Etiology Bipolar
Etiology means: the study of the causes of diseases or the cause or origin of a disease.
When it comes to bipolar disease or bipolar disorder, the etiology bipolar is as wide and varied as the characteristics of the persons suffering from the disorder.
Genes play a large role in the etiology of bipolar disorder - approximately 50% have relatives with this disorder. If both of your parents have this disorder your chances are 75%. If you have a family member who has the bipolar disorder you are also at risk of developing unipolar disorder.
In addition to drug treatment, ECT (electroconvulsive therapy) is used for depression and mania when medications do not work.
Also bright light has been used for a seasonal form of winter depression.
Transcranial magnetic stimulation has been used for bipolar disorder.
Bipolar disorder rarely comes without other disorders. As we take a look at the affective spectrum, we see that many disorders are included and it is common for people to have one or many additional disorders.
The following have been identified (so far) as part of the medical spectrum which may accompany affective disorders.
* attention deficit disorder (ADD & ADHD)
* body dysmorphic disorder
* cataplexy
* eating disorders (bulimia, anorexia, binging)
* fibromyalgia (includes chronic fatigue)
* impulse-control disorders
* irritable bowel syndrome
* kleptomania
* migraine/severe headache
* narcolepsy
* obsessive-compulsive disorder
* panic disorder
* Tourette's disorder
The following may also be a part of the spectrum accompanying affective disorders.
* anxiety disorders
* autism
* chronic pain
* intermittent explosive disorder
* pathological gambling
* pyromania
* personality disorders
* post traumatic stress disorder
* substance abuse and addiction (includes alcoholism)
* trichotillomania
All disorders must be diagnosed and treated.
Therapy such as cognitive therapy is particularly helpful in working through one's life and group therapy with this population is also particularly helpful. Studies has shown that this form of therapy has reduced the number of hospitalizations and failed marriages.
A "bad childhood" has nothing to do with developing bipolar disorder. However families are encouraged to become involved with the patient's treatment plan and become educated about the disorder.
Recently a study revealed that out of people that were hospitalized due to mania or mixed episodes, 50% were symptom free a year later. However 25% of that had a satisfactory job and family life. Another study revealed that four years later one third were supporting themselves by working.
Sources: Harvard Mental Health Letter, April 2001, May 2001
According to the US government's National Institute of Mental Health (NIMH), "There is no single cause for bipolar disorder—rather, many factors act together to produce the illness." "Because bipolar disorder tends to run in families, researchers have been searching for specific genes—the microscopic "building blocks" of DNA inside all cells that influence how the body and mind work and grow—passed down through generations that may increase a person's chance of developing the illness." "In addition, findings from gene research suggest that bipolar disorder, like other mental illnesses, does not occur because of a single gene."
It is well established that bipolar disorder is a genetically influenced condition which can respond very well to medication.
Psychological factors also play a strong role in both the psychopathology of the disorder and the psychotherapeutic factors aimed at alleviating core symptoms, recognizing episode triggers, reducing negative expressed emotion in relationships, recognizing prodromal symptoms before full-blown recurrence, and, practicing the factors that lead to maintenance of remission. Modern evidence based psychotherapies designed specifically for bipolar disorder when used in combination with standard medication treatment increase the time the individual stays well significantly longer than medications alone. These psychotherapies are Interpersonal and Social Rhythm Therapy for Bipolar Disorder, Family Focused Therapy for Bipolar Disorder, Psycho education, Cognitive Therapy for Bipolar Disorder, and Prodrome Detection. All except Psycho education and prodrome detection are available as books.
Brain scientist Husseini K. Manji M.D. of the NIMH states that at their most basic level, the bipolar disorders involve problems in brain structure and function. He stated that these structural changes respond very well to treatment with lithium and valproate in a University of California, Los Angeles Neuropsychiatric Institute (NPI) Grand Rounds Talk given in 2003.
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Most of the psychoanalytic theory concerning the etiology of bipolar mood disorders is of the view that both depressive and manic episodes arise from a low self-concept; depressive episodes demonstrate this. Manic episodes represent a defense against the low self-concept as they act in the opposite direction, a kind of reaction formation. Evidence for this theory has come into light from cognitive research that has shown that bipolar disorder symptoms in a manic episode have higher ratings of self-esteem compared to bipolar patients in a depressive episode. Despite all this, bipolar patients demonstrate lower self-esteem ratings in both manic and depressive episodes compared to unaffected individuals.
