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Bipolar Disorder: Symptomatology and Etiology

Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental disorder that causes unusual shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks [1].

The word "manic" describes the times when someone with bipolar disorder feels overly excited and confident. These feelings can also involve irritability and impulsive or reckless decision-making. About half of people during mania can also have delusions (believing things that aren't true and that they can't be talked out of) or hallucinations (seeing or hearing things that aren't there)."Hypomania" describes milder symptoms of mania, in which someone does not have delusions or hallucinations, and their high symptoms do not interfere with their everyday life. The word "depressive" describes the times when the person feels very sad or depressed. Those symptoms are the same as those described in major depressive disorder or "clinical depression," a condition in which someone never has manic or hypomanic episodes. Most people with bipolar disorder spend more time with depressive symptoms than manic or hypomanic symptoms [2].



Symptoms [3]


According to the International Bipolar Association, symptoms vary between individuals. For some people, an episode can last for several months or years. Others may experience “highs” and “lows” at the same time or in quick succession. Symptoms can be of mania/hypomania type or of depressive type. If a “high” or “low” episode is very intense, the person may experience psychosis . They may have trouble differentiating between fantasy and reality.


According to the International Bipolar Foundation, psychosis symptoms during a high include hallucinations, which involve hearing or seeing things that are not there and delusions, which are false but strongly felt beliefs. A person who experiences delusions may believe they are famous, have high-ranking social connections, or have special powers. During a depressive or “low” episode, they may believe they have committed a crime or are ruined and penniless. It is possible to manage all these symptoms with appropriate treatment.


Causes

  • Genetics - Behavioral genetic studies have suggested that many chromosomal regions and candidate genes are related to bipolar disorder susceptibility with each gene exerting a mild to moderate effect [4].The risk of bipolar disorder is nearly ten-fold higher in first degree relatives of those with bipolar disorder than in the general population; similarly, the risk of major depressive disorder is three times higher in relatives of those with bipolar disorder than in the general population [5].

  • Environmental - Psychosocial factors play a role in the development of the disorder.

  • Neurological - Various neurological conditions may result in the development of the disorder like stroke etc.

Although bipolar disorder is a lifelong condition, mood swings and other symptoms can be managed by following a treatment plan. In most cases, bipolar disorder is treated with medications and psychological counseling (psychotherapy) [6].




References

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