Thomas Reese Pattern 3 Term Paper Bipolar Disorder The phenomenon of bipolar affective disorder has been a mystery since the 16th century. History has shown that this affliction can appear in almost anyone; even the great Dutch painter Vincent Van Gogh is believed to have had bipolar disorder. It is clear that in our society many people live with bipolar disorder, however, despite the abundance of people suffering from the it, we are still waiting for definite explanations for the causes and cure. The one fact of which we are painfully aware is that bipolar disorder severely undermines its victims' ability to obtain and maintain social and occupational success. Because bipolar disorder has such debilitating symptoms, it is important that we remain hopeful in the quest for explanations of its causes and treatment. Affective disorders are characterized by a large number of symptoms that can be broken into manic and depressive episodes. The depressive episodes are characterized by intense feelings of sadness and despair that can become feelings of hopelessness and helplessness. Some of the symptoms of a depressive episode include disturbances in sleep and appetite, psychomotor retardation, loss of energy, feelings of worthlessness, guilt, and recurrent thoughts of death and suicide. The manic episodes are characterized by an elevated or irritable mood, increased energy, decreased need for sleep, poor judgment and insight, and often reckless or irresponsible behavior. Bipolar affective disorder affects approximately one percent of the population (approximately three million people) in the United States. It is presented by both males and females. Bipolar disorder involves episodes of mania and depression. These episodes may alternate with profound depressions characterized by a pervasive sadness, almost inability to move, hopelessness, and disturbances in appetite and sleep patterns. Bipolar disorder is diagnosed if an episode of mania occurs whether depression has been diagnosed or not. Most commonly, individuals with manic episodes experience a period of depression. Symptoms include elated, expansive, or irritable mood, hyperactivity, pressure of speech, flight of ideas, inflated self esteem, decreased need for sleep, distractibility, and excessive involvement in reckless activities. The rarest symptoms of bipolar disorder are periods of loss of all interest and retardation or agitation. As the National Depressive and Manic Depressive Association (MDMDA) has demonstrated, bipolar disorder can create substantial developmental delays, marital and family disruptions, occupational setbacks, and financial disasters. This devastating disease causes breakdowns of families, loss of jobs, and costs society millions of dollars a year. Many times, bipolar patients report that the depressions are longer and increase in frequency as the individual ages. Another problem patients can experience is that bipolar disorder can often be misdiagnosed as schizophrenia. The onset of Bipolar disorder usually occurs between the ages of 20 and 30 years of age, with a second peak in the mid-forties for women. A typical bipolar patient may experience eight to ten episodes in their lifetime. However, those who have rapid cycling may experience many more episodes of mania and depression that succeed each other without a period of remission. The three stages of mania begin with hypomania, in which patients report that they are energetic, extroverted and assertive. The hypomania state has led observers to feel that bipolar patients are "addicted" to their mania. Hypomania progresses into mania, often causing a lack of judgement, euphoria, and sometimes paranoia. The third stage of mania is evident when the patient experiences delusions with often paranoid themes. Speech is generally rapid and hyperactive behavior manifests sometimes associated with violence. When both manic and depressive symptoms occur at the same time it is called a mixed episode. Those afflicted are a special risk because there is a combination of hopelessness, agitation, and anxiety that 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 helpless, depressed, and unhappy; yet, they exhibit the energy associated with mania. Rapid cycling mania is another presentation 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 very quick manifestation of the bipolar disorder. This form of the disease exhibits more episodes of mania and depression than bipolar. Lithium has been the primary treatment of bipolar disorder since its introduction in the 1960's. Its main function is to stabilize the cycling characteristic of bipolar disorder. In four controlled studies by F. K. Goodwin and K. R. Jamison, the overall response rate for bipolar subjects treated with Lithium was 78%. Lithium is also the primary drug used for long-term maintenance of bipolar disorder. In a majority of bipolar patients, it lessens the duration, frequency, and severity of the episodes of both mania and depression. Unfortunately, as many as 40% of bipolar patients are either unresponsive to Lithium or can not tolerate the side effects, which include thirst, weight gain, nausea, and diarrhea. Lithim also may have some long-term side effects, such as decreased thyroid functioning and birth defects when taken taken by pregnant women. For patients who cannot take Lithium to treat bipolar disorder, there are several other options available. Antidepressants, in conjunction with other psychological treatments can sometimes help, as can electro-shock therapy. A final option is psychotherapy, which stresses a patient-doctor relationship in an attempt to analyze what is causing the patient's problem, eventually aiming to rid the patient of his/her disorder. Obviously, the facts concerning bipolar disorder are sometimes confusing, after all, not much is really known about the disorder. The hope is that overall awareness of bipolar disorder can lead to new, more effective treatments, eventually helping those afflicted with bipolar disorder to live healthier, happier lives. I personally feel sorry for those afflicted with bipolar disorder, as it seems a very tough obstacle to overcome, and because of its limited treatments. Bibliography American Psychological Association's (APA) Website, http://www.apa.org Goodwin, F.K., and Jamison, K.R. (1990). Manic Depressive Illness. New York: Oxford University Press. Hirschfeld, R.M. (1995). Recent Developments in Clinical Aspects of Bipolar Disorder. The Decade of the Brain. National Alliance for the Mentally Ill. Winter. Vol. VI. Issue II. Weisman, M.M., Livingston, B.M., Leaf, P.J., Florio, L.P., Holzer, C. (1991). Psychiatric Disorders in America. Affective Disorders. Free Press.