Unrealistic beliefs and thoughts, especially about what the person is able to do
- Poor judgment
- Spending sprees
- Increased sexual drive/ activity
- Reckless and aggressive behavior
- Abuse of prescription or nonprescription drugs
Depression on the other hand, is the opposite of the manic episode. The depression mimics standard depressive symptoms including:
- Feeling of helplessness or despair
- Loss of interest in activities that were once enjoyed
- Decreased energy
- Increase in sleep
- Change in appetite
- Chronic pain
- Thoughts of suicide or death
For someone who is bipolar, these two states fluctuate over a period of time. These periods usually last weeks or months, and do not typically change over a period of days. In both manic and depressive episodes, there is a spectrum that the person may experience. The most severe cases include psychosis, where the person will actually have hallucinations and delusions similar to a schizophrenic patient. The more mild cases include only hypomanic episodes, which typically just make the person seem a little more energetic and outgoing. This is why bipolar can be harder to diagnose, because hypomanic episodes are usually enjoyable by the person experiencing them and favorable to the people around the person.
Bipolar I: The classic form of the illness which alternates in full manic and depressive episodes.
Bipolar II: The form of illness that includes hypomanic and full depressive episodes.
Diagnosis: According to the DSM IV (Standardized criteria per the American Psychological Association), bipolar can only be diagnosed if there has been a recorded manic/hypomanic and depressive episode. However, if there is a strong family history and only a depressive episode has been recorded, the psychiatrist may still treat the patient as if he/she has bipolar.
Causes: As with any psychological disorder, there are many theories as to how bipolar is caused. Of all psychological disorders, bipolar has one of the highest genetic heritability rates. It may also be caused by a malfunctioning of certain neurotransmitters, including norepinephrine and serotonin. In addition, someone who is genetically primed for this disease may have the disease set off by certain environmental or psychological triggers.
Treatment: Bipolar is very difficult to treat because the medication for manic and depressive episodes differ. If in a manic state, the person will be treated with something to “bring them down”, however it cannot bring them so far down that they go into a depressive state and vice versa. As a result, combination medications are typically used, including antipsychotic medication, antidepressant medication, and mood stabilizers. In addition, it is a good idea for the patient to undergo psychotherapy.
Morbidity: About 5.7 million Americans, or 2.6% of the American population over the age of 18 has bipolar disorder.
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