Bipolar Affective Disorder

Bipolar Affective Disorder


     The phenomenon of Bipolar Affective Disorder has been a mystery since

the 16th and 17th century.  The Dutch painter Vincent Van Gogh was thought to of

suffered from bipolar disorder.  It appears that there are an abundance of

people with the disorder yet, no true causes or cures for the disorder.  Clearly

the Bipolar disorder severely undermines their ability to obtain and sustain

social and occupational success.  However, the journey for the causes and cures

for the Bipolar disorder must continue.


     Affective disorders are primarily characterized by depressed mood,

elevated mood or (mania), or alternations of depressed and elevated moods.  The

classical term is manic-depressive illness, a newer term is Bipolar disorder.

The two are interchangeable. Milder forms of a depressive syndrome are called

dysthymic disorder, mild forms of mania are hypomania and the milder expressions

of Bipolar disorder are called cyclothymic disorders.  The use of the term

primary affective disorder refers to the individuals who had no previous

psychiatric disorders or else only episodes of mania or depression.  Secondary

affective disorder refers to patients with preexisting psychiatric illness other

than depression or mania (Goodwin, Guze. 1989, p.7 ).


        Bipolar affective disorder affects approximately one percent or three

million persons in the United States, afflicting both males and females.

Bipolar disorder involves episodes of mania and depression.  The manic episodes

are characterized by elevated or irritable mood, increased energy, decreased

need for sleep, poor judgment and insight, and often reckless or irresponsible

behavior (Hollandsworth, Jr. 1990 ). These episodes may alternate with profound

depressions characterized by a pervasive sadness, almost inability to move,

hopelessness, and disturbances in appetite, sleep, in concentrations and driving.


     Bipolar disorder is diagnosed if an episode of mania occurs whether

depression has been diagnosed or not (Goodwin, Guze, 1989, p 11).  Most commonly,

individuals with manic episodes experience a period of depression.  Mood is

either elated, expansive, or irritable, hyperactivity, pressure of speech,

flight of ideas, inflated self esteem, decreased need for sleep, distractibility,

and excessive involvement in activities with high potential for painful

consequences.  Rarest symptoms were periods of loss of all interest and

retardation or agitation (Weisman, 1991).


     As the National Depressive and Manic Depressive Association (MDMDA) has

demonstrated, bipolar disorder can create substantial developmental delays,

marital and family disruptions, occupational setbacks, and financial disasters.

This devastating disease causes disruptions of families, loss of jobs and

millions of dollars in cost to society.  Many times bipolar patients report that

the depressions are longer and increase in frequency as the individual ages.

Many times bipolar in a psychotic state are misdiagnosed as schizophrenic.

Speech patterns help distinguish between the two disorders (Lish, 1994).


            The onset of Bipolar disorder usually occurs between the ages of

20 and 30 years of age, with a second peak in the mid-forties for women.  A

typical bipolar patient may experience eight to ten episodes in their lifetime.

However, those who have rapid cycling may experience more episodes of mania and

depression that succeed each other without a period of remission (DSM III-R).


     The three stages of mania begins with hypomania, which patients report

that they are energetic, extroverted and assertive.  The hypomania state has let

observers to feel that bipolar patients are "addicted" to their mania.

Hypomania progresses into mania as the transition is marked by loss of judgment.

Often, euphoric grandiose characters are recognized as well as a paranoid or

irritable character begins to manifest.  The third stage of mania is evident

when the patient experiences delusions with often paranoid themes. Speech is

generally rapid and behav
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