Bipolar Manic Depression

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Bipolar Manic Depression

Bipolar Disorder is a mental illness that affect between 0.8% and 1.6% of the population that is at least one out of every 100 persons. It affects women as well as men and usually starts somewhere around a person’s teens or late twenties. This particular depression has to do with mood swings and causes people to go from highs/cheerful and blissful to lows/sad and disgusted. Concerning this form of depression, people are not alike; it differs with each individual. A person who is diagnosed with bipolar manic depression faces many concerns about this different disease. Bipolar Depression is the more popular term for Manic Depressive disease. “Although no single cause of depression has been identified, it appears that interaction among genetic, biochemical, environmental, and psychosocial factors may play a role. The fact is depression is not a personal weakness or a condition that can be willed or wished away, but it can be successfully treated” (About Depression, par 1).

“Bipolar disorder (BD) is a chronic psychiatric disorder characterized by recurrent, alternating episodes of depression and mania. Two types exist: BD I, which is characterized by one or more episodes of mania or mixed symptoms (i.e., both mania and depression), usually with a major depressive episode; and BD II, which is characterized by one or more major depressive episodes with at least one mild episode of mania (hypomania). Episodes usually last for one week or more, and four or more episodes (rapid cycling) may occur in a year “(Caple, & Cabrera, 2012). Also, the way a patient present their case to the physician plays an important part of their diagnoses. A keen awareness of bipolar disorder is most important; in helping a patient and knowing the symptoms and signs to look for. Most physicians do not have the accurate knowledge of this never ending and unbearable condition.

When a patient realizes that they have the symptoms of living with bipolar or manic depression, within a year they seek medical attention. Most time they do not receive proper diagnoses until they have been seen by a least four doctors, and therefore receive harmful treatment prior. With or without proper diagnoses, sometimes the wrong diagnoses can cause more damage than good. Alone with the patient primary physician and psychiatrist best care is afforded the individual (Loganathan, Lohano, Roberts, Yonglin, & El-Mallakh, 2010). Because of the two different mood swings (highs and lows,) it is called “bipolar”: when you experience bipolar disorder your depression is increased over your manic stages. An individual who experiences the manic stage will feel very energized and positive about life.

Because, the symptoms are alike sometimes they are diagnosed wrong. Concerning manic depression, impulses are a vital sign of the manic syndrome also. There are penalties that go with this symptom, suicidal activity as well as substance abuse (“Bipolar depression,” 1995-2005). No one actually knows what the real cause of bipolar depression is, whether it’s related to Family, personality, social relationships in fact. Family influences as well as stress, and personality factors, these all affect communication with the environment, also. “The cognitive processes through which the environment––and the self in relation to the environment––is perceived” (Hammen, 2009, p. 4). “Depression is known to have a significant environmental component” (e.g.,Kendler, Gardner, & Prescott, 2002; Sullivan, Neale, & Kendler, 2000) (Hammen, 2009, p. 3). Compared to psychopathology where schizophrenia, depression, and anxiety disorder is concerned, recently they have started to do research on bipolar depression.

This may be true because two events took place, “The approval of lithium in the United States in the 1960s as a unique and specific treatment suggested a unique and specific disorder, and bolstered by the newly minted diagnostic criteria, accelerated the recognition of the need for studies of this large and severely afflicted population ” (Hammen, 2009, p .4). One basic problems of research has been the dispute of “sorting out bipolar disorder from unipolar depression as well as some forms of schizophrenia” (Hammen, 2009, p. 5). There have been some discretion concerning the symptoms of bipolar; it has been often diagnosed as unipolar depression. Unipolar depression is major depression disorder; warning sign are: agitation, touchiness, and impatient. Once a patient has been diagnosed, it is almost impossible to be given a miss diagnosis of the depression.

The most important key is to understand the difference between bipolar depression and other disorder. Bipolar disorder is a repeated and relentless mental disorder. Individuals directly affected by the disease, whether patient or caregiver, need to be aware that there is a difference in Bipolar disorder and nonbipolar, or unipolar. However, many patients are not correctly diagnosed. There can be a combination of manic and bipolar warning signs bipolar 1 and 2. Bipolar 1 and 2 is more complex to treat than depression or mania (Stensland, Schultz & Frytak, 2010). However to categorize Studies on literature searches; using Medline and Pub Med, it is design to determine clinical distinctiveness of bipolar and unipolar depression. There is no symptom or sign neither is there characteristics that bipolar l depression matches up with unipolar depression disorder.

In fact there are virtual clinical characteristic similar in bipolar l and depression and unipolar depressive disorder (Mitchell, Goodwin, Johnson, & Hirschfeld, 2008). “The following features are more common in bipolar I depression (or in unipolar _converters_to bipolar disorder): _atypical_ depressive features such as hypersomnia,hyperphagia, and leaden paralysis; psychomotorm retardation; psychoticfeatures, and ⁄ or pathological guilt; and lability of mood” (Mitchell, Goodwin, Johnson, & Hirschfeld, 2008, p. 2). For instance, the younger, the more likely a bipolar patient will have their first onset occurrence with depression. Additionally, “those who have a family history of bipolar disorder” (Mitchell, Goodwin, Johnson, & Hirschfeld, 2008, P. 1), they will have more incident of depression to shorter depressive occurrences (Mitchell, Goodwin, Johnson, & Hirschfeld, 2008).

“The following features are more common in unipolar depressive disorder: initial insomnia ⁄ reduced sleep; appetite, and ⁄ or weight loss; normal or increased activity levels; somatic complaints; later age of onset of first depressive episode; prolonged episodes; and no family history of bipolar disorder” (Mitchell, Goodwin, Johnson, & Hirschfeld, 2008,p. 3).Over a life span patience experiences more depressive periods than those with unipolar depression. There are no major differences in depression involving bipolar and unipolar depression (Mitchell, Goodwin, Johnson, & Hirschfeld, 2008). “Episodes of bipolar disorder can combine depressive and manic symptoms (1, 2). Such episodes are associated with a worse overall course of illness (3, 4) and are more difficult to treat than episodes of depression or mania alone (5).

Most information about such episodes pertains to mixed manic episodes, defined in DSM-IV as manic episodes with syndromal depression” (Swann, Gerard, Moeller, Steinberg, Schneider, Barratt, & Dougherty, 2007, p. 207). “The results of screening studies for bipolar disorder have shown that a strikingly high proportion of individuals seeking treatment for symptoms of bipolar disorder are not diagnosed. In a recent primary care screening study, less than 10% of individuals who screened positive for bipolar disorder on a brief screening tool (Mood Disorders Questionnaire; MDQ) reported being previously diagnosed with bipolar disorder [7].

In another study that rigorously confirmed the bipolar diagnosis, 25.6% of psychiatric outpatients with bipolar I and 50.5% with bipolar II disorder were not diagnosed [8]. Other survey research found an average time lag between onset of symptoms and diagnosis of 7-10 years [6,8] (Stensland, Schultz & Frytak, 2010,p.2).” Parents‘and child/children perspective with bipolar depression disorder causes much distress. Most often parent believes they are guilty about his or her child or children, when they are diagnosed with bipolar depression. Frequently parents believe that the disorder is caused by childhood traumas; substance abuse, and the fact of parenting however. Being diagnoses with such a dramatic disease, most times will cause serious social and occupational performances.

Family members are definite traumatize by the psychosocial restriction that varies and have a great deal of emotional symptoms. In fact parents who have taken all precautions to protect their children most times will blame themselves for their child disorder (CROWE, INDER, JOYCE, LUTY, MOOR, & CARTER, 2011). There are progressive treatments involved in the management of bipolar depression. These reoccurrences of major depression and bipolar depression sometimes last more than year. Bipolar depression on the average is not easy to treat therefore results in the possibility of suicide (Caple, & Cabrera, 2012). “Established treatments for BD(2)(4)(6) Psychotropic medications Lithium, valproate, and carbamazepine are first-line treatments for individuals with BD. The anticonvulsant lamotrigine can be used instead of lithium as the first-line of treatment.

If an individual experiences another depressive episode although on maintenance medication, the first step is to optimize the dose of the medication that the patient is taking. In addition to first-line medications, antipsychotic medications (e.g., olanzapine, quetiapine) may be needed for patients with acute depression and psychotic symptoms (4) “(Caple, & Cabrera, 2012, p. 1). Treating Bipolar Depression, maintenance is vital part of the treatment; therefore medicating mood swings are very important. Bipolar Depression (Pharmacotherapy) is one way of treating the disease with the use of drugs and particularly psychiatric disorders. “Malhi GS, Adams D, Berk M.Medicating mood with maintenance in mind: bipolar depression pharmacotherapy. Bipolar Disord 2009: 11 (Suppl. 2): 55–76.a 2009 John Willey & Sons A/S” (Malh, Adams, & Berk, 2009, p. 1). Of the many features of bipolar disorder, bipolar depression is a central part in which, the patients spend most of their time and that presents many levels of problems and risk.

With pharmacotherapy bipolar depression in mind there is most favorable management in observation (Malh, Adams, & Berk, 2009). A thorough writing in examination was carried out with importance on the pharmacological treatment. Pharmacological has chemicals and various properties that explain how the body is effective by the chemical. There has been a line of attack implemented for the maintenance stage of this illness. ”Electronic library and Web-based searches were performed using recognized tools(MEDLINE, PubMED, EMBASE and PsychINFO) to identify the pertinent literature. A summary of the evidence base is outlined and then distilled into broad clinical recommendations to guide the pharmacological management of bipolar depression” (Malh, Adams, & Berk, 2009, p. 3). However none of this will matter if, these methods are not put into practice as soon as the diagnoses is available (Malh, Adams, & Berk, 2009).

Based on existing proof this is not an easy therapy to implement. “The evidence from treatment trials favors the use of lithium and lamotrigine as first-line treatment in preference to valproate, and indicates that, for acute episodes, quetiapine and olanzapine have perhaps achieved equivalence at least in terms of efficacy” (Malh, Adams, & Berk, 2009, p. 4). Nevertheless, the helpfulness of antipsychotics in maintenance therapy contain a certain amount of side effects, and also long term research information as well as clinical experience in the treatment of bipolar disorder in contrast to other instruments. Because lithiumand the anticonvulsants usually take too much time to effect suggested change, it will limit its value (Malh, Adams, & Berk, 2009). Bipolar depression, this illness across its wide spectrum and in its effort of research trials, distinguishes between the sensitive and maintenance stage of bipolar depression.

On the contrary, medical bipolar depression follows, overtime, a link where the different episodes associated and therefore require persistent protection. It is important to keep in mind acute bipolar depression when medicating mood, it is essential to all ways have maintenance in frame of mind, concerning long-term success, it is this feature of treatment that is valuable. “Therefore, when medicating mood, acute bipolar depression, it is imperative to keep maintenance in mind as it is this aspect of treatment that determines long-term success” (Malh, Adams, & Berk, 2009, P. 10). It is not suggested that you treat bipolar depression with antidepressants unaccompanied with other form of medication; it is possible to bring on mild mania. If an individual has an acute depressive incident because he or she does not response to lithium the next order of treatment would be to “add lamotrigine or the selective serotonin reuptake inhibitor (SSRI) paroxetine.

Other antidepressants that may be added include other SSRIs or monamine oxidase inhibitors (MAOIs. ) Psychotherapy with interpersonal therapy, cognitive-behavioral therapy (CBT), or family therapy is often recommended as an adjunct to psychotropic medications” (Caple, & Cabrera, 2012, p. 2). With these types of medication, pregnant, and breastfeeding women are in danger of innate defects as well as child being affective as a newborn (Caple, & Cabrera, 2012). “There are currently no accepted diagnostic criteria for bipolar depression for either research or clinical purposes. This paper aimed to develop recommendations for diagnostic criteria for bipolar I depression” (Mitchell, Goodwin, Johnson, & Hirschfeld, 2008, p. 1). It is understood that family, stress, and personality has much to do with the results of the bipolar disorder and psychosocial.

Depression is very devastating and complex to deal with, therefore much more understanding is required. If there is going to be proper treatment, there needs to be more studies of bipolar depression in terms of mania and cycle mechanisms. In fact to arrive at generalization of the concept of things seen, believed, or experienced. Symptoms of the bipolar disorder, such as acute, early adversity, chronic, and the family context are a major area of unease.

These all have unfavorable effects on physiology and mood regulation of the bipolar disorder. Research should be open to all in the future if there is going be any growth of understanding (Hammen, 2009). According to Hammen, “Clinical psychology has much to contribute to the conceptualization, methodology, and design of the new generation of research on the psychosocial aspects of bipolar disorder’s course and treatment” (p. 297). A person who is diagnosed with bipolar manic depression or unipolar disorder faces many concerns about this very different disease. No single cause has been identified what causes bipolar depression. It is probably genetic, environmental as well as biochemical, and psychosocial that plays a part in this dreaded disease. This sickness is not just a personal limitation or something that we wish could go away. However it can be effectively treated. In fact bipolar depression is a chronic psychiatric disorder.

Bipolar depression, reoccurred and alternates many times between depression and mania. For the most part Simply physician do not have correct knowledge of this unbearable situation. No one knows the cause of bipolar depression; it very well could be related to family, personality, social relationships in fact. These all play a part in communication with the environment. The objective is to learn further information: different diagnosis, types and treatments, symptom, and most of all share this knowledge with whoever needs it. Whatever you do, fail not to educate and educate more: where medicines, follow up appointments, as well as side effects. Patient, family and loved ones are especially important to share all information with. Equally imperative, is talk about the warning signs of suicide and procedure support.

(1995-2005). Bipolar depression. Retrieved from (2008-2011).Aboutdepression.Retrievedfrom _depression.aspx?source=msn&HBX_PK=s_clinical

depression&HBX_OU=52&o=47362256|223601698|0&skwid=43700003070530429 Caple, C., & Cabrera, G. (2012). Bipolar Disorder: Treatment of Bipolar Disorder Depression. CINAHL Nursing Guide, CROWE, M. M., INDER, M. M., JOYCE, P. P., LUTY, S. S., MOOR, S. S., & CARTER, J. J. (2011). Was it something I did wrong? A qualitative analysis of parental perspectives of their child’s bipolar disorder. Journal Of Psychiatric & Mental Health Nursing, 18(4), 342-348.doi:10.1111/j.1365- 2850.2010.01673.x

Hammen, C. (2009). Psychosocial Research on the Course of Bipolar Disorder: Appreciating Its Past and Encouraging Its Future. Clinical Psychology: Science & Practice, 16(2), 297-300. doi:10.1111/j.1468-2850.2009.01167.x

Loganathan, M., Lohano, K., Roberts, R., Yonglin, G., & El-Mallakh, R. S. (2010). When to suspect bipolar disorder. Journal Of Family Practice, 59 (12), 682-688.
Malhi, G. S., Adams, D., & Berk, M. (2009). Medicating mood with maintenance in mind: bipolar depression pharmacotherapy. Bipolar Disorders, 1155-76. doi:10.1111/j.1399-5618.2009.00711.x

Mitchell, P. B., Goodwin, G. M., Johnson, G. F., & Hirschfeld, R. A. (2008). Diagnostic guidelines for bipolar depression: a probabilistic approach. Bipolar Disorders, 10144-152. doi:10.1111/j.1399-5618.2007 .00559.x Stensland, M. D., Schultz, J. F., & Frytak, J. R. (2010). Depression diagnoses following the identification of bipolar disorder: costly incongruent diagnoses. BMC Psychiatry, 1039-46. doi:10.1186/1471-244X-10-39 Swann, A. C., Gerard Moeller, F. F., Steinberg, J. L., Schneider, L., Barratt, E. S., & Dougherty, D. M.(2007). Manic


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  • Date: 12 November 2016

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