Bipolar Disorder
Written By: Dr. Joao De Quevedo
What is bipolar disorder?
Bipolar disorder, also known as manic-depressive illness, is a psychiatric condition that causes unusual shifts in mood state, sleep, energy and activity levels. The person can have a period of extremely high energy (manic or hypomanic episodes), less sleep necessity, more social and impulsive behavior as financial expensive. The person can either have this moment with high energy and moments with low energy, that can be accompanied by sad or hopeless periods (depressive episodes).
According to the National Comorbidity Survey (2007) the prevalence of bipolar disorder among adults in the U.S is 4,4%. The impacts of not treating this disorder are several, like problems in relationships, drug or alcohol use, financial problems or several decreases in work performance.
Causes
Fonte: Scaini G, Valvassori SS, Diaz AP, Lima CN, Benevenuto D, Fries GR, Quevedo J. Neurobiology of bipolar disorders: a review of genetic components, signaling pathways, biochemical changes, and neuroimaging findings. Braz J Psychiatry. 2020 Sep-Oct;42(5):536-551. doi: 10.1590/1516-4446-2019-0732. PMID: 32267339; PMCID: PMC7524405.
The exact cause of bipolar disorder has not yet exactly been identified. But it is already very established that it has a genetic, biological and environmental factor in the development of this disorder. Bipolar disorder is one of the most heritage disorders, so family history plays an important role. It is already well established, too, that there is a neurochemical imbalance in this disorder, involving neurotransmitters such as serotonin and dopamine.
Symptoms
Manic Episode: This is a period of at least one week where there is an abnormal, intense elevation or irritability in mood, coupled with increased activity or energy. Symptoms include extreme self-confidence, little need for sleep, excessive talking, racing thoughts, distractibility, increased obstinacy in some activity, and engaging in risky behaviors.
Hypomanic Episode: Similar to a manic episode, this lasts at least four days and includes heightened mood and energy, with symptoms like inflated self-esteem, reduced sleep need, increased talking, racing thoughts, and distractibility. It’s less severe than a manic episode and doesn’t significantly impair functioning.
Depression Episode: A two-week period marked by at least five symptoms such as a depressed mood, loss of interest in activities, significant weight change, sleep problems, fatigue, feelings of worthlessness, difficulty in concentrating, and thoughts of death or suicide.
Types of bipolar disorder:
Bipolar I Disorder: Involves severe manic episodes lasting at least 7 days or requiring hospitalization. Depressive episodes typically also occur, and episodes with mixed features are possible. Rapid cycling is having four or more episodes within a year.
Bipolar II Disorder: Characterized by patterns of depressive and hypomanic episodes.
Cyclothymic Disorder: Consists of recurring hypomanic and depressive symptoms that are not intense or long enough to be classified as full hypomanic or depressive episodes.
Risk Factors
There are several environmental and genetic risk factors associated with bipolar disorder. For instance, environmental risks can encompass childhood traumatic events, such as emotional abuse during childhood and substance misuse, including cannabis. A notable genetic risk factor, for example, is having a family member, such as a parent or sibling, with bipolar disorder.
REFERENCES
Harvard Medical School, 2007. National Comorbidity Survey (NSC). (2017, August 21). Retrieved from https://www.hcp.med.harvard.edu/ncs/index.php . Data Table 2: 12-month prevalence DSM-IV/WMH-CIDI disorders by sex and cohort .
Miklowitz DJ, Johnson SL. The psychopathology and treatment of bipolar disorder. Annu Rev Clin Psychol. 2006;2:199-235. doi: 10.1146/annurev.clinpsy.2.022305.095332. PMID: 17716069; PMCID: PMC2813703.
Rowland TA, Marwaha S. Epidemiology and risk factors for bipolar disorder. Ther Adv Psychopharmacol. 2018 Apr 26;8(9):251-269. doi: 10.1177/2045125318769235. PMID: 30181867; PMCID: PMC6116765.
Bipolar Disorder. National Institute of Mental Health. Available in: https://www.nimh.nih.gov/health/topics/bipolar-disorder