The phenomenon of bipolar affective disorder

The phenomenon of bipolar affective disease has been a mystery since the 16th Century. chronicle has shown that this affliction brush off appear in almost anyone. Even the Great lynx Vincent Van Gogh is believed to have had bipolar malady. It is clear that in our society some(prenominal) people live with bipolar illness however, despite the abundance of people pitiful from it, we be still waiting for decisive scores for the causes and cure.The one fact of which we atomic number 18 di sieveingly aw be is that bipolar incommode in earnest undermines its victims ability to obtain and of importtain affectionate and occupational success. Because bipolar disorder has such debilitating symptoms, it is imperative that we remain wakeful in the quest for explanations of its causes and treatment. Affective disorders argon characterized by a smorgasbord of symptoms that can be broken into frenetic and depressive episodes. The depressive episodes be characterized by intense tonicitys of sadness and hopelessness that can become feelings of hopelessness and helplessness. roughly of the symptoms of a depressive episode include anaerobia, disturbances in sleep and appetite, psychomotor retardation, red ink of energy, feelings of worthlessness, guilt, ifficulty thinking, indecision, and re menstruation thoughts of death and suicide (Hollandsworth, jr. 1990 ). The manic episodes atomic number 18 characterized by elevated or irritable biliousness, increased energy, decreased quest for sleep, poor savvy and insight, and often foolhardy or irresponsible behavior (Hollandsworth, Jr. 1990). bipolar affective disorder affects most one percent of the population ( somewhat triplet million people) in the United States.It is presented by both males and females. Bipolar disorder involves episodes of heat and drop-off. These episodes whitethorn alternate with profound epressions characterized by a pervasive sadness, almost softness to move, hopelessness, and disturbances in appetite, sleep, in concentrations and driving. Bipolar disorder is diagnosed if an episode of madness occurs whether depression has been diagnosed or not (Leiby,1988). Most commonly, individuals with manic episodes bugger off a period of depression.Symptoms include elated, expansive, or irritable mood, hyperactivity, pressure of speech, f open-eyed of ideas, noble-minded self-esteem, decreased need for sleep, distractibility, and excessive inter-radical communication in reckless activities (Hollandsworth, Jr. 1990). R best symptoms were periods of loss of all interest and retardation or agitation (Gurman, 1991). As the National Depressive and frenzied Depressive Association (MDMDA) have demonstrated, bipolar disorder can create substantial develop rational delays, marital and family disruptions, occupational setbacks, and financial disasters.This devastating disease causes disruptions of families, loss of jobs and millions of dollars in exist to society. umpteen times bipolar patient roles state that the depressions argon longer and increase in frequency as the individual ages. Many times bipolar states and psychotic states be isdiagnosed as schizophrenia. Speech patterns help chance upon between the two disorders (Turner,1989). The onset of Bipolar disorder usually occurs between the ages of 20 and 30 years of age, with a instant peak in the mid-forties for women. A typical bipolar patient may down eight to ten episodes in their lifetime.However, those who have fast cycling may experience much episodes of mania and depression that succeed each other without a period of remission (DSM III-R). The triplet stages of mania begin with sodium thiosulphate mania, in which patients stem that they are energetic, extroverted and ssertive (Hirschfeld, 1995). The hypomania state has draw observers to feel that bipolar patients are prone to their mania. Hypo mania progresses into mania and the convert is label by loss of judgmen t (Hirschfeld, 1995). Often, euphoric grandiose indications are displayed, and paranoid or irritable characteristics begin to manifest.The terce stage of mania is evident when the patient experiences delusions with often- paranoid themes. Speech is generally rapid and hyperactive behavior manifests sometimes associated with force play (Hirschfeld, 1995). When both manic and depressive ymptoms occur at the homogeneous time it is called a compound episode. Those afflicted are a extra risk because there is a gang of hopelessness, agitation, and anxiety that makes them feel like they could leaping out of their skin(Hirschfeld, 1995). Up to 50% of all patients with mania have a variety of depressed moods.Patients report feeling dysphonic, depressed, and unhappy yet, they exhibit the energy associated with mania. quick cycling mania is another foundation of bipolar disorder. Mania may be present with 4 or more than distinct episodes within a 12- month period. in that respect is now evidence to uggest that sometimes rapid cycling may be a transient manifestation of the bipolar disorder. This draw of the disease exhibits more episodes of mania and depression than bipolar. atomic number 3 has been the primary treatment of bipolar disorder since its introduction in the 1960s.It is main function is to stabilize the cycling characteristic of bipolar disorder. In four controlled studies by F. K. Goodwin and K. R. Jamison, the overall receipt rate for bipolar subjects inured with Lithium was 78% (Turner,1998). Lithium is excessively the primary drug use for long- term maintenance of bipolar disorder. In a majority of bipolar patients, it lessens the duration, frequency, and stiffness of the episodes of both mania and depression. Unfortunately, as some(prenominal) as 40% of bipolar patients are either unresponsive to atomic number 3 or cannot tolerate the situation effects.Some of the side effects include thirst, weight gain, nausea, diarrhea, and edema . Patients who are unresponsive to lithium treatment are often those who experience dysphonic mania, mixed states, or rapid cycling bipolar disorder. mavin of the bothers associated with lithium is the fact the long-term lithium treatment has been associated with decreased hyroid functioning in patients with bipolar disorder. Preliminary evidence as well kick up that hypothyroidism may actually lead to rapid-cycling (Gurman,1991).Pregnant women experience another problem associated with the use of lithium. Its use during pregnancy has been associated with alliance defects, particularly Ebsteins unusual person. Based on current data, the risk of a child with Ebsteins anomaly being born to a experience who took lithium during her first trimester of pregnancy is approximately 1 in 8,000, or 2. 5 times that of the general population (Leiby,1988). in that location are other effective treatments for bipolar disorder that are utilize in cases where the patients cannot tolerate lithium, or have been unresponsive to it in the past.The American Psychiatric Associations guidelines suggest the next line of treatment to be Anticonvulsant drugs such as valproate and carbamazepine. These drugs are useful as antimanic agents, especially in those patients with mixed states. Both of these practice of medicines can be used in combination with lithium or in combination with each other. Valproate is especially helpful for patients who are ithium noncompliant, experience rapid-cycling, or have comorbid alcohol or drug abuse. Neuroleptics such as haloperidol or chlorpromazine have also been used to help stabilize manic patients who are highly agitated or psychotic.Use of these drugs is often necessary because the response to them are rapid, but there are risks involved in their use. Because of the often crude(a) side effects, Benzodiazepines are often used in their place. Benzodiazepines can achieve the same results as Neuroleptics for most patients in damage of rapid control of agitation and excitement, without the unrelenting side effects. Antidepressants such as the discriminating serotonin reuptake inhibitors (SSRIs) fluovamine and amitriptyline has also been used by some doctors as treatment for bipolar disorder. A double-blind theater by M. Gasperini, F. Gatti, L. Bellini, R. Anniverno, and E.Smeraldi showed that fluvoxamine and amitriptyline are highly effective treatments for bipolar patients experiencing depressive episodes (Leiby,1988). This speculate is polemical however, because conflicting research shows that SSRIs and other antidepressants can actually decrease manic episodes. Most doctors can elate the usefulness of ntidepressants when used in coupling with mood stabilizing medications such as lithium. In addition to the mentioned medical treatments of bipolar disorder, there are several other options available to bipolar patients, most of which are used in conjunction with medicine. wizard such treatment is spark therapy. mavin hit the books compared the response to clear(p) therapy of bipolar patients with that of unipolar patients. Patients were free of psychotropic and mesmeric medications for at least one month before treatment. Bipolar patients in this study showed an average of 90. 3% improvement in their depressive ymptoms, with no incidence of mania or hypomania. They all continued to use crystalize therapy, and all showed a sustained unequivocal response at a three month follow-up (Turner,1998).Another study involved a four workweek treatment of bright morning light treatment for patients with seasonal affective disorder and bipolar patients. This study found a statistically significant decrement in depressive symptoms, with the maximum antidepressant effect of light not being reached until week four (Hollandsworth, Jr. 1990). Hypomanic symptoms were experienced by 36% of bipolar patients in this study. Predominant hypo manic symptoms included racing thoughts, dead soul sleep and ir ritability. Surprisingly, one-third of controls also substantial symptoms such as those mentioned above.Regardless of the explanation of the emergence of hypo manic symptoms in undiagnosed controls, it is evident from this study that light treatment may be associated with the spy symptoms. Based on the results, careful skipper monitoring during light treatment is necessary, thus far for those without a history of major mood disorders. Another popular treatment for bipolar disorder is electro-convulsive hock therapy. ECT is the favored treatment for earnestly manic large(predicate) patients and patients who are homicidal, psychotic, catatonic, medically compromised, or severely suicidal.In one study, researchers found marked improvement in 78% of patients treated with ECT, compared to 62% of patients treated only with lithium and 37% of patients who received neither, ECT or lithium (Gurman,1991). A final token of therapy is outpatient group psychotherapy. According to Dr. Joh n Graves, vocalism for the National Depressive and Manic Depressive Association has called forethought to the value f support groups, and challenged mental health professionals to take a more serious look at group therapy for the bipolar population.Research shows that group elaboration may help increase lithium compliance, decrease denial regarding the illness, and increase sensation of both external and internal stress factors leading to manic and depressive episodes. Group therapy for patients with bipolar disorders responds to the need for support and reinforcement of medication management, and the need for education and support for the interpersonal difficulties that arise during the course of the disorder.