Introduction
Bipolar Disorder is a chronic disorder characterized by extreme changes in mood, these changes go from mania to depression. Because of its comorbidity condition, it can leads to risky behaviors and greater problems in areas of their social life such as employment, economic and personal relationships stability and even suicidal tendencies if it is not treated.(Leahy, 2007).
Its known that women tend to have more periods of depression than men. So that, they are at higher risk for rapid cycling, this means having at least four mood episodes in one year. Because of its diverse presentation and complexity, Bipolar Disorder is one of the most undiagnosed mental illness. (Leahy, 2007).
The development of bipolar disorder is cyclical and recurring as studies have shown. To prove this statement the Systematic Treatment Enhacement Program for Bipolar Disorder (STEP-BD) conducted an investigation in which 1469 bipolar patients were followed over 2 years. “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 no markedly so(Friedman et al., 2006).” (Leahy, page 418).
Etiology
The exact cause of Bipolar Disorder is not entirely known. Genetic, neurochemical and environment factors probably interact at many levels to play a role in the onset and development of bipolar disorder. The current believe is that there is a biological disorder that occurs in a specific part of the brain and is due to malfunction of the neurotransmitters, which are the chemical messengers in the brain.
Although, no one is quite sure about the exact causes of Bipolar Disorder, researchers have found these important clues: * Genetic factors: Bipolar Disorder tends to be familiar, meaning that it may runs in families. About half of the people with Bipolar Disorder have a family member with a mood disorder such as depression, substance abuse, panic disorder, phobias, alcohol related disorders, or some combination of these disorders .However, what may be inherited is not the disorder itself but rather a vulnerability to the disorder (Sarason & Sarason, 2005). * A person who has a parent with bipolar disorder has up to a 30% chance of having the condition. * A person who has a non- identical twin with the illness has up to a 30% chance of illness, the same risk as if both parents have BPD. * A person who had an identical twin (having exactly the same genetic information) with Bipolar Disorder has an even greater risk of developing the illness(40% to 70%). * Another study suggests that “ people who have genetic vulnerability to stress are more likely to develop symptoms of the disorder if there is a great deal of stress in their lives (Sarason & Sarason, 2005, page 361). An example of this statement is if in a mono-zygotic twin pairs who just one of them has the disorder, the children of the twin without the illness have the same risk for the disorder as their cousins, who are the children of the twin who have developed the disorder (Sarason & Sarason, 2005). * Studies of adopted children, where a child whose biological parent had the illness is raised in an adoptive family untouched by the illness has helped researchers learn more about the genetic causes versus environmental and life event causes. * Environmental Factors in Bipolar Disorder: There are a few environmental circumstances that can trigger the onset of bipolar disorder, such as : * A life event may lead a mood episode in a person with a genetic disposition for bipolar disorder. Even without clear genetic factors, an unhealthy lifestyle, alcohol or drug abuse can generate an episode. Besides that substance abuse is not considered a cause of bipolar disorder, it can make the illness worse. Use of alcohol, drugs or tranquilizers may induce a more severe depression phase. *
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