Bipolar Disorder

Bipolar disorder, earlier referred to as manic depression, is a mental disorder that produces abnormally high times and times of depression. The high mood is important and, based on its seriousness, it is regarded as mania or hypomania and psychosis signs are present. During madness, an person is or feels abnormally vigorous, glad or irritable. Individuals often decide badly in terms of the implications. During manic phases, the need for sleep is generally decreased. Prayer, adverse life perspectives and bad eye contact with others may be present during phases of depression. Suicide danger is high among those with the disease

While the causes are not clear, economic and genetic variables are important. Many small-effect genes add to the danger. Approximately 85% of the danger has been assigned to genetics.[8] This is considered to be a bipolar 1 disease if there is at least one manic episode with or without depressive episodes, and a bipolal II disorder if there has been at least one hypomanic (but no manic) episode and one significant depressive one. Environmental risk variables include background for child-related violence and long-term stress. When drugs o are responsible for the causes

Bipolar Disorder Bipolar disorder earlier referred manic depression mental disorder produces abnormally high times times depression The high mood based seriousness regarded mania hypomania psychosis signs During madness person feels abnormally vigorous glad irritable Individuals decide badly terms implications During manic phases sleep generally decreased Prayer adverse life perspectives bad eye contact phases depression Suicide danger high disease While clear economic genetic variables Many small genes add danger Approximately danger assigned genetics This considered bipolar disease manic episode depressive episodes bipolal disorder hypomanic manic episode depressive Environmental risk variables include background child violence long term stress When drugs responsible Bipolar disorder manic depression mental disorder periods depression periods abnormally elevated mood The elevated mood mania hypomania depending severity symptoms psychosis During mania individual behaves feels abnormally energetic happy irritable Individuals thought decisions regard consequences The sleep reduced manic phases During periods depression crying negative outlook life poor eye contact The risk suicide illness high greater percent years harm occurs percent Other mental health issues anxiety disorders substance disorder commonly bipolar disorder The understood environmental genetic factors play role Many genes small contribute risk Environmental risk factors include history childhood abuse long term stress About risk attributed genetics The condition classified bipolar disorder manic episode depressive episodes bipolar disorder hypomanic episode manic episodes major depressive episode severe symptoms prolonged duration condition cyclothymic disorder diagnosed symptoms drugs medical problems classified separately Other conditions include attention deficit hyperactivity disorder personality disorders schizophrenia substance disorder number medical conditions Medical testing required diagnosis blood tests medical imaging rule problems Bipolar disorder treated medications mood stabilizers antipsychotics psychotherapy Mood stabilizers improve mood disturbances include lithium anticonvulsants valproate carbemazepine Involuntary treatment hospital needed person risk refuses treatment Severe behavioral problems agitation combativeness managed short term antipsychotics benzodiazepines periods mania recommended antidepressants stopped antidepressants periods depression mood stabilizer Electroconvulsive therapy ECT studied respond treatments treatments stopped recommended slowly Many individuals financial social work problems illness These difficulties occur quarter time average Due lifestyle choices effects medications risk death natural heart disease people bipolar general population Bipolar disorder global population United States estimated point life rates females males The common age symptoms The economic cost disorder estimated billion United States 1991 large proportion higher number missed work days estimated year People bipolar disorder face problems social stigma Signs symptomsBoth mania depression characterized disruptions normal mood psychomotor activity circadian rhythm cognition Mania varying levels mood disturbance ranging euphoria classic mania dysphoria irritability The core symptom mania involves increase energy psychomotor activity Mania increased esteem grandiosity rapid speech subjective feeling rapid thoughts disinhibited social behavior impulsivity Mania distinguished hypomania length hypomania requires consecutive days mania requires week Unlike mania hypomania impaired functioning The biological mechanisms responsible switching manic hypomanic episode depressive episode vice versa remain understood Manic episodes 1892 color lithograph depicting woman diagnosed Hilarious Mania Mania distinct period week elevated irritable mood range euphoria delirium experiencing hypomania mania generally exhibit behaviors speaking rapid uninterruptible manner decreased sleep short attention span racing thoughts increased goal oriented activities agitation exhibition behaviors characterized impulsive high risk hypersexuality excessive spending meet definition manic episode behaviors impair individual ability socialize work untreated manic episode lasts months Manic individuals history substance abuse developed years form medication extreme person blown manic experience psychosis break reality thinking mood They feel unstoppable chosen special mission grandiose delusional ideas This lead violent behavior hospitalization inpatient psychiatric hospital The severity manic symptoms measured rating scales Young Mania Rating Scale questions remain reliability scales The onset manic depressive episode foreshadowed sleep disturbances Mood psychomotor appetite increase anxiety occur weeks manic episode develops Hypomanic episodesHypomania milder form mania defined days criteria mania decrease individual ability socialize work lacks psychotic features delusions hallucinations require psychiatric hospitalization Overall functioning increase episodes hypomania thought serve defense mechanism depression Hypomanic episodes rarely progress blown manic episodes Some people experience hypomania increased creativity irritable demonstrate poor judgment Hypomania feel good persons experience people experience hypomania stress experience painful Bipolar people experience hypomania tend forget effects actions Even family friends recognize mood swings individual deny wrong What called hypomanic event accompanied depressive episodes deemed problematic mood uncontrollable volatile Most commonly symptoms continue weeks months Depressive episodesSymptoms depressive phase bipolar disorder include persistent feelings sadness irritability anger loss enjoyed activities excessive inappropriate guilt hopelessness sleeping appetite weight fatigue problems concentrating loathing feelings worthlessness thoughts death suicide severe cases individual develop symptoms psychosis condition severe bipolar disorder psychotic features These symptoms include delusionsand hallucinations major depressive episode persists weeks result suicide left untreated The earlier age onset episodes depressive Since diagnosis bipolar disorder requires manic hypomanic episode individuals initially misdiagnosed major depression incorrectly treated prescribed antidepressants Mixed affective episodesIn bipolar disorder mixed condition symptoms mania depression occur simultaneously Individuals experiencing mixed manic symptoms grandiose thoughts simultaneously experiencing depressive symptoms excessive guilt feeling suicidal Mixed considered high risk suicidal behavior depressive emotions hopelessness paired mood swings difficulties impulse control Anxiety disorders occur frequently comorbidity mixed bipolar episodes mixed bipolar depression mania Substance abuse including alcohol trend appearing depict bipolar symptoms consequence substance abuse Associated featuresAssociated features clinical phenomena accompany disorder diagnostic criteria adults condition bipolar disorder accompanied cognitive processes abilities These include reduced attentional executive capabilities impaired memory How individual processes universe depends phase disorder differential characteristics manic hypomanic depressive Those bipolar disorder difficulty maintaining relationships There common childhood precursors children receive diagnosis bipolar disorder mood abnormalities including major depressive episodes attention deficit hyperactivity disorder ADHD Comorbid conditionsThe diagnosis bipolar disorder complicated coexisting comorbid psychiatric conditions including obsessive compulsive disorder substance disorder eating disorders attention deficit hyperactivity disorder social phobia premenstrual syndrome including premenstrual dysphoric disorder panic disorder careful longitudinal analysis symptoms episodes enriched discussions friends family members crucial establishing treatment plan comorbidities exist CausesThe bipolar disorder vary individuals exact mechanism underlying disorder remains unclear Genetic influences believed account percent risk developing disorder indicating strong hereditary component The heritability bipolar spectrum estimated Twin studies limited small sample sizes substantial genetic contribution environmental influence For bipolar disorder type rate identical twins genes bipolar disorder type concordance estimated percent compared percent fraternal twins combination bipolar cyclothymia produced rates percent percent identical fraternal twins ratio bipolar reflects heterogeneity There overlap major unipolar depression counted twin concordance bipolar disorder rises percent identical twins percent fraternal twins The concordance fraternal twins brought suggests shared family environmental effects limited ability detect limited small sample sizes Estrogen women linked bipolar disorder GeneticBehavioral genetic studies suggested chromosomal regions candidate genes bipolar disorder susceptibility gene exerting mild moderate The risk bipolar disorder fold higher degree relatives bipolar disorder compared general population risk major depressive disorder times higher relatives bipolar disorder compared general population Although genetic linkage finding mania 1969 linkage studies inconsistent The largest genome wide association study GWAS failed locus exerts large reinforcing idea single gene responsible bipolar disorder cases Polymorphisms BDNF DRD4 DAO TPH1 frequently bipolar disorder initially successful meta analysis failed correction multiple testing hand polymorphisms TPH2 identified bipolar disorder Due inconsistent findings genome wide association study multiple studies undertaken approach analyzing single nucleotide polymorphisms SNPs biological pathways Signaling pathways traditionally bipolar disorder supported studies include corticotropin releasing hormone CRH signaling cardiac adrenergic signaling Phospholipase signaling glutamate receptor signaling cardiac hypertrophy signaling Wnt signaling Notch signaling endothelin 1signaling genes identified pathways dysregulated dorsolateral prefrontal cortex portion brain post mortem studies CACNA1C GNG2 ITPR2 Findings point heterogeneity genes implicated families Robust replicable genome wide associations common SNPs including variants genes CACNA1C ODZ4 NCAN Bipolar disorder reduced expression specific DNA repair enzymes increased levels oxidative DNA damages Advanced paternal age linked increased chance bipolar disorder offspring consistent hypothesis increased genetic mutations EnvironmentalPsychosocial factors play role development bipolar disorder individual psychosocial variables interact genetic dispositions probable life events interpersonal relationships contribute onset recurrence bipolar mood episodes unipolar depression surveys percent adults diagnosed bipolar disorder report traumatic abusive experiences childhood earlier onset higher rate suicide attempts occurring disorders post traumatic stress disorder PTSD The number reported stressful events childhood higher adult diagnosis bipolar spectrum disorder compared events stemming harsh environment child behavior NeurologicalLess commonly bipolar disorder bipolar disorder occur result association neurological condition injury Conditions injuries include stroke traumatic brain injury HIV infection multiple sclerosis porphyria rarely temporal lobe epilepsy MechanismFurther Biology bipolar disorderPhysiologicalBrain imaging studies revealed differences volume brain regions patients bipolar disorder healthy control subjectsAbnormalities structure function brain circuits underlie bipolar disorder Meta analyses structural MRI studies bipolar disorder report decreased volume left rostral anterior cingulate cortex ACC fronto insular cortex ventral prefrontal cortex claustrum Increases reported volume lateral ventricles globus pallidus subgenual anterior cingulate amygdala rates deep white matter hyperintensities Functional MRI findings abnormal modulation ventral prefrontal limbic regions amygdala contributes poor emotional regulation mood symptoms Pharmacological treatment mania increases ventral prefrontal cortex vPFC activity normalizing relative controls suggesting vPFC hypoactivity indicator mood hand pretreatment hyperactivity amygdala reduced post treatment increased relative controls suggesting trait marker Manic depressive episodes tend characterized ventral dorsal dysfunction ventral prefrontal cortex During attentional tasks resting mania decreased orbitofrontal cortex activity depression increased resting metabolism Consistent affective disorders lesions mania depression lateralized vPFC dysfunction depression left vPFC mania vPFC Abnormal vPFC activity amygdala hyperactivity euthymia healthy relatives bipolar indicating trait features Euthymic bipolar people decreased activity lingual gyrus people manic demonstrate decreased activity inferior frontal cortex differences people bipolar depression People bipolar increased activation left hemisphere ventral limbic areas decreased activation hemisphere cortical structures cognition One proposed model bipolar disorder suggests hypersensitivity reward circuits consisting frontostriatal circuits mania hyposensitivity circuits depression According kindling hypothesis people genetically predisposed bipolar disorder experience stressful events stress threshold mood occur progressively episodes eventually start recur spontaneously There evidence supporting association early life stress dysfunction hypothalamic pituitary adrenal axis HPA axis leading overactivation play role pathogenesis bipolar disorder Some brain components proposed play role mitochondria sodium ATPase pump Circadian rhythms regulation hormone melatonin altered NeurochemicalDopamine neurotransmitter responsible mood cycling increased transmission manic phase The dopamine hypothesis increase dopamine secondary homeostatic downregulation key systems receptors increase dopamine mediated protein coupled receptors This decreased dopamine transmission characteristic depressive phase The depressive phase ends homeostatic regulation restarting cycle Glutamate increased left dorsolateral prefrontal cortex manic phase bipolar disorder returns normal levels phase The increase gamma Aminobutyric acid GABA caused disturbance early development causing disturbance cell migration formation normal lamination layering brain structures commonly cerebral cortex Medications treat bipolar exert modulating intracellular signaling depleting myo inositol levels inhibition cAMP signaling altering coupled proteins Consistent elevated levels Gαi Gαs Gαq 11have reported brain blood samples increased protein kinase expression sensitivity Decreased levels hydroxyindoleacetic acid byproduct serotonin cerebrospinal fluid persons bipolar disorder depressed manic phases Increased dopaminergic activity hypothesized manic ability dopamine agonists stimulate mania people bipolar disorder Decreased sensitivity regulatory adrenergic receptors increased cell counts locus ceruleus increased noradrenergic activity manic people Low plasma GABA levels sides mood spectrum One review difference monoamine levels abnormal norepinephrine turnover people bipolar disorder Tyrosine depletion reduce effects methamphetamine people bipolar disorder symptoms mania implicating dopamine mania VMAT2 binding increased study people bipolar mania DiagnosisBipolar disorder commonly diagnosed adolescence early adulthood onset occur life cycle The disorder difficult distinguish unipolar depression average delay diagnosis years symptoms Diagnosis bipolar disorder takes factors account considers reported experiences symptomatic individual abnormal behavior reported family members friends workers observable signs illness assessed clinician medical work rule medical diagnosis caregiver scored rating scales mother accurate teacher youth report predicting identifying youths bipolar disorder Assessment outpatient basis admission inpatient facility considered risk oneself The criteria diagnosing bipolar disorder American Psychiatric Association APA Diagnostic Statistical Manual Mental Disorders Fifth Edition DSM World Health Organization WHO International Statistical Classification Diseases Related Health Problems 10th Edition ICD The ICD criteria clinical settings DSM criteria clinically prevailing criteria internationally studies The DSM published 2013 included accurate specifiers compared predecessor DSM Semi structured interviews Kiddie Schedule Affective Disorders Schizophrenia KSADS Structured Clinical Interview DSM SCID diagnostic confirmation bipolar disorder Several rating scales screening evaluation bipolar disorder exist including Bipolar spectrum diagnostic scale Mood Disorder Questionnaire General Behavior Inventory Hypomania Checklist The evaluation scales substitute clinical interview serve systematize recollection symptoms hand instruments screening bipolar disorder tend sensitivity Differential diagnosisThere mental disorders symptoms bipolar disorder These disorders include schizophrenia major depressive disorder attention deficit hyperactivity disorder ADHD personality disorders borderline personality disorder Although biological tests diagnostic bipolar disorder blood tests imaging carried exclude medical illnesses clinical presentations bipolar disorder Neurologic diseases multiple sclerosis complex partial seizures strokes brain tumors Wilson disease traumatic brain injury Huntington disease complex migraines mimic features bipolar disorder EEG exclude neurological disorders epilepsy scan MRI head exclude brain lesions Additionally disorders endocrine hypothyroidism hyperthyroidism Cushing disease differential connective tissue disease systemic lupus erythematosus Infectious mania bipolar mania include herpes encephalitis HIV influenza neurosyphilis Certain vitamin deficiencies pellagra niacin deficiency Vitamin B12 deficiency folate deficiency Wernicke Korsakoff syndrome thiamine deficiency lead mania review current medications drug considered rule common medications manic symptoms include antidepressants prednisone Parkinson disease medications thyroid hormone stimulants including cocaineand methamphetamine antibiotics Bipolar spectrumSince Emil Kraepelin distinction bipolar disorder schizophrenia 19th century researchers defined spectrum types bipolar disorderBipolar spectrum disorders includes bipolar disorder bipolar disorder cyclothymic disorder cases subthreshold symptoms clinically impairment distress These disorders involve major depressive episodes alternate manic hypomanic episodes mixed episodes feature symptoms mood The concept bipolar spectrum Emil Kraepelin original concept manic depressive illness Unipolar hypomania accompanying depression medical literature There speculation condition occur greater frequency general untreated population successful social function high achieving individuals lead labeled normal individuals substantial dysregulation PreventionAttempts prevention bipolar disorder focused stress childhood adversity highly conflictual families diagnostically specific causal agent bipolar place genetically biologically vulnerable individuals risk severe illness There debate causal relationship usage cannabis bipolar disorder Bipolar Disorder ZodiacPage

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