WHAT IS BIPOLAR DISORDER AND WHAT CAUSES IT?

What is Bipolar Disorder and what causes it?

What is Bipolar Disorder and what causes it?

Introduction

Bipolar disorder afflicts 3 to 5% of the population with detrimental effect on life chances. Individuals with bipolar disorder face a lifetime risk for mood variations? often with devastating—even fatal—consequences. It is the sixth most common cause of disability in the United States (Altman et al.? 2006). Lifetime rates for completed suicide are 60 times higher than that for the general population? with a much higher rate of completed suicides for each attempt—1:3 versus 1:30 (Baldessarini? Pompili? &Tondo? 2006). Quality of life is often compromised for individuals with bipolar disorder. Lower wages? higher unemployment? work absenteeism? reliance on workmen's compensation? higher rates of divorce? lower levels of educational attainment? higher arrest rates? and hospitalization are often the consequences (Depp? Davis? Mittal? Patterson? & Jeste? 2006; Gardner et al.? 2006; Glahn? Bearden? Bowden? & Soares? 2006; Michalak? Yatham? Kolesar? & Lam? 2006).

In recent years? there has been increased attention to medical comorbidity? including obesity? that characterizes this problem. In one study? 81% of individuals with bipolar disorder had a current comorbid medical condition (Fenn et al.? 2005). Medical conditions found at increased rates include coronary heart disease? hypertension? hyperthyroidism? diabetes? dysplidemias? and hepatitis. Bipolar individuals also manifest elevated rates of smoking and drug and alcohol abuse. Poorer self-care (e.g.? dearth of exercise? less medical care? inactive lifestyles) may contribute to higher obesity rates (Morriss & Mohammed? 2005). Increased risk of pulmonary embolism may be a consequence of increased obesity and lifestyle factors in bipolar disorder (Strudsholm? Johannessen? Foldager? & Munk-Jorgensen? 2005). These medical conditions only exacerbate the stress? depression? and struggles of the bipolar illness itself. The course of bipolar disorder? as the diagnostic label implies? is cyclical and recurring. In the largest multicenter study conducted—the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD)—1?469 participants with bipolar disorder were followed over a 24-month period. During this period? 48.5% experienced recurrences? with depressive episodes twice as likely to occur as manic episodes (Perlis et al.? 2006). Depressive episodes are influenced by seasonal variation? but not markedly so (Friedman et al.? 2006). To more complicate matters? individuals with bipolar seldom present with one mental disorder.

A high percent of bipolar patients present with anxiety disorders? personality disorders? and substance abuse (Altindag? Yanik? & Nebioglu? 2006; McIntyre & Keck? 2006). Each of these comorbid disorders contribute to more coping difficulties (McIntyre et al.? 2006). However? putative relationships between adolescent attention-deficit disorder and later onset of bipolar disorder appear to be questionable (Jaideep? Janardhan Reddy? & Srinath? 2006). Higher rates (19.4%) of bipolar disorder are found in patients with borderline personality disorder than among patients with other personality disorders (Gunderson et al.? 2006)? although this does not appear to be related to outcome. Bipolar individuals with comorbid alcohol abuse will have higher rates of rapid cycling? symptom severity? suicidality? aggressivity? and impulsivity (Frye & Salloum? 2006). Bipolar individuals will experience considerably greater problems with employment? ...