Bipolar Disorder

   Bipolar disorder is a chronic mood disorder that affects about 2.8% of the US adult population annually (National Alliance on Mental Health, 2022). It’s characterized by manic or hypomanic states alternating or intermixed with cycles of depression. It consists of three types (Bipolar 1, Bipolar 2, and Cyclothymia) which involve clear changes in mood, energy, and activity levels. (National Institute of Mental Health, 2020). 

   The median age of onset for bipolar disorder is 25 years, and it can develop equally in men and women of all races, ethnic groups, and social classes (National Alliance on Mental Health, 2022). The way they may differ, however, is how rapid each mood cycle is and how often they occur. In addition, more than two-thirds of people with bipolar disorder have at least one close relative with the disorder or with unipolar major depression, indicating that the disease has a heritable component (National Institute of Mental Health, 2020). 

   Some bipolar disorder symptoms are similar to those of other illnesses, which can make it challenging for a healthcare provider to make a diagnosis. Also, many individuals with bipolar disorder may have another mental condition or disorder such as anxiety disorder, substance use disorder, ADHD, or an eating disorder (National Institute of Mental Health, 2020). Sometimes, a person with severe episodes of mania or depression may experience psychotic symptoms, such as hallucinations or delusions that tend to match the person’s extreme mood. As a result, people with bipolar disorder who also have psychotic symptoms are often incorrectly diagnosed with schizophrenia. When those who have symptoms of bipolar disorder also experience periods of psychosis that are separate from mood episodes, the diagnosis may be schizoaffective disorder (National Institute of Mental Health, 2020).

   Bipolar disorder carries one of the highest risks of suicide compared to all other mental disorders, meaning almost half of people with bipolar disorder attempt suicide in their life (National Alliance on Mental Health, 2022).  Suicidal behavior is primarily associated with depressed mood cycles - major depressive episodes are associated with the highest risk of suicide, followed by mixed episodes, and finally manic episodes, which are associated with the lowest risk of suicide. In addition, researchers found that risk factors for suicide include male gender, living alone, divorced, no children, Caucasian, unemployment, and a personal history of suicide attempt and family history of suicide attempt or suicide (Miller & Black, 2020). By assessing the risk of suicide in those with bipolar disorder, early intervention and treatment of bipolar depression along with close observation and follow-up is the most effective way to mitigate the risk of suicide. 

    Unfortunately, bipolar disorder is left untreated in half of the diagnosed individuals in any given year. Although there is no cure, the optimal treatment plan for bipolar disorder is a combination of medication and cognitive-behavioral therapy (McIntyre et al., 2020). And while pharmacological treatments have been found to be effective in treating the disorder, they’re not universally available. Culture and society also play key roles in how mental health and mental health treatment are perceived. Luckily, there is change being made and more resources are becoming available to help bring awareness to the accessibility of mental health treatment. If you want to learn more about bipolar disorder, visit the International Society for Bipolar Disorder and International Bipolar Foundation.

References

• McIntyre, R. S., Berk, M., Brietzke, E., Goldstein, B. I., López-Jaramillo, C., Kessing, L. V., Malhi, G. S., Nierenberg, A. A., Rosenblat, J. D., Majeed, A., Vieta, E., Vinberg, M., Young, A. H., & Mansur, R. B. (2020). Bipolar disorders. The Lancet, 396(10265), 1841–1856. https://doi.org/10.1016/s0140-6736(20)31544-0   
• Miller, J. N. & Black, D. W. (2020). Bipolar disorder and suicide: A review. Current Psychiatry Reports, 22(6). https://doi.org/10.1007/s11920-020-1130-0 
• National Alliance on Mental Health. (2020). Mental Health by the Numbers. Retrieved from https://www.nami.org/mhstats 
• National Institute of Mental Health. (2020). Bipolar Disorder. Retrieved from https://www.nimh.nih.gov/health/topics/bipolar-disorder​