Bipolar disorder is a chronic mood disorder that affects more than 3 million Americans every year. It is characterized by jumps between major depressive episodes where the individual is pessimistic and unmotivated and episodes of mania where the individual is dangerously optimistic, easily agitated, and reluctant to take advice from others. Biological components like genealogy and neurochemistry of an individual’s brain particularly dealing with the neurotransmitters norepinephrine and serotonin, psychological components dealing with the thought processes of the individual, and sociocultural components in relation to the Theory of Learned Helplessness and gender roles are all believed factors in the development of bipolar disorder. While bipolar disorder is serious and life altering, scientists and doctors have identified therapies like counseling and medications like antidepressants, mood stabilizers, and antipsychotics to control the patient’s mood and ensure that the depressive and manic episodes’ occurrences are few and far between if at all allowing the individual to live a life of normalcy.
The Basics of Bipolar Disorder
Bipolar disorder, previously known as manic depressive disorder, is a mood disorder characterized by extreme swings between major depressive episodes and episodes of mania, or extreme confidence. Bipolar disorder only occurs in about 1% of the global population, and it affects men and women equally. Episodes of depression or mania alike typically strike after a steady routine of daily activities or normalcy and begin with the disruption of sleep. Bipolar disorder can be extremely detrimental and disruptive to an individual’s life. Both manic and depressive episodes have no specific expiration date, and in some cases can continue on for years.
The earliest findings of this particular disorder can date back as far as 1st century Greece. It was not uncommon for people to display states of mania, depression, or psychosis in which cases the doctors of that time typically deemed them possessed. It was common during that time for people to be executed for having bipolar disorder.
Interestingly enough, throughout history many artists, poets, musicians, and creators were diagnosed with bipolar disorder. Some of these people include Walt Whitman, Ernest Hemingway, and the actress Margot Kidder. One of the characteristics that goes along with mania are huge outbursts of creativity. While the results of a manic episode for some can be detrimental, for artists and creators the outbursts can be almost influential. For example, after experiencing a two-year long manic episode, Robert Schumann, a German composer and music critic, once composed 51 pieces of music. Seemingly, professionals who rely on logic and precision are less susceptible to bipolar disorder than are artists, musicians, poets, etc whom rely on creativity and emotion.
Symptoms of Bipolar Disorder
As stated previously, the main symptom of Bipolar Disorder are the emotional alternations between depressive and manic episodes a patient can experience. Some emotional indicators of a manic episode can include grandiose optimism and unusually high self esteem. Consequentially, this can lead to reckless investments, spending sprees, and unsafe sex. Manic episodes can be noted by eraddic or overly optimistic behavior. The individual will become over talkative, overactive, consistently elated, but easily irritated if annoyed; there is little need for sleep, and there are fewer sexual inhibitions. Speech can be noted as loud, flighty, and hard to interrupt. Additionally, they will reject advice even though they are a danger to his or herself. Once a manic episode ends, the individual can typically crash falling into a place of severe depression. Essentially, a person with bipolar disorder cannot find their emotional middle ground.
When in a depressive episode, subjects will become unmotivated or inactive. They will adopt a pessimistic view on life becoming especially sensitive to negative outcomes, expect negative outcomes, and are more likely to recall negative information. Depressive episodes have no time limit, but typically will self-terminate being replaced by a period of mania. Bipolar patients suffer through a vicious cycle of mania to depression to mania again, but can be regulated with mood stabilizers.
Another indicator of bipolar disorder found in an article posted by the American Journal of Psychology, was that cognitive function in patients with bipolar disorder was significantly reduced when compared to normally functioning subjects. It was found that verbal memory and executive function were particularly impaired. In a different study published by the AJP, it was found that, as children, bipolar patients tended to have difficulty functioning socially. Despite this, they did not seem to have any issues functioning scholastically.
Explanations of Bipolar Disorder
In a study of both schizophrenia and bipolar disorder, it was found that there may be a genetic factor behind bipolar disorder. First-degree relatives of someone with bipolar disorder were at an increased risk for also developing the disorder. If one maternal half-sibling was diagnosed with bipolar disorder, the other sibling was at a significantly increased risk for developing said disorder. Additionally, children of adopted families were at an increased risk for developing the disorder if their biological parents also had said disorder.
Essentially, genes are the basic composition of the body. They control the biochemical aspect of the body which, in turn, controls an individual’s behavior. The key biochemical component in bipolar disorder is the functioning of neurotransmitters. Norepinephrine is essentially a mood booster. It increases arousal and is what makes people feel happy. In mania, norepinephrine is over abundant causing the extreme boost of self esteem and optimism. When norepinephrine is too abundant, it can be associated with violent outbursts, which can explain why during mania, bipolar patients are also easily agitated, and psychosis. During depressive episodes though, norepinephrine is lacking causing the individual’s mood to be pessimistic; they can also become stoic due to the lack of arousal that would normally come from norepinephrine. Serotonin is also another neurotransmitter found to be scarce during depressive episodes.
Positive emotions are demonstrated through activity in the left frontal lobe. An additional finding in bipolar depressive episodes, shown using MRI scans, was that the left frontal lobe was likely to be inactive.
Sociocultural Explanations of Bipolar Disorder
When discussing the inability to control stress, it seems that gender roles may play a part in the depressive state that comes along with bipolar disorder. Women more often than men suffer from severe suppression, belittling, and the feeling of helplessness. Due to this they may be at more of an effect to stress.
Martin Seligman, American Psychologist educator and creator of the Theory of Learned Helplessness, argues that depressive episodes may last longer and be more common among western youth due to an epidemic of helplessness, an incline of individualism, and a decline of commitment to religion or family. He additionally notes that the individualism experienced throughout the western youth creates a feeling of sole responsibility when a negative event occurs, allowing nothing for one to fall back on other than his or herself. These ideas can feed the depressive swings associated with bipolar disorder because the individual feels that they have no metaphorical ladder to help them reach the emotional middle ground.
Psychological Explanations of Bipolar Disorder
Scientists suspect that the way patients think may play a large role in the reality of their situation. Meaning that, when in a depressed state, the bipolar patient will think in terms of blaming his or herself causing the depression to continue and creating thought processes like I can’t do anything right which only contributes to the growth of the depressive episode. David G. Myers, author of Psychology: The 7th Edition, writes that people in depressive episodes tend to explain bad events in terms that are stable (it’s going to last forever), global (it’s going to affect everything), and internal (it’s all my fault) (Myers, 640). This is part of what is believed to keep a bipolar patient in a depressed state, never reaching normalcy, and potentially jumping into mania if and once the abundance of norepinephrine returns.
Treatment for Bipolar Disorder
When experiencing depressive episodes, there is a lack of norepinephrine and serotonin. Due to this, the use of antidepressants is typically part of the treatment for depressive episodes. Antidepressants such as Prozac, Zoloft, and Paxil aim to block the reuptake of norepinephrine and serotonin, increasing the existence of both neurotransmitters in the brain.
When experiencing episodes of mania, antipsychotic drugs are seemingly useful because they help to block the stimulus to send out norepinephrine to the brain. This combined with the anti-depressants equalizes the amount of serotonin and norepinephrine existing in the brain which creates the middle ground that the patient cannot achieve on their own. Some examples of antipsychotics are olanzapine, risperidone, and quetiapine. Doctors may also prescribe a mood stabilizer in conjunction with the antidepressant, antipsychotic, or both. Some common mood stabilizers are lithium, carbamazepine, and lamotrigine. Other forms of treatment may include day treatment programs like counseling while one gets his or her symptoms under control. In severe cases where the patient becomes dangerous to his or herself or to others, the doctors may suggest hospitalization.
While bipolar disorder can be detrimental to an individual’s lifestyle, due to modern medicine and therapies there is treatment that can stabilize the mood swings. With medical assistance and counseling patients can typically return to a normal lifestyle. Without medication though, it becomes difficult for the individual to hold jobs regularly, and there is typically issues with social functioning in adolescents and teens. While genealogy, psychology, and sociocultural aspects do play a role in bipolar disorder, the key to controlling the disorder seems to be controlling the neurotransmitters norepinephrine and serotonin.