Bipolar disorder is one of the known brain disorders that cause mood shifts, energy increment, and rise in the level of activities performed. The brain condition is also known as manic-depressive illness. Basically, there are four types of bipolar disorder. The four types are all involved in causing mood changes, activity, and energy levels. The attitudes include extreme periods of elated and energized characteristics. Such periods are also known as manic episodes. On the contrary, they may also include extremely hopeless or low periods, branded as depressive episodes (Bipolar Disorder, 2017). When the manic periods are less severe, they are termed as hypomanic episodes.
Bipolar I Disorder
It is recognized by its manic episodes which last for at least one week. It may also be recognized by its manic symptoms which may be quite severe that the affected individual may require immediate hospitalization. This type of bipolar disorder is also characterized by depressive episodes that last for at least two weeks (Bipolar Disorder, 2017). The episodes usually come with depression and manic symptoms at a go.
Bipolar II Disorder
This type of bipolar disorder is characterized by a series of depressive and hypomanic episodes. On the contrary, the manic episodes are not full-blown.
Cyclothymic Disorder or the cyclothymia
This type of disorder is characterized by many hypomanic symptomatic periods. It is also characterized by several kinds of depressive symptoms. Such symptoms may last for at least two years. On the contrary, its symptoms dont conform to Hypomanic and depressive episodes diagnostic requirements.
Specified and Unspecified Bipolar Disorders
Such bipolar and related disorders are described by symptoms which happen not to be matching the other three types of bipolar disorders.
Signs and Symptoms
Individuals who have been diagnosed with bipolar disorder may experience unusually intense emotions, changes in activity performance levels and changes in sleep patterns, and also unusual behaviors (Bipolar Disorder, 2017). Such distinct phases are known as mood episodes. These mood phases are different from distinct behaviors of a particular individual. Also, severe changes in activity and patterns of sleep happen to be going alongside these mood episodes.
People with manic episode: People with depressive episode:
They always feel elated
They possess lot of energy
Increased levels of activity
Feel wired
Poor sleeping patterns
The feeling of being extra active
Speak randomly and fast about different things
Being irritable and agitated
Have thoughts that go very fast
Being able to think and do many things at once
Being able to do risky things like having reckless sex They are always moody, empty, and hopeless
They have little energy
Their activity levels are extremely reduced
They may sleep too much or too little
They feel not to be enjoy anything
They are always worried and feel empty
Cant easily concentrate
They have the tendency to forget fast and a lot of things
They may too little or eat too much
They are always tired.
Always think of suicide or death
At times, moody episodes are associated with depressive and manic symptoms. Such a phase is known as an episode of mixed features. Bipolar patients who experience such a phase may show sadness, emptiness, and hopelessness. However, they may also feel highly energized. This brain condition may be present with or without mood swings (Bipolar Disorder, 2017). In cases of hypomanic episodes, patients would feel very good and highly productive. Also, the individual may feel that nothing is wrong but those close to the like family members or friends would recognize mood swings or extremity in activity levels. If not properly treated, such people may develop severe depression or mania (Bipolar Disorder, 2017).
Causes of Bipolar Disorder and other Mental Illnesses
There is no particular cause of bipolar disorder (Nordqvist, 2016). It is however resulting from a combination of different factors including:
Genetics
Several studies have indicated that a genetic cause of bipolar disorder exists. Those who have relatives with history of having contracted bipolar disorder are likely to develop bipolar disorder themselves. There are particular genes that are likely to contract bipolar disorder compared to others. However, research indicates that not only genes, but also other risk factors cause bipolar disorder (Nordqvist, 2016).
Biological traits
Those who suffer from bipolar disorder are characterized with physical changes within their brains. However, research activities on the same issue dont show which particular brain activities lead to the disorder (Nordqvist, 2016).
Brain-chemical imbalance
Imbalance in neurotransmitters happens to be the core cause of most mood disorders (Nordqvist, 2016).
Hormonal problems
Imbalances in hormone may also cause bipolar disorder (Nordqvist, 2016).
Family History
Bipolar disorder is a disorder associated with families. Parents who suffer from bipolar disorder are likely to pass the illness to their children (Nordqvist, 2016).
Does the Environment Cause Bipolar Disorder?
The impact of the environment as risk factors for bipolar disorder development has not been well established (Marangoni, 2016). By conducting a longitudinal research that is geared towards evaluating the duration and prevalence, the predictable values towards exposures to the environment may be determined. From the research, environmental exposure may result to three risk factors. Such risk factors include neurodevelopment, substances abuse, and physical or psychological stress like parental loss and brain injury (Marangoni, 2016).
How is Genetics Linked to Bipolar Disorder?
In the study of disorders which are complex, common variants may be used to indicate a slight rise in genetic risk. Therefore, genetic testing to indicate susceptibility to bipolar disorder has been an issue of discussion among researchers and clinicians (Kerner, 2014). Even though genetic testing can be used to determine either monogenic Mendelian or chromosomal disorder, the results achieved in complex multigenic conditions have been ambiguous. Such ambiguity is as a result of the genomic variants nature as identified (Kerner, 2014). There are three established criteria that require to be fulfilled before ensuring that a new genetic test is introduced. The criteria include:
Analytical validity: It is concerned with the precision and accuracy of a genetic test.
Clinical validity: It is defined as the measured range of clinical performance. Such range includes clinical sensitivity, positive predictive value, and clinical specificity.
Clinical utility: It is defined as the level of usefulness of clinical tests towards ensuring that the health of patients is improved.
Both monogenic Mendelian and chromosomal disorders that are associated with psychosis and mood symptoms can be caused by protein-damaging mutations and structural genomic variants within single genes (Kerner, 2014). The rare genetic mutations in this case are disease specific, functional and has high penetrating capabilities (Kerner, 2014). Though such conditions happen to be rare in different people, they still pose risks that cannot be ignored since their rate of occurrence may be high enough in case the genetic risk factor is available in one of the patients parents. In case the parent is asymptomatic, testing genetically may be considered for patients whose mood symptoms are either associated with cognitive symptoms or neurological abnormalities and thus suggest a genetic syndrome or a Mendelian disorder (Kerner, 2014).
Although such genetic tests may be properly established, sensitive and specific to high predictive value, the tests may pose controversial results for complex disorders that are common. This is due to the fact that most patients carrying the allele for common risk is always healthy and not expected develop any particular disease. Also, the variants associated with the conditions are not disease specific yet they are associated with several disorders. Common variants do not predict whether a clinical disease is available or not (Kerner, 2014). Therefore, there is no establishment of clinical utility for tests that are genetic in association with complex disorders that are common. Since the riskbenefit ratio is also unclear, misuse and misinterpretation of genetic tests in cases of complex psychiatric disorders will remain high. Also, stigmatization, anxiety, and discrimination potentiality shouldnt be underestimated. Conclusively, with the advances in psychiatric genetics, community interests regarding risk allele has increased. More research activities should therefore be performed before the establishment of genetic testing for complex disorders (Kerner, 2014).
4.0 Hereditary Traits and Genes
4.1 X Linkage
For a very long period of time X linkage has been associated with affective disorders. In this case, bipolar disorder aggregates into families. The inheritance pattern in most pedigrees is complex. Even though the likelihood of occasional families may exist where single genes determine illness susceptibility, pieces of evidence show that transmission of single gene may not occur in various cases.
4.2 Molecular genetic studies
Both association and linkage studies show that DNA markers happen to be the cutting edge of current approaches towards complex genetic diseases. In studies concerning molecular genetics, two approaches exist, such approaches include candidate gene and positional. About positional approaches, susceptibility genes in relation to chromosomal locations are determined by linkage studies. However, approaches about candidate gene require researchers to possess enough knowledge concerning disease biology understanding. Such understanding is required to recognize genes which are involved in causing bipolar disorder.
Twin studies have established that the heritability of bipolar disorder is due to the rates of concordance of which is estimated to be between 60% and 80%. However, lower estimates are suggested to be associated with large population and family cohorts. Both monogenic Mendelian and chromosomal disorders that are associated with psychosis and mood symptoms can be caused by protein-damaging mutations and structural genomic variants within single genes (Kerner, 2014). The rare genetic mutations in this case are disease specific, functional and has high penetrating capabilities (Kerner, 2014). Though such conditions happen to be rare in different people, they still pose risks that cannot be ignored since their rate of occurrence may be high enough in case the genetic risk factor is available in one of the patients parents. In case the parent is asymptomatic, testing genetically may be considered for patients whose mood symptoms are either associated with cognitive symptoms or neurological abnormalities and thus suggest a genetic syndrome or a Mendelian disorder (Kerner, 2014).
Common variants do not predict whether a clinical disease is available or not (Kerner, 2014). Therefore, there is no establishment of clinical utility for tests that are genetic in association with complex disorders that are common. Since the riskbenefit ratio is also unclear, misuse and misinterpretation of genetic tests in cases of complex psychiatric disorders will remain high. Also, stigmatization, anxiety, and discrimination potentiality shouldnt be underestimated. Conclusively, with the advances in psychiatric genetics, community interests regarding risk allele has increased. More research activities should therefore be performed before the establishment of genetic testing for comple...
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