Bipolar Disorder: Historical Background, Causes, Symptoms & More - Research Paper

Abstract

Bipolar disorder is a condition that results in extreme changes in moods and shifts in the energy levels of an individual. It is a mental illness that can make difficult the day -to -day life of an individual if left untreated. It can have harmful effects on a person's relationships, career prospects, as well as academic performance. The paper, therefore, seeks to provide a discussion of the bipolar disorder on several fronts such as historical background, proposed origin, signs and symptoms, monitoring parameters, and available treatment options of the Condition. It also identifies and provides an evaluation of the recent research findings concerning the future direction of treating the Condition.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Save 25%

History/Background/Introduction Into the Condition

The history of Bipolar Disorder in the medical field can be traced back to the early 1st century when a Greek, Aretaeus of Cappadocia, made available details of symptoms, which created a link between mania and depression. Both '' mania" and" melancholia were both used to refer to the '' manic" and '' depressive" nature of the Condition. Robert Burton made further advancements in the 17th century in his book The Anatomy of Melancholy, in which he introduced music and dance as ways of treating melancholy (Grunze, 2015). The book expanded research and knowledge on the symptoms and treatment of major depressive disorder. A significant step was made by Theophilus Bonet later in the century in his work Sepuchretum where he gave his experiences from performing 3000 autopsies in which he created a link between mania and melancholy to a condition known as manico-melancholicus.

In the 19th century, a French psychiatrist Jean-Pierre Falret published the first documentary diagnosis of bipolar disorder, la folie circulaire (circular insanity), which provided details of people switching from manic excitement into severe depression. Falret also identified the genetic connection in bipolar disorder. In the 20th century, a German psychiatrist Emil Kraepelin identified the biological causes of mental illnesses (Geddes & Miklowitz, 2013).

In his 1921st work, Manic Depressive Insanity and Paranoia, he gave the difference between manic-depressive and praecox (schizophrenia). Bipolar is a term used to signify the two opposites of mania and depression (Geddes & Miklowitz, 2013). It was initially introduced in the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) in its third revision in 1980.

In the fifth version (DSM -5), the term mania was done away with to avoid calling patients maniacs. DSM contains diagnostic and treatment guidelines that assist doctors in managing the care of bipolar disorder patients, and until today it is considered the leading manual for mental health professionals. According to The National Institute of Mental Health (NIMH) estimates, bipolar disorder affects almost 4.5 percent of adults in the United States. About 83 percent of these people have severe cases of the disease (Carter, 2017). Less than 40 percent of people with bipolar disorder are the ones able to receive the '' minimally adequate treatment" because of funding issues, social stigma as well as lack of education.

Pathophysiological or Proposed Origin of the Condition

The bipolar disorder first evolved in the northern temperate zones, which provided useful adaptations to the selective pressures of severe climatic conditions, especially during the Pleistocene. Due to evidence of Neanderthal contributions to the human genome, EOBD is further extended to EOBD-R, suggesting Neanderthal as the ancestral origin of bipolar vulnerability genes. According to EOBD-R, bipolar disorder has the epidemiology of adaptation, which gets correlated with a cold-adapted build with moods varying according to season and light.

It gets realized that people with seasonal affective disorder (related to bipolar disorder) have always shown a biological sign of season change, which is similar to that found in hibernating animals. Furthermore, the circadian gene network has also got confirmed to be involved in the pathophysiology of bipolar disorder. Women of reproductive age got expected to manifest winter depression more than males or younger females because they experience more significant selective pressures during the Pleistocene (Goldsmith, Rapaport, & Miller, 2016).

The sex difference is also present in hibernating mammals. It is unexpected for people of African descent who lack Neanderthal genes to manifest circular bipolar disorder. The reason gets based on the evolution of the disease that occurred in the northern temperate zone during the Pleistocene hence supporting the incidence of fewer bipolar disorder cases among black people compared to the whites (Green, Rees, Walters, Smith, Forty, Grozeva, & Genovese, 2016). Other research findings also identify high levels of the stress hormone cortisol, neurotransmitter imbalances, and abnormal thyroid functioning as some of the other causes of bipolar disorder.

Signs/Symptoms/Hallmarks of the Condition

There are four types of mood episodes in bipolar disorder, each with its unique set of signs and symptoms. The symptoms vary widely in terms of pattern, frequency, as well as severity. For instance, some individuals are more prone to either mania or depression, while others have an equal alternation between the two types of episodes. Moreover, some people experience frequent mood disruptions while others experience only a few mood disruptions over a lifetime (Reginsson, Ingason, Euesden, Bjornsdottir, Olafsson, Sigurdsson, & Steinberg, 2018).

Individuals in the manic phase of bipolar disorder commonly experience feelings of heightened energy, creativity, as well as euphoria. For instance, they talk a lot within a short time, sleepless, and are hyperactive. They may also have feelings of being all-powerful, invincible, and destined for greatness (Green et al., 2016). Although mania feelings are good at first, they tend to get out of control because one may start behaving recklessly during this episode. Other people may also become aggressive, angry, and irritable. For instance, picking fights and blaming those who criticize their behavior. Some people even go to the extreme of becoming delusional and hallucinating.

A hypomania is a mild form of mania. Individuals in the phase feel euphoric, energetic, and productive. They are still able to move on with their daily lives without forgetting reality. Hypomania can, however, lead to bad decisions that may be harmful to one's career, reputation, as well as relationships (Green et al., 2016). It often heightens to full-blow mania or followed by a major depressive episode. Individuals in the bipolar depression phase experience feelings of irritability, unpredictable mood changes, guilt, as well as restlessness.

These individuals may speak or move slowly, sleep a lot, and gain weight. Moreover, they are more likely to develop psychotic depression and start experiencing significant challenges in their work and social life (Harrison, Geddes, & Tunbridge, 2018). Individuals in the mixed episode experience symptoms of mania or hypomania as well as depression. These include depression together with agitation, irritability, anxiety, distractibility, insomnia as well as racing thoughts. The combination of high energy and low moods puts an individual at a high risk of suicide.

Monitoring Parameters of the Condition

Bipolar Condition can get screened and monitored using several formal clinician-administered assessment tools and other self-rating tools for patients. Screening and monitoring tools have, however, been developed for use in research settings and not in clinical settings. The commonly used screening tool is the Mood Disorder Questionnaire (MDQ) that screens for a lifetime history of mania or hypomania (Harrison et al., 2018). There are, however, recent concerns regarding the ability of the instrument to over-diagnose bipolar disorder. Some examples of scales used in research settings include the Bipolar Depression Rating Scale as well as the Young Mania Rating Scale. Daily mood charts get commonly used in clinical settings (Hibar, Westlye, Doan, Jahanshad, Cheung, Ching, & Kramer, 2018).

The charts allow the clinicians to monitor patients' daily mood swings, specific target symptoms, stressors, activity levels, as well as daily routines. They provide an overview of patients' progress and are currently gaining use as a psychological treatment program. For instance, the daily mood charts focus on identification as well as management of the early warnings, which are essential in psychotherapy.

Available Treatment Options for the Condition

The available treatment options seek to minimize the frequency of manic and depressive episodes, thus reducing the severity of symptoms, therefore, enabling patients with bipolar disorder to lead a healthy and productive life. A bout of depression or mania can persist for up to one year if left untreated, but with treatments, improvements can get realized in about 3 to 4 months. Combinations of therapies, including medications as well as physical and psychological interventions, are involved in the treatment of the Condition (Grunze, 2015). The individual may, however, continue to experience mood swings, but working closely with the doctor can help minimize the severity of the symptoms, thus making them more manageable.

Mechanism of Action of the Available Treatments (Drug Classes)

The commonly prescribed long-term drug treatment for long-term episodes of depression as well as mania or hypomania is the Lithium carbonate. Patients take lithium drug for at least six months. For the drugs to function effectively, the patients need to adhere to the doctor's instructions concerning when and how to take their medication. The available drug treatments include Anticonvulsants, which gets prescribed to treat mania episodes and Antipsychotics (Aripiprazole, Olanzapine, and Risperidone). These are some of the options available in case of disturbing behavior or severe symptoms of the Condition. Some of the drugs, however, have side effects, and it is essential to adjust medication depending on mood changes (Stahl, Breen, Forstner, McQuillin, Ripke, Trubetskoy, & de Leeuw, 2019). For instance, some antidepressants administered to patients before getting a diagnosis of bipolar disorder can result in an initial manic episode. It is, therefore, essential for physicians to monitor this when treating patients with depression.

Recent Research Findings of the Future Direction of Treating the Condition

The latest research findings of the future course of addressing the Condition include psychotherapy, cognitive-behavioral therapy (CBT) as well as hospitalization. Psychotherapy seeks to reduce and enable the patient to manage symptoms of the Condition. For instance, a patient who can identify and recognize the critical contributing factors may be in an excellent position to minimize the secondary effects of the Condition. This has been effective in maintaining positive relationships both at home and at work. Cognitive-behavioral therapy, done either as an individual or family-focused treatment, can also assist in preventing relapses. Combined with CBT, Interpersonal, as well as social rhythm therapy can help in reducing depressive symptoms. Hospitalization is another recent finding concerning the future direction of treating the Condition. It is, however, advisable in case there is a potential risk of the patients harming themselves or others. Also, Electroconvulsive Therapy (ECT) can assist in treatment if the other treatment options are ineffective. To maintain stability, the individual needs to main...