Bipolar Disorder

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Bipolar Disorder

Basic Characteristics

  • Description

Bipolar disorder is a mood disorder marked by periods of elevated or depressed moods also known as manic and depressive episodes. These episodes are normally broken up by periods of normal moods. A depressive phase may be marked by feelings of sadness, guilt, anger, isolation, and hopelessness. Disturbances in sleep and appetite along with a loss of interest in previously enjoyed activities is also common. A manic phase appears with increased energy and a decreased need for sleep as well as racing thoughts and a tendency to indulge in substances such as drugs or alcohol. A manic person may be described as euphoric, aggressive, and highly irritable. If a person's mood is alternating rapidly (more than four episodes per year) they are experiencing what is known as rapid cycling. In extreme cases psychotic symptoms may appear in the form of delusions or hallucinations. Four subdivisions of the disorder exist: bipolar I, bipolar II, bipolar disorder NOS, and cyclothymia. Diagnosis is based on self reports and reports from family, friends, and co-workers. Secondary symptoms are observed by professionals such as clinical psychologists, psychiatrists, and nurses. The presence and duration of symptoms is also a key component of the diagnosis. Onset for the disorder most often occurs near late adolescence and early adulthood. While there is yet to be a specific identifiable cause for bipolar disorder a person's genetics, early environment, neurobiology, and psychological and social processes are considered significant contributors. Neurocognitive deficits in visuospatial/constructional, executive function, and motor domains have been associated with bipolar disorder. Treatment for this disorder is generally a combination of medication or "mood stabilizers" to prevent further episodes, and counseling. Significant cognitive impairment and creative abilities are often associated with bipolar disorder.

  • History

Bipolar disorder is considered one of the oldest known mental illnesses dating back to medical records of the second century.Jules Falret, developed the term "folie circulaire", circular insanity, to refer to the link between depression and suicide. He was also the first to make the distinction between moments of depression and heightened moods. In 1875 his research findings set the stage for what was known as Manic-Depressive Psychosis. He was also responsible for noting the genetic component of the illness through his observations of substantial family prevalence of the disorder. It was Emil Kraeplin in 1913 who finally coined the term manic-depressive. People who received this diagnosis throughout the 1960's were institutionalized with little financial aid because congress refused to recognize manic depression as a legitimized mental illness. In 1980 bipolar disorder replaced manic-depressive disorder as a diagnostic term in the DSM. Since then, research has lead to the distinction between adult and childhood bipolar disorder. More research is needed to investigate the causes of bipolar disorder and to find effective methods of treatment.

  • References

MacQueen et al, 2005. The phenotypes of bipolar disorder: relevance for genetic investigations PMID 15970930

Frantom et al, 2008. Neurocognitive endophenotypes for bipolar disorder PMID 18402627

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