Diseases often manifest physiologically, when a person is diagnosed with an illness oftentimes you are able to see it with your own two eyes. If it’s the flu; you may see that they are flushed with fever, lethargic, and congested. Mental disorders, on the other hand, are not always easily identifiable and cannot be seen at first glance. The brain is an organ that is still very undiscovered, and mental health is not widely acknowledged around the world and is often stigmatized, even in highly developed countries. An example of a mental illness that often goes unnoticed in the public’s eye is bipolar disorder. Formerly called manic-depressive illness, bipolar disorder is characterized by shifts in mood, energy levels, and activity levels. The most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has a strict definition for all mental health disorders, in the DSM-5 bipolar disorder is divided into different categories based on the symptoms; Bipolar I Disorder, Bipolar II Disorder, and Cyclothymic Disorder.
To be diagnosed with any form of bipolar disorder the individual must experience at least one episode of mania and one depressive episode. Bipolar I Disorder, the most common form of bipolar disorder among those diagnosed, has a specific set of criteria in the DSM-5; a manic-depressive disorder that can exist either with or without episodes of psychosis. Bipolar II Disorder has a seperate set of criteria, it is defined as alternating depressive and manic episodes that are less severe and does not hinder one’s ability to function. This form of the disorder is a lot easier to manage but unfortunately because of that it can go undetected and undiagnosed. Cyclothymic Disorder is defined as a cyclic disorder causing brief episodes of hypomania and depression. This form of bipolar disorder is not as easy to endure in the way that the episodes cycle makes it very difficult to live with, but the hypomanic episodes in Cyclothymic disorder are more manageable than manic episodes experienced in Bipolar Disorder I and II.
Mental illnesses are generally very stigmatized, even in the West where access to mental health resources are more readily available. The stigmatization of bipolar disorder may not come from a place of disrespect but rather from a lack of knowledge on mental healthcare, because people do not freely talk about psychological issues they are often seen as rare and odd but the truth is that one in five people experience a mental illness at some point in their life. Individuals with bipolar disorder are often mislabeled as “crazy,” and many inaccurately use the name of the disorder to describe how they are feeling. The truth is that bipolar disorder is a serious mental disorder that must be diagnosed by a psychiatrist or mental healthcare provider and often requires medication and intensive counseling to be managed.
The cause for bipolar disorder is not entirely understood, but neuroscientists are aware that neurochemistry has a lot to do with the disorder. Genetic factors account for sixty to eighty percent of the cause of bipolar disorder, the rest is determined by environmental factors such as trauma, stressful life factors, major life changes, and even seasonal factors. Other triggers of bipolar disorder include heavy drug and alcohol use, during pregnancy, and the postpartum period. Bipolar disorder is not transmittable in the traditional sense. Normally, we would think of the common cold as transmittable through the air or respiratory droplets when a compromised individual sneezes or coughs. Mental illnesses are not contagious, but it is believed that there are genetic components of the disorder that can make it hereditary. This means that there is a higher probability of developing bipolar disorder at some point in one’s life if they have a family history of bipolar disorder or any mental illness. The probability of being diagnosed with bipolar disorder increases significantly with trauma and other environmental factors. A person with a family history of mental illness can live free of mental health issues, but trauma may trigger the disorder because the effects of traumatic events often outweigh genetic predispositions.
For a more detailed view of the disorder it is beneficial to take a look at a case study. Client A is a 29 year old woman recently diagnosed with bipolar disorder. This client has a family history of mental illness on both sides of her family; her father was diagnosed with bipolar disorder and her mother experienced postpartum depression after her pregnancy, along with a few aunts and uncles with varying mental illnesses including generalized anxiety disorder and major depressive disorder. Up until her recent diagnosis, this client has not experienced mental illness despite her significant genetic predisposition until the recent death of her significant other, loss of her job, and an increase in substance and alcohol use. The impact of the events caused significant trauma for the client and ultimately led to the trigger of bipolar disorder. Client A now experiences several weeks in a major depressive episode during which she has a lack of appetite, sleeps excessively, has a major loss of energy, cries uncontrollably, and is easily irritated. After weeks of a depressive episode, Client A suddenly gets a burst of energy lasting anywhere from one to two weeks, during this manic episode she experiences a quick shift from irritability and sadness to extreme joy and excessive happiness. Throughout this period the client feels overly confident and takes on major projects with unattainable goals, she does not sleep regularly, and often makes irrational decisions with unfortunate repercussions. This cycle is very familiar to Client A, she later attends a yearly physical with her primary care physician who is cautiously aware of her symptoms and refers her to a private psychiatrist. Her psychiatrist is then able to diagnose her with Bipolar Disorder I, she experiences severe episodes of mania and depression with psychosis.
The symptoms of bipolar disorder can be categorized into two classifications, mental health professionals often separate the manic symptoms from the depressive symptoms. Mania is a state of high excitement, euphoria, and overactivity. Symptoms that may occur during mania include; extreme confidence, impulsivity that leads to reckless decision making, increased energy, less need for sleep, unusually high sex drive, excessive hapiness, hopefulness, excitement, and delusions and hallucinations can also be experienced during manic episodes. Individuals with bipolar disorder often experience a form of a manic episode, these episodes make them feel uncharacteristically confident and may often lead to irrational decisions. A manic episode may be experienced for as short as a week to as long as a couple months before a depressive episode begins, manic episodes are generally very emotionally and physically draining for the individual and generally do not last as long as depressive episodes for this reason. Hypomania can occur only in cyclothymic bipolar disorder and is defined as a mild form of mania, all of the symptoms are the same; they are just not as extreme. Symptoms of a depressive episode include; sadness, loss of energy, trouble concentrating, loss of appetite, insomnia or oversleeping, and feelings of hopelessness or suicidal ideation. These episodes can be very debilitating, especially with Bipolar Disorder I, they may make daily tasks such as going to work, school, or socializing very hard to complete. The right medication and psychotherapy can make the symptoms of both manic and depressive episodes easier to manage, and healthy coping mechanisms can be given to help manage the disorder.
Brain chemistry has a lot to do with various mental disorders, bipolar disorder included. What happens inside of our brains on a microscopic level, greatly affects our mental health. The cells in our brains, nerve cells also known as neurons, interact with each other and send messages to other parts of our brain and our bodies. These messages are sent through chemicals called neurotransmitters, the axon terminal of the neuron sends the chemical to the next neuron where it passes through the synapse and to the receiving end of the neuron called the dendrite. The neurotransmitters of the brain are in charge of sending messages that determine how we feel, if we can talk, move, and even breathe. Individuals may be genetically disposed to experience either a lack of a certain type of neurotransmitter, an overload of specific neurotransmitters, or an issue with the transmission of neurotransmitters. The neurotransmitters involved in bipolar disorder include dopamine, norepinephrine, serotonin, gamma-aminobutyrate, glutamate, and acetylcholine. The imbalance of these chemicals affects individuals with bipolar disorder greatly by causing the dramatic shifts in mood. For instance, norepinephrine is a neurotransmitter that plays one of the most significant roles in mood disorders, specifically manic depressive disorders such as bipolar. When norepinephrine levels are high the neurotransmitter has the ability to give feelings of euphoria, induce elevated blood pressure, and cause hyperactivity. Lower levels of norepinephrine can cause a lack of energy, inability to concentrate, and even depression. Another example is dopamine, which causes feelings of euphoria and happiness in the reward center of one’s brain, when dopamine is low it can contribute to a depressive episode and when the levels are too abundant it can trigger a manic episode. Gamma-aminobutyrate does not directly affect mood levels, rather it affects the ability for the communication of cells in the brain, thereby affecting whether a neuron is able to receive a signal. The hypothalamus controls many of these neurotransmitters and is able to either send more or limit the distribution of these chemicals. Neurotransmitters are significant when looking at the various factors that affect bipolar disorder, and medication is often able to stabilize these imbalances in brain chemistry, but medication alone does not suffice as a method to treat bipolar disorder cognitive therapy and a support system is key in treatment.
Bipolar disorder does not have a concrete treatment that can outright cure the disorder, management would be a better term to describe treatment for bipolar disorder because the mental illness will likely always be a factor in the individual’s life. Treatments for bipolar disorder can be separated into two categories; psychotherapy which includes various therapy methods to help the individual find healthy coping mechanisms and an outlet for the symptoms of their disorder and psychiatric medication, where brain chemistry is altered by medication to assist with the symptoms of bipolar disorder. Psychotherapy is generally administered by psychologists, psychiatrists, or other mental health providers such as counselors and certified clinicians. The most common type of therapy used for bipolar disorder is cognitive behavioral therapy oftentimes along with family therapy and support group therapy; which is especially beneficial for children and adolescents with bipolar disorder as support therapy allows the youth to have a strong support system that could help with triggers or safety planning. There are a few other forms of therapy and procedures that are no longer commonly used to treat bipolar disorder but have been known to improve symptoms. These procedures include electroconvulsive therapy, which uses small electrical impulses through the brain to reverse symptoms and transcranial magnetic stimulation which uses magnets to stimulate cells in the brain to relieve the symptoms of depression. Medications are also often used alongside therapy, to aid with the imbalance of neurotransmitters in the brain. The medications often prescribed for individuals with bipolar disorder include; selective serotonin reuptake inhibitors, a type of antidepressant that works by increasing serotonin levels in the brain, lithium is most well known and widely used for bipolar disorder it helps with the severity and frequency of manic episodes, and antipsychotics such as Haloperidol which can be used to manage psychotic breaks during manic episodes. While medication is very useful and effective for side effects, it is important to remember that bipolar is not curable and medication alone cannot rid the individual of the disorder. Intensive therapy, counseling, and support from family and friends is essential alongside medication for individuals to manage the disorder.
Bipolar disorder affects individuals in all parts of the world and while mental illness is prevalent everywhere, information on it is not. For this reason, we see a lot of cases of bipolar disorder, amid other mental disorders, go untreated and unaccounted for. Of the statistics available on the disorder, the highest known rates of bipolar disorder are found in Australia, Brazil, New Zealand, and Finland. The exact reasons for the higher rates in these nations are unknown, but it is inferred that the statistics for the disorder are found to be prevalent in these countries because the individuals are seeking treatment and the disorder is reported. This means that in less developed regions bipolar disorder is not reported and there are not statistics on it. As we know, bipolar disorder is caused by various factors including genetics and environmental stressors, so it is likely that people around the world experience it.
Over the years, bipolar disorder has grown more and more prevalent among youth and adolescents. The percentage of adolescents between the ages of seventeen and eighteen with bipolar disorder is 4.3%, and for those fifteen to sixteen years old the percentage is 3.1%. Bipolar disorder has increased in the younger population at a significant rate, psychologists and researchers are doing their best to interpret these numbers and find a reason for the spike in adolescent bipolar disorder. One speculated reason for these numbers would be the effects that social media, school, bullying, and the many other pressures that teenagers face. Trauma is one of the main triggers for bipolar disorder, which means that teens and young adults are facing trauma very early on in life. It’s important for adults and the leaders in children’s lives to take a look at these issues in their communities, and try to better understand where this trauma may be stemming from to find a solution to this problem.
Bipolar Disorder cannot be eradicated, but a few significant actions can prevent some individuals from going undiagnosed, untreated and undiscovered. It all starts by ending the stigma behind mental illness, being open to talking about feelings and emotions, and creating a safe environment for those struggling with mental illness. By allowing individuals to express emotions and encouraging they seek professional help, the rate of suicide and untreated Bipolar disorder will very likely decrease. Knowing how to handle mental illness and crisis in teenagers is important for those who spend a significant amount of time around children and teens; teachers, youth leaders, and parents should have a significant amount of knowledge surrounding the topic and should know what to do in certain situations. Knowing when it is time to see a professional, identifying a mental health crisis, and understanding what language is appropriate to use with youth suffering from mental illness is also very important. Taking these precautions and steps can help decrease the amount of undiagnosed individuals and individuals without a support system.
Bipolar disorder is a mental disorder that affects individuals all over the world, it is important to understand the signs and symptoms of an individual with this type of disorder to know when it is time to get professional help. Bipolar disorder is characterized as a mood disorder creating a cycle of depression followed by a manic episode, the severity of the changes in mood and the longevity of the episodes is based off of what type of bipolar disorder the individual has; bipolar disorder I is the most severe form of the disorder causing drastic mood changes, longer manic and depressive episodes, and in some cases psychotic episodes. This disorder is not contagious, it is brought on by various factors, the most significant ones being genetics and environmental stressors especially trauma. The disorder is a lifelong disorder but can be managed with a combination of cognitive therapy and medication. Knowing the facts surrounding the disorder can not only help destigmatize mental illness, but it can also help reduce the amount of people who go undiagnosed and untreated.