Manic Depression Essay, Research Paper

From high to low. From exhilaration to despair. From wildness to apathy. These are the extremes associated with bipolar disorder, which can be a serious and disabling mental illness. The condition is also known as manic-depressive illness (from manias on the one extreme to depression on the other).

Bipolar disorder affects a likely 1 percent to 5 percent of adults in the United States. It often begins in adolescence or early adulthood and may continue for life.

Its causes are vague, and there is no cure. But it can be managed. Left untreated, the condition usually gets worse. The flares of bipolar disorder may last for weeks or months, causing great turmoil in the lives of the affected person, friends and family.

Signs and Symptoms

Bipolar disorder is characterized by an alternating pattern of emotional highs (mania) and lows (depression). The intensity of the signs and symptoms varies. Bipolar disorder can range from a mild to a severe condition.

For many, the manic signs and symptoms include:

+ Feelings of euphoria, extreme optimism and inflated self-esteem

+ Rapid speech, racing thoughts, agitation and increased physical activity

+ Poor judgment and recklessness

+ Difficulty sleeping

+ Tendency to be easily distracted

+ Extreme irritability

In the depression phase, signs and symptoms include:

+ Persistent feelings of sadness, anxiety, guilt or hopelessness

+ Disturbances in sleep and appetite

+ Fatigue and loss of interest in your daily activities

+ Difficulty in concentrating

+ Recurring thoughts of suicide

Causes

Doctors and researchers don’t know just what causes bipolar disorder. But a range of biologic, genetic and environmental factors seem to be involved in causing and triggering episodes of the illness. Evidence indicates that differences in the chemical messengers between nerve cells in the brain (neurotransmitters) occur in people who have bipolar disorder. In many cases people with bipolar disorder may have a genetic disposition for the disorder. The abnormality may be in genes that regulate neurotransmitters. Another factor that may contribute to bipolar disorder is drug abuse. Stressful or psychologically traumatic events may act as triggers for episodes of bipolar disorder.

Risk Factors

Bipolar disorder tends to run in families. More than two-thirds of people with the illness have at least one close relative who has experienced either bipolar disorder or major depression. Researchers are attempting to categorize genes that may make people at risk to bipolar disorder.

When to Seek Medical Advice

People with bipolar disorder often don’t recognize how impaired they are in addition to how greatly the disorder is affecting their lives and the lives of others. Friends, family and primary care physicians are important in recognizing possible signs of bipolar disorder and encouraging the person to look for professional help. If a family member or friend shows the apparent signs of bipolar disorder, encourage that person to seek the care of a psychiatrist.

Diagnosis

Your doctor may ask you or a family member who has accompanied you about your signs and symptoms and to describe apparent episodes of mania and depression. Diagnosis also involves ruling out other mental health situations that may produce some symptoms similar to bipolar disorder. These may include other mood disorders, sometimes schizophrenia, attention-deficit/hyperactivity disorder or borderline personality disorder.

You may also undergo tests to see if your mood swings are because of to physical causes, such as:

+ Substance abuse. Abuse of alcohol, marijuana and cocaine may affect your moods.

+ Thyroid disorders. A blood test for thyroid function can determine whether you have a thyroid disorder, such as an underactive thyroid.

Your doctor may also ask about your use of medications. Certain medications counting corticosteroids, such as prednisone, and medications used to treat depression, anxiety and Parkinson’s disease can cause mood swings.

Complications

Bipolar disorder isn’t as black-and-white as it may sound.

People with bipolar disorder may be affected by other troubles as well, such as anxiety disorder or alcoholism. The length, severity and frequency of mood swings vary from person to person. Sometimes there is rapid cycling in bipolar disorder, with more frequent and shorter periods of mood disturbance.

It’s also possible for mania and depression to be present at the same time. In this mixed state, you may experience combinations of agitation, disturbances in sleep and appetite, psychosis a major mental disorder in which the personality is disorganized and contact with reality is impaired and suicidal tendencies.

Treatment

Medication and psychotherapy are the main treatments. Seldom, electroconvulsive (shock) therapy (ECT) also is used.

+ Medication. Most people with bipolar disorder take medication to regulate their moods. Lithium has been widely used as a mood stabilizer. Another drug widely used as a mood regulator is the antiseizure medication, valproic acid (Depakote). Sometimes, antidepressant medications also are used to treat bipolar disorder. These may include paroxetine (Paxil), fluoxetine (Prozac), sertraline (Zoloft) and bupropion (Wellbutrin). You may need to take medications for 4 to 6 weeks before they reach their full effect.

+ Psychotherapy. This approach often is used with medication. Your therapist will help you detect patterns leading up to episodes of bipolar disorder, trying to identify triggers for the episodes. These patterns might include your use of medications or anything that happens to you physically or emotionally. Psychotherapy helps provide strategies for managing stress and coping with uncertainties. This, along with basic education about the nature of the disorder, helps you understand why you may well need to keep taking medication over many years.

+ ECT.This form of treatment mainly is used for episodes of major depression associated with suicidal tendencies or when using medication has proven to be ineffective. In this therapy, electrodes are taped to your head. Then, while you’re anesthetized and after you’ve received a muscle relaxant, a small amount of electrical current is passed through your brain for less than a second. This current produces a brain seizure, but because of the muscle relaxant your body remains calm. ECT profoundly affects brain metabolism and blood flow to various areas of the brain. But how that correlates to easing depression remains unknown. ECT works quickly usually showing a response after several treatments, generally within the first week and significantly lowers the risks of untreated depression, including suicide.

Self-Care

Bipolar disorder isn’t an illness that you can care for on your own. But you can do some stuff for yourself that will bolster your treatment program:

+ Take your medications. Even if you’re feeling well, resist the temptation not to take your medications. If you stop, you may again encounter signs and symptoms of bipolar disorder.

+ Pay attention to warning signs. You and your therapist may have identified a pattern to your episodes of bipolar disorder and what triggers them. Call your doctor if you feel you’re facing an episode. Involve family members or friends in watching for warning signs.

+ Avoid drugs and alcohol. Drugs, especially stimulants including diet drugs, and alcohol may be part of what triggers episodes of bipolar disorder.

+ Check first before taking other medications. Call the doctor who’s treating you for bipolar disorder before you take medications prescribed by another doctor. Sometimes other medications trigger episodes of bipolar disorder or may interact with medications you’re taking for bipolar disorder.

Coping Strategies

Self-help organizations have become potent allies for people who are coping with mental illness or who care about someone with such an illness. For bipolar disorder or other mental illnesses, self-help groups include the National Mental Health Association (NMHA) and National Alliance for the Mentally Ill (NAMI).

The NMHA is based in Washington, D.C., and has 340 affiliates in the United States. The group teaches the public and policy makers about mental health issues. The NAMI provides support and education to people with severe mental illness and their families. Founded in 1979, the group has more than 1,200 state and local chapters. The chapters rely on volunteers, most of whom have had mental illness in their families.

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