BIPOLAR DISORDER ( MANIC DEPRESSIVE ILLNESS )
CAUSES
GENETIC
There is strong evidence for the genetic aetiology in this disorder.There is a 60-80% concordance rate in monozygotic twins,compared to 15% in dizygotic twins,suggesting a high rate of heritability.Adoption studies show similar rates ,so this high rate is probably genetic and not due to the family enviornment .Linkage studies have so far proved disappointing,suggesting there is no single gene with a large effect.Instead it is likely that the information will establish to be caused by several genes acting together.
BIOCHEMICAL
It is difficult to carry discover investigate on patients with acute mania,so studies are few .Brain monoamines seem to be accumulated in mania.Patients with mania tend not to suppress their corticosteroid levels with dexamethasone,suggesting a similar pattern of non-suppression as seen in severe depressive illness.
PSYCHOLOGICAL
The personalty of life events is much weaker in bipolar compared to unipolar sickness ,with most effect apparent at prototypal start .Similarly,personality does not seem to be a field influence,in contrast to unipolar depression, although there is some evidence of a link with creativity and divergent thinking that is an advantage in the right occupation.
SIGN AND SYMPTOMS
With mania,an elevated ,expansive mood ,irritability,angry outbursts and impulsive are charcteristic.Specific symptoms include:
1. Increased motor activity and restlessness.
2. Unusual talktiveness.
3. Flight of ideas and racing thoughts.
4. Inflate self-esteem that can become delusional.
5. Decreased need for sleep( often the first feature of an incipient manic episode ).
6. Decreased appetite.
7. Distract-ability.
8. Excessive involvement in risky activities ( purchase sprees,sexual indiscretions ).Patients with full-blown mania can become psychotic.
Hypo-mania is characterized by attenuated manic symptoms and its greatly under-diagnosed ,as are 'mixed episodes' where both depressive and manic or hypo-manic symptoms coexist simultaneously.
Untreated ,a manic or depressive episodes typically lasts for 1-3 months ,with cycles of 1-2 episodes per year.Risk for manic episodes increases in the outflow and fall.Variants of bipolar disorder include rapid and ultra-rapid cycling ( manic and depressed episodes occuring at cycles of week s,days or hours).
In many patients ,especially females ,antidepressants trigger rapid cycling worsen the course of illness.Patients with bipolar disorder are at risk for psychoactive substance use,especially alcohol abuse,and for medical consequences of risky sexual behavior.
Bipolar disorder has a strong genetic component.Patients with bipolar disorder are vulnerable to sleep deprivation to changes in the photo-period,and to the effects of jet lag.
CAUSES
GENETIC
There is strong evidence for the genetic aetiology in this disorder.There is a 60-80% concordance rate in monozygotic twins,compared to 15% in dizygotic twins,suggesting a high rate of heritability.Adoption studies show similar rates ,so this high rate is probably genetic and not due to the family enviornment .Linkage studies have so far proved disappointing,suggesting there is no single gene with a large effect.Instead it is likely that the information will establish to be caused by several genes acting together.
BIOCHEMICAL
It is difficult to carry discover investigate on patients with acute mania,so studies are few .Brain monoamines seem to be accumulated in mania.Patients with mania tend not to suppress their corticosteroid levels with dexamethasone,suggesting a similar pattern of non-suppression as seen in severe depressive illness.
PSYCHOLOGICAL
The personalty of life events is much weaker in bipolar compared to unipolar sickness ,with most effect apparent at prototypal start .Similarly,personality does not seem to be a field influence,in contrast to unipolar depression, although there is some evidence of a link with creativity and divergent thinking that is an advantage in the right occupation.
SIGN AND SYMPTOMS
With mania,an elevated ,expansive mood ,irritability,angry outbursts and impulsive are charcteristic.Specific symptoms include:
1. Increased motor activity and restlessness.
2. Unusual talktiveness.
3. Flight of ideas and racing thoughts.
4. Inflate self-esteem that can become delusional.
5. Decreased need for sleep( often the first feature of an incipient manic episode ).
6. Decreased appetite.
7. Distract-ability.
8. Excessive involvement in risky activities ( purchase sprees,sexual indiscretions ).Patients with full-blown mania can become psychotic.
Hypo-mania is characterized by attenuated manic symptoms and its greatly under-diagnosed ,as are 'mixed episodes' where both depressive and manic or hypo-manic symptoms coexist simultaneously.
Untreated ,a manic or depressive episodes typically lasts for 1-3 months ,with cycles of 1-2 episodes per year.Risk for manic episodes increases in the outflow and fall.Variants of bipolar disorder include rapid and ultra-rapid cycling ( manic and depressed episodes occuring at cycles of week s,days or hours).
In many patients ,especially females ,antidepressants trigger rapid cycling worsen the course of illness.Patients with bipolar disorder are at risk for psychoactive substance use,especially alcohol abuse,and for medical consequences of risky sexual behavior.
Bipolar disorder has a strong genetic component.Patients with bipolar disorder are vulnerable to sleep deprivation to changes in the photo-period,and to the effects of jet lag.
DIAGNOSIS
The first step in getting a comely diagnosis is to talk to a doctor, who may carry a physical examination, an interview, and work tests. Bipolar modify cannot currently be identified through a blood test or a brain scan, but these tests crapper support rule out another contributing factors, such as a stroke or brain tumor. If the problems are not caused by another illnesses, the student may carry a noetic upbeat evaluation.
The student or mental health professional should conduct a complete diagnostic evaluation. He or she should handle any kinsfolk story of bipolar disorder or other mental illnesses and get a complete story of symptoms. The student or mental health professionals should also talk to the person's near relatives or spouse and note how they describe the person's symptoms and kinsfolk medical history.
People with bipolar disorder are more likely to seek help when they are downcast than when experiencing mania or hypo-mania.Therefore, a careful medical story is needed to assure that bipolar disorder is not mistakenly diagnosed as field depressive disorder, which is also called unipolar depression. Unlike people with bipolar disorder, people who have unipolar depression do not experience mania. Whenever possible, previous records and input from kinsfolk and friends should also be included in the medical history......read more
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