The aspect of Bipolar Disorder has been a mystery since the 16th century. It was rumored that Vincent Van Gogh suffered from bipolar disorder. There is a large group of people suffering from this disorder, however there are no causes or cures for it. Bipolar disorder impairs one’s ability to obtain and sustain social and occupational success. The journey for even a cause will continue for many years to come. Affective disorders are characterized by a depressed mood, an elevated mood or an alternation of depressed and elevated moods.
The basic term for the manic-depressive illness is Bipolar disorder. There are milder and heavier forms of each. A patient can be placed in two different categories of this disorder: dysthymic disorder and cyclothymic disorder, depending on how strong the symptoms are with each individual patient. The use of the term primary affective disorder refers to individuals who had no previous psychiatric disorders or only episodes of mania or depression.
Secondary affective disorder refers to patients with preexisting psychiatric illness other than depression or mania. Bipolar affective disorder affects around 1% or three million people in the United States. Both males and females can become victims of this disorder. Bipolar disorder involves episodes of mania and depression. The manic episodes are characterized by elevated or irritable mood, increased energy, decreased need for sleep, poor judgment and insight, and often reckless or irresponsible behavior. These episodes can alternate with heavy depressions characterized by complete sadness, almost an inability to move, hopelessness, and agitation in appetite, sleep, and concentration while driving. Bipolar disorder is diagnosed if an episode of mania occurs, whether depression has been diagnosed or not (Goodwin, Guze, 1989, p. 11).
The common symptoms of a manic-depressive episode include an elated, expansive, irritable, or hyperactive mood. Their speech may become difficult to understand, and they may experience racing thoughts, high self-esteem, and a lack of fatigue. They may also engage in activities that could potentially harm them. Rare symptoms include periods of loss of interest and retardation or agitation (Weisman, 1991). The National Depressive and Manic Depressive Association (MDMDA) has demonstrated that bipolar disorder can contribute to developmental delays, marital and family problems, job loss, and an inability to maintain a steady income.
Many bipolar patients report that the depressions are longer and more frequent as they get older. Schizophrenia is commonly diagnosed in patients with bipolar disorder and can be misdiagnosed for most of their lives. Speech patterns can help doctors differentiate between the two disorders. The first signs or symptoms of bipolar disorder usually occur between the ages of 20 and 30, and then reappear in women in their 40s. A typical bipolar patient will experience eight to ten episodes in their lifetime.
However, there are those who have rapid cycling and can experience more episodes of mania and depression that succeed each other without a period of remission (DSM III-R). The three stages of mania begin with hypomania. This is where the patients are often very energetic, hyper, and assertive. The hypomania state has shown doctors that a person suffering from bipolar almost feels addicted to their mania. Hypomania progresses into mania, and the transition is marked by a loss of judgment. Often, a paranoid or irritable character begins to manifest.
The third stage of mania becomes clear when the patient experiences delusions, often with paranoid themes. Speech is generally rapid and behavior manifests with hyperactivity. When both manic and depressive symptoms occur at the same time, it is called a mixed episode. These people are at a special risk because the combination of hopelessness, agitation, and anxiety makes them feel like they could jump out of their skin” (Hirschfeld, 1995). Up to 50% of all patients with mania have a mixture of depressed moods. Patients report feeling very dysphoric, depressed, and unhappy yet exhibit the energy associated with mania. Rapid cycling mania is another symptom of bipolar disorder.
Mania may be present with four or more distinct episodes within a 12-month period. There is now evidence to suggest that sometimes rapid cycling may be a transient manifestation of bipolar disorder. This form of the disease experiences more episodes of mania and depression than bipolar disorder. Lithium has been the primary treatment of bipolar disorder since its introduction in the 1960s. Its main function is to stabilize the cycling characteristic of bipolar disorder. In four controlled studies by F.
K. Goodwin and K. R. Jamison reported that the overall response rate for bipolar subjects treated with lithium was 78% in 1990.
