In its simplest definition, BRD is a mental disorder characterized by cyclical swings between periods of heightened mood as well as times of depression. The periods of elevated mood are called mania or hypomania. During these periods, an individual suffering from the condition experiences unusual happiness, may be energetic and irritable (Youngstrom, 2012). On the other hand, the periods of depression make those affected cry, generally maintain low eye contact and cause lack of self-confidence. Long periods of depression can invoke suicidal tendencies, but this happens when patients are stretched to the extreme. Generally, while periods of either hypomania or depression, bipolar people exhibit poor judgment and are not normally in a position to act rationally. The extent of either mania or depression varies from one individual to another among affected patients.
Types of BRD
There are various types of bipolar and related disorders:
Bipolar I disorder.
This is marked by periods of intense mood swings between a mania and a depression. It is a transition period; thus, those affected will exhibit exceedingly changing behavioral patterns.
Bipolar II disorder.
This also involves changes in mood. However, the change is milder than in bipolar one disorder and takes place when periods of hypomania alternate with periods of severe depression.
This marks an alternation between a hypomania and a depression, but with shorter periods so that the change in moods is not as extensive as the one in bipolar II disorder.
This is when an individual experiences simultaneous symptoms of both a mania and depression. It results in high energy, sleeplessness and irritability on the one hand while still feeling, melancholic and even suicidal on the other (Hilty, Leamon, Lim, Kelly, & Hales, 2006).
When a bipolar person has four or more mood episodes within a period of 12 months, the situation is called rapid-cycling. To be considered as distinct episodes, mood swings must last for a minimum number of days. Rapid-cycling is dangerous and increases the chances of a depression leading to suicide.
Signs and Symptoms
Bipolar and related diseases have distinct symptoms that serve to signify that the condition is present. Signs and symptoms include the following:
During Mania Episodes
This period is generally characterized by an irritable mood. Besides being irritable, individuals may speak both rapidly and incoherently, are easily distracted, and their pattern of thought may be unpredictable. They may show the tendency to be goal oriented – at least in the short run. However, in the long run, they become agitated and impulsive to the point of becoming reckless and detached – this can be demonstrated through various ways, such as hyper sexuality and excessive money spending. At extreme levels, individuals may lose touch with reality, leading to a condition called psychosis, characterized by both delusions and hallucinations.
During Hypomania Episodes
During this stage, the symptoms are milder and may not significantly impair an individual’s ability to socialize or work. As a matter of fact, the overall functioning of an individual may rise during this period; hence, they may become highly active and engaged. The general sign is increased activity, which may actually lead to raised creativity in the process. However, those around the individual in question may be able to point out a hypo manic episode because the individual affected generally suffers from a “feel good” effect.
The signs and symptoms during this stage are feelings of melancholy and hopelessness, intense sadness, guilt loneliness, and isolation. This is normally accompanied by fatigue and sleeplessness, loss of interest in activities that one would otherwise be interested in, as well as loss of appetite. Individuals will also be apathetic and indifferent. There will also be a noticeable lack of concentration and unexplainable shyness. Extended periods depression may usher in suicidal tendencies, making those affected commit suicide if they do not seek assistance. During change of episodes from a mania to a depression and vice versa, delusion, psychosis, and hallucinations may occur creating a false sense of reality that may be both frightening and intimidating.
During Mixed Episodes
From the discussion on types of BRD, it was mentioned that a mixed episode is when symptoms and a mania and depression occur together (Daglas et al., 2015). Individuals at this stage may demonstrate heightened activity and a “feel good effect” on one hand, while paradoxically being extremely sad and hopeless on the other. They may also be highly impulsive, risk taking, and suicidal.
Causes of BRD
The causes of BRD vary from one individual to another. Therefore, the exact factor, which causes the conditions, remains unclear. However, studies have shown that genetic factors contribute 60-80% of the risks of contracting bipolar and related diseases.
Various studies have pointed out the possibility of some chromosomes being responsible for BRD, thereby indicating that to a large degree, BRD remains a hereditary condition (Martinowich, Schloesser, & Manji, 2009). Compared with the general population, the risk of contracting BRD is ten times higher for first degree relatives of those suffering from bipolar, with the risk of major depressive disorder remaining three times higher.
Some abnormalities in the structure and function of the brain could be responsible for BRD too. The analysis of the structural MRI show that the lateral ventricles, globus pallidus, increase in the rates of deep white matter, and hyper-intensities in the brain could increase the chances of getting the bipolar condition. The studies further suggest that abnormal placement of modules between the ventral prefrontal and limbic regions are increasingly likely to contribute to poor emotional regulation and mood fluctuations, in essence increasing the chances of contracting bipolar and related diseases.
An existing body of knowledge – not too small to be ignored – suggests that environmental factors may contribute to BRD too. The environment that an individual is raised in determines to some degree whether they will end up being bipolar or not. It has been established that 30-50% of bipolar adults report that they were abused in one way or another when they were young. Children raised in abusive environments by abusive parents are likely to develop feelings of sadness, melancholy, and low self-esteem. With a small trigger, such feelings may spark prolonged sadness, inducing a depression in the process.
During majority of instances, it is almost impossible to diagnose bipolar disorder when a child is young – it is simply too hard to notice. BRD is normally diagnosed during adolescence or early adulthood after it has been established that the symptoms are not a result of any other things. For diagnosis to be proper, symptoms must be present and evident. Diagnosis may be through two major ways: through the Diagnostic and Statistical Manual of Mental Disorders or through the International Statistical Classification of Diseases and Related Health Problems (Martinowich, Schloesser, & Manji, 2009). The former is designed by the American Psychiatric Association while the later is by the World Health Organization. During diagnosis, the following techniques may be used: