What are Bipolar & Unipolar Disorders?

It’s not the end; they’re treatable.

Being diagnosed with a mood disorder is not the end of the world as many people live with this ailment. Understanding the mood disorder is the first step in being proactive in recovery and management. There are many treatment options available today that a doctor will prescribe and following a medical regiment is very important along with being knowledgeable of the condition.

Bipolar and Unipolar Disorders are mood disorders characterized by mood ranging between manic and depressive. Bipolar disorder is marked by mood swings ranging from manic to depressive states while unipolar disorder (also know as major deprresion) is characterized by the single state of depression which is often debilitating. Differentiating these disorders can be difficult since many bipolar people will suffer depression and mood swings are less obvious or take time to realize in the patient (NIMH, 2010).

A person could be diagnosed with having an episode of bipolar disorder if he or she exhibits manic or depressive symptoms for a majority of time during a one-to-two-week period. Sometimes symptoms are so severe that the person cannot function normally at work, school, or home. The symptoms of bipolar disorder are typically divided into two categories. The first category is mania includes feeling ‘high’, or an overly happy, extremely irritable mood, agitation, feeling hyper, talking very fast, leaping from one idea to the next in conversation, racing thoughts, easily distracted, taking on new projects, being restless, sleeping little, having unrealistic belief in one’s abilities, impulsiveness and taking part in high-risk behaviors. The second category, depression includes long periods of feeling worried or empty, loss of interest in activities once enjoyed, feeling tired, difficulty concentrating, memory difficulty, difficulty making decisions, restlessness, irritability, thinking of suicide, or attempting suicide (NIMH, 2010).

Unipolar disorder also known as Major Depression, is a mood disorder characterized by degrees of sadness, disappointment, loneliness, hopelessness, self-doubt, and guilt. The symptoms of unipolar disorder are the same as the second category of symptoms in bipolar disorder. The feelings exhibited in these symptoms might be very intense and could persist for a long period. Depression can cause normal daily activities to become very difficult. Sometimes this difficulty is so severe that the individual may not be able to cope with daily activities such as work or household chores. At this level, feelings of hopelessness can become so intense that the individual may need hospitalization (NIMH, 2010).

There are various theories as to the causes of bipolar and unipolar disorder. But the preponderance evidence suggests that environmental and social factors play the strongest role in the development of bipolar disorder. These factors only increase the likelihood of developing either disorder when genetic dispositions are present (Serretti, & Mandelli, 2008). As well, recent life events such as marriage, divorce, death, relationship troubles, and unhealthy relationships increase the likelihood onset of either disorder and the recurrence of episodes (Alloy et al, 2005). Further proof of the affects of environmental factors can be realized by fact that studies have shown that a third to a half of all adults diagnosed with bipolar disorder have reported traumatic or abusive childhood experiences. In these cases, the course of the disorders was severe and was often co-occurring with disorders such as PTSD (Leverich & Post, 2006). Research has also shown that the number of reported stressful events experienced in childhood is higher in adults diagnosed with bipolar and unipolar disorder. Interestingly the stressful events that were reported typically stemmed from a harsh environment not from the child’s behavior (Louisa et al, 2007).

There also exist theories of biological predispositions for bipolar and unipolar disorder. However, against the mainstream belief that genetics are largely causal for disorders there is still little conclusive proof. Genetic studies suggest chromosomal regions and certain genes appearing relate to the development of these disorders. However, results are inconsistent and have proven to be difficult to replicate (Kato, 2007). There are also theories that have developed from the science of brain mapping through MRI and other image technologies. These theories search for abnormalities both physical and in pattern usage. But after 25 years of research, studies continue to show conflicting data and there remains a large debate due to scientific findings (Kato, 2007).

Treatment for both bipolar and unipolar disorder includes the use of psychotherapy. Psychotherapy targets the discovery of core symptoms, recognizing episode triggers, reducing the expression of negative emotion in relationships, and developing patterns of living that maintain remission. Behavioral therapies have show a high degree of effectiveness with preventing relapses. Cognitive therapy has proven to be very effective in alleviating depressive symptoms (Bauer & Mitchner, 2004).

The main staple of treatment for both unipolar and bipolar disorders has been the use of mood stabilizers. The most commonly used and most effective mood stabilizers have been lithium bicarbonate or lamotrigine. Lamotrigine is commonly used for the prevention of depressions. Lithium is the only mood stabilizer that has been proven to reduce suicides in bipolar patients. Sometimes in cases of severe depression in unipolar episodes, antidepressants are prescribed in order to stop the feelings of depression or suicide. However, the use of antidepressants is avoided in cases of bipolar depression as studies have shown that this can induce manic or hypomanic states (Bauer & Mitchner, 2004).

The use of medication in the treatment of bipolar and unipolar disorders has been the single greatest hope for afflicted individuals to lead normal productive lives. Lithium in particular has been a godsend and although there are several other mood stabilizers in use Lithium is the most commonly used and most effective. Without medication many individuals with unipolar and bipolar disorder would have to be institutionalized.

References

Alloy LB, Abramson LY, Urosevic S, Walshaw PD, Nusslock R, Neeren AM. (2005) The psychosocial context of bipolar disorder: environmental, cognitive, and developmental risk factors. Clinical Psychology Rev. 2005 December, 25(8), 1043–75.

Bauer MS, Mitchner L (January 2004). What is a “mood stabilizer”? An evidence-based response”. Am J Psychiatry 161 (1), 3–18.

Kato, T. (2007). Molecular genetics of bipolar disorder and depression. Psychiatry Clinical Neuroscience 61(1), 3–19.

Leverich, G. Post, R.A. Course of bipolar illness after history of childhood trauma The Lancet. 2006, 367, (9516), 1040–1042.

Louisa D. Grandin, Lauren B. Alloy, Lyn Y. Abramson (2007) Childhood Stressful Life Events and Bipolar Spectrum Disorders Journal of Social and Clinical Psychology, 26 (4), 460–478 NIMH. (2010). Bipolar disorder. Retrieved from http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml

NIMH. (2010). Major depression . Retrieved from http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml

Serretti, A, & Mandelli, L. (2008). The Genetics of bipolar disorder: genome ‘hot regions,’ genes, new potential candidates and future directions. Molecular Psychiatry, 13(8), 741–742.

Photo by Iulia Mihailov on Unsplash