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Sara Hassan Ali

Marisol Althea rosales

Psychology

28 June 2024

Bipolar Disorder

Bipolar disorder is a complex and heritable disorder characterized by recurrent episodes

of dispersion or many psychological factors such as stressful life events and disturbances in

social-familial support systems, plays a significant role in the course of the disorder.

Psychological treatments, in conjunction with pharmacotherapy, aim to modify the effects of

these risk factors to improve outcomes. Additionally , comorbid personality disorders can impact

the course of bipolar disorder , with patients with comorbid personality disorders being less

likely to respond well to treatment. Epigenetic modifications , such as DNA methylation and

histone modifications , have even implicated in the pathogenesis of bipolar disorder. For

example, individuals with bipolar disorder have shown lower methylation levels of certain genes

involved in neurotransmission . Understanding the interplay between genetic , biological ,

cognitive vulnerabilities, and psychological factors is crucial in managing bipolar disorder

effectively.

Epidemiology of bipolar disorder

The epidemiology of bipolar disorder has been extensively studied through various

research methods. Family, twin, and adoption studies have played a crucial role in defining the

genetic epidemiology of bipolar disorder, indicating a significant familial risk and heritability
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estimates. These studies have also helped in identifying familial subtypes of bipolar disorder and

validating nosologic boundaries . Studies have shown that individuals with serious impairment

due to bipolar disorder have levels of service utilization similar to the general population but are

more likely to report a poorer quality of life and unmet service needs. Urban living, lower

socioeconomic status, and single marital status have been identified as potential risk factors for

developing bipolar disorder.

The prevalence of bipolar disorder in adults and children has been a topic of interest in recent

years, with estimates showing that the disability-adjusted life years of bipolar disorder surpass

those of certain cancers and primary neurological disorders. The burden disorder globally has

been assessed through the Global Burden of Disease Study 2013, which utilized Bayesian

meta-regression modeling to produce prevalence estimates by country, age, sex and year.

Identifying causative factors for bipolar disorder is crucial for early intervention and improved

outcomes. Research has focused on demographic, genetic, and environmental risk factors for

bipolar disorder, assessing the strength of these associations and their potential causative role.

Understanding Bipolar Disorder : Symptoms and Treatments

Bipolar disorder affects millions of individuals worldwide, impacting their daily lives ,

relationships , and overall well-being . Understanding the symptoms, diagnosis , and treatment

options for bipolar disorder is crucial in providing effective support and care for those affected by

this complex condition.

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Symptoms of Bipolar disorder : When someone is experiencing bipolar disorder, their behavior

and thoughts can be beyond their own control. Family and friends and workmates can often be

the ones to notice first. Someone with bipolar has episodes of depression and highs.

Bipolar symptoms during manic phase May include:

(1) feeling incredibly or euphoric (2) delusions of self importance (3) high levels of creativity ,

energy and activity (4) getting much less sleep or no sleep (5) poor concentration,easily

distracted (6) racing thoughts, racing speech, talking over people (7) highly irritable, impatient or

aggressive.

Bipolar symptoms during a depressed phase may include:

(1) feelings of sadness or hopelessness (2) lost of interest in usually pleasurable activities (3)

withdrawal from family and friends (3) excessive sleep (4) loss of energy, feeling exhausted (5)

physical slowing (6) low self-esteem and feelings of guilt (7) suicidal thoughts.

Treatment of bipolar disorder: The treatment of bipolar disorder involves a combination of

pharmacological and psychological techniques. Pharmacotherapy, including mood stabilizers , is

the cornerstone of management , with lithium , valproate,and typical antipsychotics being

first-line treatments for acute mania. For bipolar depression, lithium, lamotrigine, or

combinations of antidepressants and mood stabilizers are recommended. Maintenance treatment

often includes lithium, lamotrigine, valproate,and olanzapine. Psychotherapy, such as

family-focused treatment (FFT), is an efficacious adjunct to pharmacotherapy.

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Treatment aims to control symptoms and the course of the disorder, as bipolar disorder is a

chronic condition. Suicide risk assessment is crucial, as individuals with bipolar disorder have a

high rate of suicide completion.

Diagnosis and Classification

Diagnosis and classification of bipolar disorder are crucial for understanding etiology, course,

assessment and intervention. Studies highlight challenges in diagnosing bipolar disorder

accurately, with misclassification rates in psychiatric hospitals. Diagnostic stability over time is

essential for validating psychiatric diagnosis, with bipolar disorder showing greater construct

validity and long-term stability compared to other mental disorders. The DSM-5 and ICD-11

criteria impact the prevalence and validity of bipolar disorder not otherwise specified (BD-NOS)

is a subtype that falls outside established categories, with a prevalence of 1.4%. Treatment for

BD-NOS typically involves mood stabilizers, antipsychotics, and psychotherapy.

Overall, accurate diagnosis and classification are critical for effective management and

understanding of bipolar disorder

Emerging Research and Future Direction

In the field of bipolar disorder research, emerging studies are focusing on innovative treatment

approaches, such as digital therapeutics and personalized medicine . Future directions include
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investigating the role of genetics in bipolar disorder susceptibility , exploring the impact of

environmental factors on disease onset progression, and developing targeted interventions for

specific subtypes of the disorder.

Collaborative efforts between researchers, clinicians and policymakers are essential to advance

our understanding of bipolar disorder and improve patient outcomes.

CONCLUSION

Bipolar disorder is a complex mental health condition characterized by recurrent episodes of

mania and depression with genetic basis . It's classified into: Bipolar Disorder I and Bipolar

Disorder II according to its severity.

Works Cited

1/ Journal Of Abnormal Psychology , 1999

2/ CNS Neuroscience & Therapeutics , 2012

3/ Harvard Medical School

4/ Journal Of Clinical Psychology , 2007

5/ Guidelines For The Management Of Patients With "Bipolar Disorder " <Canadian Network

for Mood and Anxiety Treatment>

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6/ The Lancet. Psychiatry, 2018

7/ Diagnostic Guidelines for Bipolar Depression

8/ Textbook in Psychiatric Epidemiology

9/ American Journal Of Medical Genetics <Part C>, 2003

10/ Harvard Review Of Psychiatry, 2006

11/ Clinical Psychology-Science And Practice , 2009

12/ Epidemiology And Risk Factors For Bipolar Disorder

13/ The Journal Of the European College Of Neuropsychopharmacology