Научная электронная библиотека
Монографии, изданные в издательстве Российской Академии Естествознания
What is bipolar disorder?
Bipolar disorder, also called manic depression, is a mental illness that is characterized by severe mood swings, repeated episodes of depression, and at least one episode of mania. Bipolar disorder is one kind of mood disorder that afflicts more than 1 % of adults in the United States, up to as many as 4 million people. Here are some additional statistics about bipolar disorder:
- Bipolar disorder is the fifth leading cause of disability worldwide.
- The number of individuals with bipolar disorder who commit suicide is 60 times higher than that of the general population.
- People who have bipolar disorder are at a higher risk of also suffering from substance abuse and other mental health problems.
- Males may develop bipolar disorder earlier in life compared to females.
- Blacks are sometimes diagnosed more often with bipolar disorder compared to whites.
What is the history of bipolar disorder?
This disease was formally conceptualized by Emil Kraeplin more than 100 years ago, at which time he described it as manic-depressive insanity. However, mood problems that include depression alternating with symptoms that are now understood to be manic have been referenced in history as long ago as 200 A.D. At that time, this illness, like unipolar depression, was thought to be the result of bad blood, called black bile. In the 19th century, this illness was referred to by terms like biphasic illness, circular insanity, and dual-form insanity. Despite such unfortunate terminology for this disease, bipolar disorder is also known to be associated with significant achievement in some individuals. Many historical figures and current luminaries suffer from this disorder, whose creativity and accomplishments can therefore be an inspiration for current sufferers of bipolar disorder.
What are the types of bipolar disorder?
Bipolar disorder has a number of types, including bipolar type I and bipolar type II disorder. Depending on how rapidly the mood swings occur, the episodes of bipolar disorder can also be classified as mixed (mood disordered episodes that last less than the usual amount of time required for the diagnosis) or rapid cycling (four or more mood disordered episodes per year). About two-fifths of people with bipolar disorder have at least one period of rapid cycling over the course of their lifetime. For every type and duration of the illness, the sufferer experiences significant problems with his or her functioning at school, at work, or socially, may require hospitalization, or may have psychotic symptoms (for example, delusions or hallucinations). The diagnosis of bipolar I disorder requires that the individual has at least one manic episode but does not require a history of major depression. Bipolar II disorder is diagnosed if the person has experienced at least one episode of major depression and at least one episode of hypomania (a milder form of mania).
A mixed episode is defined as a period of time in which both the criteria to diagnose a major depressive episode and a manic episode are fully met, except for the duration requirements of each. The mood problem (manic alternating with depressive symptoms) takes place nearly every day for a total of at least a week.
What are bipolar disorder causes and risk factors?
One frequently asked question about bipolar disorder is if it is hereditary. As with most other mental disorders, bipolar disorder is not directly passed from one generation to another genetically. Rather, it is the result of a complex group of genetic, psychological, and environmental factors. Genetically, bipolar disorder and schizophrenia have much in common, in that the two disorders share a number of the same risk genes. However, both illnesses also have some genetic factors that are unique. Stress has been found to be a significant contributor to the development of most mental illnesses, including bipolar disorder.
What are bipolar disorder symptoms and signs in adults, teenagers, and children?
In order to qualify for the diagnosis of bipolar disorder, a person must experience at least one manic episode. Characteristics of manic episodes must last at least a week (unless it is a mixed episode) and include elevated, expansive, or irritable mood; racing thoughts; pressured speech (rapid, excessive speech); decreased need for sleep; grandiose beliefs (for example, feeling like one has super powers or superlative talents or faults); tangential speech (repeatedly changing conversational topics to topics that are hardly related); increased goal directed activity; impulsivity and poor judgment.
Symptoms of the manic episode of early onset bipolar disorder tend to include outbursts of anger and rage, as well as irritability, as opposed to the expansive, excessively elevated mood seen in adults. The adolescent with bipolar disorder is more likely to exhibit depression and mixed episodes, with rapid changes in mood. Despite differences in the symptoms of bipolar disorder in teens and children compared to adults, many who are diagnosed with certain kinds of bipolar disorder before adulthood continue to have those symptoms as adults. Symptoms of bipolar disorder in women tend to include more depression and anxiety and a rapid cycling pattern compared to symptoms in men.
Although a major depressive episode is not required for the diagnosis of bipolar disorder, such episodes often alternate with manic episodes. In fact, depression occurs more often than mania in many people with bipolar disorder. Characteristics of depressive episodes include a number of the following symptoms: persistently depressed or irritable mood; decreased interest in previously pleasurable activities; change or problems in appetite, weight, or sleep; agitation or lack of activity; fatigue; feelings of worthlessness; trouble concentrating; thoughts of death or suicidal thoughts, plans or actions.
How is bipolar disorder diagnosed?
In asking questions about mental health symptoms, mental health professionals are often exploring if the individual suffers from depression and/or manic symptoms but also anxiety, substance abuse, hallucinations or delusions, as well as some personality and behavioral disorders. Health care professionals may provide the people they evaluate with a quiz or self-test as a screening tool for bipolar disorder and other mood disorders. Since some of the symptoms of bipolar disorder can also occur in other mental illnesses, the mental health screening is to determine if the individual suffers from bipolar disorder, an anxiety disorder like panic disorder, generalized anxiety disorder, or posttraumatic stress disorder (PTSD). The examiner also explores whether the person with bipolar disorder suffers from other mental illnesses like schizophrenia, schizoaffective disorder, and other psychotic disorders, or a substance abuse, personality, or behavior disorders like attention deficit hyperactivity disorder (ADHD). Any disorder that is associated with sudden changes in behavior, mood, or thinking, like a psychotic disorder, borderline personality disorder, or multiple personality disorder(MPD), may be particularly challenging to distinguish from bipolar disorder. In order to assess the person’s current emotional state, health care professionals perform a mental status examination as well.
What illnesses coexist with bipolar disorder?
In addition to providing treatment that is appropriate to the diagnosis, determining the presence of mental illnesses that may co-occur (be co-morbid) with bipolar disorder is important in preventing bad outcomes. For example, people with bipolar disorder are at increased risk of committing suicide, particularly after engaging in previous episodes of cutting or other self-harm. Therefore, mental health care professionals will take care to examine for any warning signs that the person with bipolar disorder is thinking of harming himself or herself or others. Individuals who suffer from this illness, in addition to either alcohol or substance abuse problems or borderline personality disorder, are also at particular risk of committing suicide. People with bipolar disorder are at higher risk of having an anxiety disorder like panic disorder, phobias, generalized anxiety disorder, or obsessive compulsive disorder(OCD).
Psychotherapies
Talk therapy (psychotherapy) is an important part of helping individuals with bipolar disorder achieve the highest level of functioning possible by improving ways of coping with the illness. These interventions are therefore seen by some as being forms of occupational therapy for people with bipolar disorder. Psychotherapy may also engage people with bipolar disorder who prefer to receive treatment without medication. While medications can be quite helpful in alleviating and preventing overt symptoms, they do not address the many complex social and psychological issues that can play a major role in how the person with this disease functions at work, home, and in his or her relationships. Since about 60 % of people with bipolar disorder take less than 30 % of their medications as prescribed, any supports that can promote compliance with treatment and otherwise promote the health of individuals in this population are valuable.
Psychotherapies that have been found to be effective in treating bipolar disorder include family focused therapy, psycho-education, cognitive therapy, interpersonal therapy, and social rhythm therapy. Family focused therapy involves education of family members about the disorder and how to provide appropriate support (psycho-education) to their loved one. This intervention also includes communication-enhancement training, and teaching family members problem-solving skills training. Psycho-education involves teaching the person with bipolar disorder and their family members about the symptoms of full-blown depressive and manic symptoms, as well as warning signs (for example, change in sleep pattern or appetite, change in activity level or increased irritability) that the person is beginning to experience either mood episode. In cognitive behavioral therapy, the mental health professional works to help the person with bipolar disorder identify, challenge, and decrease negative thinking and otherwise dysfunctional belief systems. The goal of interpersonal therapy tends to be identifying and managing problems the sufferers of bipolar disorder may have in their relationships with others. Social rhythm therapy encourages stability of sleep-wake cycles, with the goal of preventing or alleviating the sleep disturbances often associated with this disorder.
Match the terms and definitions
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Mood swings |
an extreme or rapid change in mood |
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Mania |
a mental disorder characterized by great excitement and occasionally violent behaviour |
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Depression |
a mental disorder characterized by extreme gloom, feelings of inadequacy, and inability to concentrate |
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Hereditary |
relating to, or denoting factors that can be transmitted genetically from one generation to another |
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afflict |
to cause suffering or unhappiness to; distress greatly |
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Substance abuse |
a patterned use of a substance (drug) in which the user consumes the substance in amounts or with methods which are harmful to themselves or others. |
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Black bile |
one of the four bodily humours; melancholy |
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Episode |
an incident, event, or series of events |
Say if these statements are true or false
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true |
false |
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Stress does not influence on the development of mental disorders |
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Symptoms of the manic episode of early onset bipolar disorder tend to include outbursts of anger and rage, as well as irritability |
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In order to qualify for the diagnosis of bipolar disorder, a person must experience at least one manic episode. |
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All people with bipolar disorder have at least one period of rapid cycling over the course of their lifetime. |
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Bipolar disorder is one kind of eating disorder that afflicts more than 1 % of adults in the United States |
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Many famous people suffer from this disorder |
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Genetically, bipolar disorder and schizophrenia have nothing in common |
3. Fill in the gaps with appropriate words from the box
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a screening tool; exhibit; bad outcomes; coping; severe mood swings; compliance; co-morbid ; cycling |
1. Bipolar disorder, also called manic depression, is a mental illness that is characterized by ____ ____ ____, repeated episodes of depression, and at least one episode of mania
2. Depending on how rapidly the mood swings occur, the episodes of bipolar disorder can also be classified as mixed or rapid ________
3. In addition to providing treatment that is appropriate to the diagnosis, determining the presence of mental illnesses that may be _________ with bipolar disorder is important in preventing ______ _____
4. Health care professionals may provide the people they evaluate with a quiz or self-test as ______ ______ for bipolar disorder and other mood disorders
5. The adolescent with bipolar disorder is more likely to _______ depression and mixed episodes, with rapid changes in mood.
6. Talk therapy (psychotherapy) is an important part of helping individuals with bipolar disorder achieve the highest level of functioning possible by improving ways of ___________ with the illness
7. Since about 60 % of people with bipolar disorder take less than 30 % of their medications as prescribed, any supports that can promote _____________ with treatment and otherwise promote the health of individuals in this population are valuable