The idea of learning about the nature of human health and diseases brought light to the fascinating and mysterious ailment that is bipolar disorder. It has often been thought that bipolar disorder has an unclear origin and is developed through a combination of both genetic predisposition and environmental exposure. However, there are a multitude of proposed genetic contributors. For example, there is mixed research regarding whether the paternal or maternal lineage is more genetically responsible for the inheritance or if it leans more into an environmental factor that triggers the disorder. The main reason that this disorder is so mysterious is that there are multiple theories of how the individual inherits the mutated gene which causes the drastic mood swings of great mania followed by extreme depression. Unfortunately, bipolar disorder can only be treated and not cured. Today, various treatments can aid the individual, but due to the disorder being a lifelong struggle, there is no cure.
The overarching concept of bipolar disorder consists of episodes of mania and depression that switch between one another in a short time span. This is a brain illness that causes multiple shifts in the individual’s behavior, energy, and appropriate/correct decision making. As more research goes on, there is more awareness of this disorder. It is very often misdiagnosed with depression. Even though both illnesses have depression in common as one of the symptoms, the difference between depression and bipolar is that bipolar also has great euphoria, which depressed patients don't experience. The prevalence of bipolar disorder worldwide is hard to gather, however, in the United States, studies have shown that there are more than 10 million people that face the struggle of the disorder. That is proportional to roughly four percent of the population. The reason the number is lower than other widespread mental illnesses such as Alzheimer's is that a lot of people are either misdiagnosed or don’t know or are in denial of thinking they have the disorder and don't receive proper medical help to control the life-changing symptoms. The most common age where it becomes more clear whether someone is mentally ill is late teens and early 20s. This is such a fundamental age for a person's mental growth and maturity where it is significantly visible to realize the symptoms rather than at a younger age where it could be excused for a form of slight attention-deficit/hyperactivity disorder or just childish behaviors. Being a young adult requires, and is expected, maturity and better decision making. It is commonly seen that due to unpredictable mood swings, individuals struggling with bipolar disorder are more prone to making worse decisions and even may get more physical towards another person. Even though both men and women are equally genetically capable of experiencing this psychiatric disorder, there is a more rapid cycle seen in females rather than males. Women have been seen to experience more significant depression as opposed to men. Studies have also shown that men’s first few episodes are manic. This could be due to character traits such as stereotypical beliefs that men fear to show they’re vulnerability when women are more open to express their sadness.
Due to bipolar disorder not having identical symptoms within each individual, two types roughly categorize to everyone's needs. Type 1 and type 2. Bipolar type 1 disorder is more focused on the strength in which the mood swings occur. If the mania and depressive episodes are abnormally significantly intenser, then that person would be categorized with type 1. Whereas, type 2 encounters more mellow mood elevations which are classified as hypomanic and less severe depression. Overall, the severity is what marks the difference between one another. Nonetheless, both types should be equally treated and not seen as less important.
After understanding the gravity and different ways of how this psychiatric disorder affects each person uniquely, it is now time to interpret and grasp the potential causes of bipolar disorder. The human brain is the most complex organ of the body, one of the hardest things for most scientists to fathom. Like many mental disorders, bipolar disease is one of which the cause is not one hundred percent scientifically proven yet. Most studies have concluded that it is a mix between nature and nurture. The term nature and nurture refer to genetic linked factors paired with exterior environmental exposure. It is commonly known that bipolar disorder is genetic, however, not completely confirmed. There have been hundreds of experiments done to try to prove which gene is passed down generations that cause this mental illness, but there isn’t only one theory. It is a mixture of predisposition genes that can then be expressed and triggered by environmental factors. Overall, the main element of bipolar disorder is the mood swings, the hippocampus area of the brain is in charge of memory as well as emotion. The emotional mood swings are controlled by neurotransmitters that release chemicals and regulate mood. Noradrenaline and serotonin are two brain chemicals that have been consistently tied back to psychiatric disorders like bipolar when not secreted appropriately by the body. If there is an imbalance with the release of these chemicals, this can be one of the causes of the disorder. Statistics have shown that if one parent has it, the child is at a 15-30% risk and if two parents carry the gene, there is a 50-75% risk. Overall, scientists have come to a common conclusion that the disease is not likely caused by only single mutated gene but believe that it is caused by small defaults in multiple genes that combine and increase the risk of developing the condition (NIH 2018) and as well mixed with stress, traumas and lifestyle habits.
An example of a lifestyle habit that associates with the disorder is the interrelationship between the disease and the abuse of drugs and alcohol. This illness has surprisingly high commonality with substance use disorder, more specifically alcohol use disorder (AUD). According to the US National Institutes of Health, more than 50% of people that have bipolar disorder have also been diagnosed with AUD. Individuals may turn to the overuse of alcohol to calm their feelings. This then ties done with the common behaviors usually seen with bipolar disorder like unacceptable judgment, aggressive actions, which then leads to poor decision making. Allowing those individuals to be a potential threat to themselves and others around them.
Environmental factors, in fact, can modify and change a person’s hormones and even their neurological state of living. It has been frequently seen that with bipolar disorder not only comes a faulty gene but almost more importantly, the jumpstart or trigger to the commencement of the illness. This jumpstart can be a variety of things, depending on the person. It can be as simple as a change in weather or a life-changing event like losing a loved one unexpectedly. Depending on the stakes or what occurred for the particular individual, it can determine the severity of whether the person would be diagnosed with type 1 or type 2. Of course, not every little stressful situation that happens in a person’s life will lead that individual to be bipolar, but, people who are more prone are allowing themselves to be at risk to be affected by a non-genetic factor.
Having seen first-hand someone who had experienced a very traumatic event of their father dying at a young age, really puts all the pieces together. This child had severe ADHD and then was faced to overcome this emotional obstacle of living without a father. At first, no one knew he was bipolar, however, as the years went by, the young boy became a young adult. He began to act impulsively and violently causing himself to get into trouble, and feeling intense highs and lows. After, he realized that he wasn't only facing a difficult moment of his life he now had to come to terms and understand he was mentally ill and diagnosed with a lifelong disease like bipolar disorder.
The toughest complication of all is when it comes to treating bipolar disease. The most common mistake a lot of doctors and patients make is they misdiagnose because this mental illness cannot be scientifically proven, there is no way to test whether a person has it or not neurologically. It is almost always mistaken for depression or temporary abnormal hormone changes. Even though hormones are genetically created, they are environmentally modified.
There are so many other factors that can lead family members or doctors to believe it is not bipolar disorder. Nonetheless, after years of examinations, it becomes clear which mental illness the patient may have. Several steps and methods doctors take to diagnose a patient are: looking at all of the patient's previous symptoms and medical history, asking the patient to fill out a mental health evaluation questionnaire which provides the doctor with more information on how the patient behaves in their every day, asking the patient to keep a record of their mood patterns, doctors will also definitely look at the family's medical background and see if anyone else, most likely a first-degree relative, has or had a similar experience, and lastly to cancel out other options, the doctor will proceed to do a physical examination which should eliminate other diseases like overacting thyroid or hyperthyroidism.
Once the patient believes they might have the mental illness, then decides to be seen by a Doctor, which leads to them correctly diagnosing the patient with the condition, they are now at the final step. The treatment. To get to the last stage, it usually can take years. All the previous steps are very time consuming which means that the patient with bipolar disorder has been suffering from the disease for a long time until they receive the correct treatment. Even though there isn't a cure, there are a couple of ways to help the person’s lifestyle and quality of life. Treatment usually consists of a combination of both medications and psychotherapy. Medication varies between patient to patient; everyone reacts differently. However, the most used medicines due to its success rate is Lithium. Lithium comes from a prophylactic agent that provides a long-term benefit for roughly two-thirds of people diagnosed with bipolar disorder and has also been proven to lower the rates of suicide amongst patients (National Collaborating Centre for Mental Health (UK) 2006). Psychotherapy treatment consists of different forms of therapy and supportive care. Therapy is a way to give comfort and reassurance to highlight that there is a better way to go about one’s day, but most importantly therapy is also a method to avoid medication if not completely necessary. Medicine does come with side effects; therefore, therapists will try everything possible before prescribing something. Supportive groups, cognitive behavioral therapy, psychoeducation, and family therapy are all very positive ways to make the patient believe in themselves. Not only does it boost their self-confidence but also reduce mood fluctuations and encourages good coping skills. The symptoms of bipolar disorder are very radical and can be potentially dangerous for the individual increases the risk of self-harm.
Hospitalization is the last barrier for a person with bipolar disorder to tackle. Hospitalization is required for a person where their mania and depression episodes are a hazard to themselves or others. As stated before, because bipolar I is more intense than type two, it is rarer to find cases in which the person will end in imitate hospital care (NIH 2018). Multiple studies have shown that when the person with the disorder takes their medication correctly, goes to all the forms of theory, such as family-focused therapy and cognitive behavioral therapy, statistics prove that the patient is significantly less likely to relapse and has lowered the rate for bipolar patients at hospitals. 86% of people who participated in a ‘patient-to-patient’ support group showed that there was also a reduction in hospitalization. Hospitalization is the most radical treatment a person can undergo.
All in all, bipolar disease is an incredibly vast disorder that, while has been greatly investigated, still has room for further research. The incredibly high prevalence of the disorder conveys the importance of looking into more treatment options. With the many discussed forms of treatment, which are comprised of a combination of both factors of nature and nurture, medicine, and therapy respectively, it is critical for researchers to continue to test different combinations of these to find the most effective solution. Because finding new substantial treatments may be time-consuming, it is equally as important to help such individuals with bipolar disorder to live an accommodating lifestyle in a manner that keeps up with the fast-pace and ever-changing era.
www.ncbi.nlm.nih.gov/books/NBK55366
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