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Animation Description: Bipolar Disorder encompasses a wide spectrum of symptoms and is classified according to the types of mood episodes exhibited, including: manic, hypomanic, major depressive and mixed episodes.
Bipolar I disorder involves a manic or mixed episode in contrast to Bipolar II disorder, which involves at least one major depressive episode and at least one hypomanic episode, but no full manic or mixed episodes.
Bipolar Disorder should be differentiated from Major Depressive Disorder (MDD), which is diagnosed when a patient experiences one or more major depressive episodes without any lifetime episodes of hypomania or mania.
Depicted here is a life chart (or mood chart), which follows the patient’s lifetime history of mood episodes. This permits the identification of mood episodes that are the most prevalent and important to prevent.
In this patient, as with many patients with bipolar disorder, depressive episodes become the more prominent aspect of the illness as the person ages.
Several morphometric differences have been observed in the brains of Bipolar Disorder patients relative to healthy subjects.
White matter hyperintensities and reduction in grey matter volume, identified with MRI, have been described in patients with Bipolar Disorder.
Increased ventricular size and decreased frontal cortical area volumes may also be observed in Bipolar Disorder patients.
The pathophysiology of Bipolar Disorder encompasses environmental, behavioural, neuronal, cellular, and molecular levels.
At the molecular level, aberrant signaling cascades alter synaptic plasticity. Strong evidence supporting the importance of second messenger signaling has come from studying the targets of mood stabilizing drugs such as lithium.
GSK-3 and IP3 signaling cascades are known to mediate axonogenesis, synaptogenesis, neuronal growth and cone spreading. Other downstream effects may also be involved.
The heritability of bipolar disorder is around 80%. Monozygotic twins are reported to have a higher incidence of developing Bipolar Disorder, approximately 40%, whereas the incidence is only 10% in dizygotic twins.
Although the process of developing bipolar disorder likely arises from complex interactions between genes and environmental factors, the specific genes that contribute to this risk are not known with certainty. Variations of several genes have been identified as potential contributors to the pathophysiology of bipolar disorder.
Among the identified genes are those associated with serotonin signaling (SLC6A4, TPH2), dopamine signaling (SLC6A3, DRD4), glutamate transmission (DAOA, DTNBP1), and cell maintenance and growth (NRG1, BDNF, DISC1).
The most significant environmental triggers of mood episodes among patients with bipolar disorder include use of drugs with mood-altering properties, changes in circadian rhythm, and life stressors.
Successful management of bipolar disorder requires particular attention to minimizing the effects of these influences.
It is also available on – wholly CME guideline resource dedicated to the needs of busy, practice-based physicians, which spans multiple therapeutic areas.
How to Cope With Depression
For people suffering from depression, finding a way to make life easier is the best first step. It’s important to get the support of friends and family members. If the depression is severe, it may be necessary to get professional help. A health care provider specializing in mental illness can help you find the right treatment. Using the NIMH’s Find Help for Mental Illnesses tool is also a great place to start. You should be active and surround yourself with people. Talk to a trusted friend or family member. Don’t isolate yourself from the world. Don’t be discouraged if it takes some time. Although you may be feeling bad right now, depression will improve gradually.
It’s important to note that people from different cultures experience depression in different ways. In China, for example, emotional depression is commonly denied, although this practice has been modified in recent decades. Other cultures, however, elevate some expressions of distress to the status of disorder, such as in the Western world. The American archetypal psychologist James Hillman writes that, for some people, depression is healthy. It gives them a sense of focus, limitation, and humility. The attempts to eliminate depression from the lives of sufferers demonize the state of being, and thus the denial of it is not healthy.
While not everyone experiences all of the symptoms associated with depression, many individuals who experience it struggle to cope with their emotions. They may experience feelings of hopelessness, guilt, worthlessness, and irritability. They may also experience difficulty concentrating or sleeping. These problems can cause many health issues, including an increased risk of heart disease and osteoporosis. Chronically low mood is known as dysthymia and is often accompanied by symptoms of decreased energy and irritability.
Although the biological causes of depression are numerous, it’s important to remember that it’s not one particular event that brings about symptoms. Rather, a combination of factors contribute to the development of depression. For example, genetic factors may play a role. A person’s family may experience depression more often than their parents, indicating a genetic tendency. Additionally, alcohol and drug use are often related to depression. If one has a family history of depression, the risk for depression is significantly higher.
The symptoms of depression will vary from person to person. Some people may not talk about their depression with friends or family members. They may show signs of depression by pretending to be sick, and may worry about their parent’s death. Others may engage in harmful behaviors at school. If you notice a behavior similar to these, seek help. If your teen is experiencing any of these symptoms, call 911 immediately. If you suspect that he or she is suffering from depression, contact a mental health professional or seek emergency treatment.
In some cases, depression may be a result of another illness or physical problem. Seeing a healthcare provider to get a proper diagnosis is crucial for ensuring that the depression is treated early. A mental health exam and medical history will be necessary before a doctor can determine if there is a more serious illness. The sooner the depression is diagnosed, the better chances you have of recovering. If you’re not able to make the necessary changes, your condition may become much more serious and difficult to overcome.