What is bipolar disorder ?
A bipolar disorder is a disorder that is characterized by mood swings, manic or hypomanic then again, then again depressed. It is considered one of the affective spectrum and reach 2-4% of the population. The manic episode is the opposite or the opposite of a depressive episode, hence the term bipolar (bipolar).
The mood swings can occur occasionally, with periods of normal mood in between, but also quick succession. Fast and changing successive forms of voting called rapid cycling. Also, mixed episodes occur in some who are afflicted with the disorder.
This disorder often manifests itself for the first time during or after adolescence.
Bipolar disorder types
In the Diagnostic and Statistical Manual of Mental Disorders are three types of bipolar disorder:
- Bipolar I disorder, there occurs at least one manic or mixed episode, but there are possible hypomanic or depressive episodes. This form comes closest to what used to be called "manic-depressive".
- Bipolar II disorder: there is at least one episode of hypomania and at least one depressive episode. There is no manic or mixed episode occurred.
- Cyclothymia: there occurs a series hypomanic episodes on, interrupted by periods of lighter depression and exhaustion.
It is a permanent (life-long), mental illness, often with recurring episodes that can be severe. It therefore requires an active treatment. The mood swings can complicate normal relationships and can also affect all other aspects of life.
Causes of bipolar disorder
Bipolar disorder is probably caused by several factors partly interrelated:
Biochemical factors
According to various studies of biochemical factors in relation to a bipolar disorder have noradrenaline, dopamine and serotonin is a major role in this mood disorder. This is a deficiency in a major depressive episode and probably abundant in mania. Possibly the cause is a deficiency of omega 3 fatty acids such as in childhood or later ages. These fatty acids are known as fatty acids DHA, EPA. There are conclusions and findings from studies that omega 3 fatty acids (EPA and DHA) are applied to depressed patients and / or patients with mental disorders such as ADHD, bipolar, schizophrenia and autism.
Biogenetic factors
Numerous studies show that individual vulnerability or heredity could be a major factor for bipolar disorder. The probability of this mood disorder is especially marked when close family members also suffer from the disorder. The chance that children of a parent with bipolar disorder also suffer from bipolar disorder is 20%. If both parents have bipolar disorder, then the chances of children developing the disorder 50%.
Cognitive
By disturbed thought processes can develop a negative self-image which contributes to depression. The cognitive dysfunction that person can get a pessimistic mindset and For example feel worthless. This can cause depression or a relapse and promote expensive.
Learning theory
Through real and alleged failure, people are convinced that everything in life failed them and that they have a grip on life. This may be a factor in the development of a depression. This is called a 'learned helplessness'.
Object-loss theory
This is a theory that is about a bonding process interrupted during the first 6 months of life. After leaving or separating with an important person in this life, the child is going to withdraw from others.
Further possible causes
A.L. Querido (psychiatrist) writes about the differences between psychological factors, and psychosocial factors. These are respectively internal, external and personal factors, environmental factors, which affect the inner world.
Both positive and negative events, such as promotion or divorce, can bring with it stress. Too much stress (for someone who is prone to it) may contribute to depression or mania. In addition, the social environment is also an important factor. It is scientifically proven that someone will perform better if it is part of a group (or network) in which he accepted and / or supported.
When psychological factors are among others about the life events from the past that are not processed properly (trauma). Besides the fact that the probability is increased by (non-chronic) depression after a traumatic event, games problems in the processing a role in the development of (chronic) mania or depression. Blocking painful memories and / or feelings can lead to a disturbance in the emotional life, and so to bipolarity.
Psychoanalytic theory
A psychoanalytic theory suggests that during the upbringing of a child a love-hate relationship could arise between the child and the parent / guardian on the road to independence. The nurse will instruct the child to obey, even when this is at the expense of his needs and desires. The child wants to meet the expectations of the parent, but at the same time he / she is angry about their demands. Bipolar disorder would result from the distorted ego development where anger turns inward (depression). The denial of this inner depression might manifest a mirror image. The thus formed superego would then lead to manic behavior.
Treatment for bipolar disorder
Long-term treatment is focused on the prevention of manic and depressive episodes. It is often a combination of medication, education and sometimes applied psychotherapy.
As a medication for the occurrence of episodes to be used mood stabilizing agents. Lithium carbonate is the most widely used agent. In addition, the means valproate, aripiprazole, carbamazepine, lamotrigine and olanzapine.
For the treatment of mania be used as medicines antipsychotics. For the treatment of depressions antidepressants are used reluctant, as hereby there is a risk that these means provoke a mania. In addition to these resources are also fears dampening and used peaceful means.
There currently exists no protocol that describes how mood stabilizers "if necessary" may be used. Opinions seem black and white are divided between ever use or never use.