Bipolar disorder is classified by the DSM IV as a mood disorder. Therefore in order to understand it one must understand what a mood disorder is. A mood disorder affects a person’s emotions dramatically enough to disrupt normal life. It does not just affect the patient but also his/her friends and family. The patient is distressed most of the time and suffers in his/her social, work, and love aspects of life. For example: Johnny is suffering from mayor depression, he keeps having thoughts of death, and is uninterested in spending time with his friends, now his friends are concerned and are wondering what is going on with their beloved friend.
Typically mood disorders run in families, they are caused by chemical imbalances of serotonin (involved in sleep, memory and depression), norepinephrine(sugar levels in blood), and dopamine(regulates movement and emotion)(Langwith 2009). Mood disorders are divided into two categories, unipolar and bipolar. Furthermore unipolar is made up of only one mood state: depression, there are no highs and lows. On the contrary bipolar is made up of a high mood state and a low mood state.
The “high” on bipolar is mania, during thoughts, poor judgment. A patient experiencing mania may come up with big ideas and projects that may result in good or terrible consequences. The “low” mood state in bipolar is mayor depression; characterized by sadness, inferiority, feelings of worthlessness, emptiness, thoughts of death, diminished ability to concentrate, insomnia or oversleeping, and significant weight gain or loss(Langwith, 2009). Nonetheless there are two categories for bipolar disorder; bipolar I and bipolar II. Bipolar I consist of at least one manic episode lasting one week or any duration if hospitalization is required, patient may lose touch with reality to the point of being psychotic”(Langwith, 2009,p 28-29). In bipolar one either mania or a mixed episode must take place. The mixed episode is at least one week long and is made up of both depression and mania mixed with their symptoms alternating, (inferiority, overconfidence, thoughts of death, irritability).
Depression may also take place in bipolar I, but it is not part of the diagnosis criteria (American Psychiatric Association, 2000). Some of the consequences that bipolar I may cause are; suicide in ten to fifteen percent of patients (during a mixed, or depressed episode, domestic violence (due to irritability in manic episode), and failure in school, work, or marriage. Bipolar II is composed of at least one mayor depression episode lasting at least one week, and one hypomanic episode. Hypomania is a less severe version of mania it has the same . haracteristics; however hypomania does not affect regular life enough to require hospitalization. There are no mixed episodes in bipolar II (Langwith, 2009). In bipolar II the patient spends more time depressed than hypomanic, however during the hypomanic state they may become more productive than usual, and more socially active “life of the party”, this may be one of the reasons a lot of bipolar II patients do not seek treatment (Langwith, 2009). Bipolar disorder is one of the leading causes of disability worldwide.
Once a patient of bipolar I is hospitalized from a full blown episode, recovery occurs slowly it may even take years. Also only a few of these patients go back to a normal life, aftereffects of mania may keep affecting the patient’s occupational, social, and family aspects of life. Although mania takes a part in making bipolar a disability, depression seems to cause more impairment due to the length of time the patient feels ill by the effects of bipolar depression around half a year.
Treatment of bipolar disorders has not been fully developed yet, because drugs used commonly as mood stabilizers are directed towards ant seizure and epilepsy. Antidepressants are being mostly used to treat unipolar depression and antipsychotics are used to treat schizophrenia (Langwith, 2009). Psychotherapy however takes a big part in the treatment of bipolar disorder. “If successfully combined with drug treatment psychotherapy may increase the months the patient feels well, hasten recovery, and decrease the risk of relapse” (Harvard medical school, 2008).