Bipolar Disorder

Definition

“A bipolar disorder occurs when the client experiences both episodes of depression and episodes of mania or hypomania overtime. Bipolar disorders are the pattern of manic, hypomanic, and depressed episodes overtime” (Fortinash, Holoday, 2008, p. 220)

Bipolar disorder holds within the spectrum of possible mood disturbances. It is a relatively common and chronic psychiatric condition in which patients experience episodes of mania and depression, usually with intervening periods of relative mood stability. Bipolar disorder is associated with cognitive and behavioral difficulties and in severe cases psychosis can present in the manic and depressive states (Fortinash, Holoday, 2008),

Often beginning in adolescence or early adulthood, bipolar disorder has a profound negative

effect on interpersonal, social, family and vocational outcomes and is a risk factor for substance

abuse and suicide.

Approximately 60% of people with bipolar disorder have a substance abuse problem (NIMH,

2000), and a recent study by the National Institute of Mental Health (NIMH) found that 46% of patients with bipolar disorder are dependent on alcohol and about 40% exhibit drug abuse or dependency (Evans, 2000). Substance abuse can make bipolar disorder more severe and worsen the course of the disease by exacerbating symptoms or precipitating episodes (Evans, 2000). The factors which may increase the risk of comorbid substance abuse are family history of substance use, an early age of onset of bipolar disorder and the presence of mixed episodes (NIMH, 2000)

Suicide is one of the major causes of increased mortality in patients with mood disorders, and patients with bipolar disorder are at higher risk of committing suicide than patients with other psychiatric disorders. The lifetime prevalence of suicide in bipolar disorder patients is 15% compared with 6% in mood disorder patients. Increased risk of suicide is associated with past suicide attempts, alcohol abuse and the length of time elapsed after hospital discharge. Women attempt suicide 2–3 times more often than men, but generally use less lethal means.

The exact cause of bipolar disorder has not been clear. There are likely to be multiple

Contributors to the pathoetiology of the disorder. It is thought that bipolar affects several

areas of the brain it is apparent that abnormalities in neurotransmitters exist.

There are two distinct forms of bipolar disorder, which differ in their epidemiology. Bipolar I

disorder is an illness characterized