Bipolar disorder A summary of clinical issues and treatment options

Bipolar Disorder Bipolar disorder is one of the most common mental disorders in the United s, affecting a minimum of 2 million people in the country (CenterSite, 2000). This disorder is also commonly known as manic-depression. People with this disorder experience mood swings, from mania characterized by elation or irritability, to depression as characterized by sadness and hopelessness. Bipolar disorder usually starts during adolescence and continues throughout the life of the person afflicted with the disorder, affecting that person’s ability to normally function in the workplace and in family and social life.
Young and Klerman categorized bipolar disorder into: bipolar I, characterized by episodes of mania and major depression. bipolar II, which is characterized by hypomania and major depression. bipolar III, recognized through the presence of cyclothymia. bipolar IV, characterized by Antidepressant Induced Hypo/Mania. bipolar V, defined by major depression with a family history of bipolar disorder. and bipolar VI, which is defined by Unipolar Mania (as cited in Canadian Network for Mood and Anxiety Treatments [CANMAT], 1997). Bipolar I and II disorders are the most common of these types.
Bipolar I disorder is considered as one of the most severe mental disorders, and has around 15% risk of death by suicide if the illness remains untreated (Long, 2005). People with bipolar I disorder exhibit mood swings from full mania to major depression. During episodes of mania, the person is oblivious of risks and would engage in dangerous behaviors such as violence, substance abuse and sexual promiscuity (Griswold &amp. Pessar, 2000). Bipolar II disorder is characterized by recurring episodes of major depression and hypomania, a state in which the person shows a high level of energy, excessive moodiness or irritability, and impulsive or reckless behavior (CenterSite, 2001).
Studies suggest that bipolar disorder is usually hereditary. Studies also show brain abnormalities in the amygdala, the basal ganglia and prefrontal cortex as well as abnormal levels of serotonin, norepinephrine and dopamine (Long, 2005). If untreated, bipolar disorder could lead to substance abuse and dependence, failure in jobs, social dysfunction, violence and homicide, or suicidal tendencies (CANMAT, 1997).
Bipolar disorder has a physical and a psychological aspect, and the treatment to address the illness has to include both medication and psychotherapy in order for the patient to lead a normal life. Treatment for bipolar disorder usually requires lifelong attention and thorough examination from the physician and psychiatrist. It calls for strong collaboration between the physician and the psychiatrist so as to come up with the most accurate diagnosis, monitoring the patient for symptoms of psychosis, mood variations, violence and self-inflicted harm (Griswold &amp. Pessar, 2000).
Medication for manic-depressive patients may include mood stabilizers such as lithium, valporic acid (Depakene) and carbamazepine. Other drugs include antipsychotic agents for mania with psychosis or psychotic depression, benzodiazepine for sleep and sedation in mania or insomnia, and bupropion for bipolar depression (Griswold and Pessar, 2000). The prescription of medication to bipolar patients is a key element in the treatment of bipolar disorder, but this has to be developed through an accurate diagnosis determined from the history of the patient. Long (2005) emphasized that effective treatment involves a "combination of supportive psychotherapy, psychoeducation, and the use of a mood-stabilizer (often combined with an antipsychotic medication)." Bipolar disorder is often difficult to identify and is dangerous to the person affected if left untreated, thus thorough diagnosis and monitoring is required to aid the person suffering from the illness.
References
Canadian Network for Mood and Anxiety Treatments. (1997, April). Bipolar disorder: A summary of clinical issues and treatment options. Retrieved February 4, 2006, from http://www.mentalhealth.com/rx2/bp-can1.html.
Long, P. W. (2005). Bipolar I disorder. Retrieved February 3, 2006, from http://www.mentalhealth.com/.
CenterSite. (2001, October 24). Bipolar disorder. Retrieved February 4, 2006, from http://www.mentalhelp.net/poc/center_index.phpid=4&amp.cn=4.
Griswold, K. S. &amp. Pessar, L. F. (2000, September 15). Management of Bipolar Disorder. American Family Physician. Retrieved February 4, 2006, from http://www.aafp.org/
afp/20000915/1343.html.