Unit 4: Understanding Bipolar Disorder - Globaledulink.co.uk
Unit 4: Understanding Bipolar Disorder
Table of contents1. Introduction2. Learning Outcomes3. Understanding the Term ‘Bipolar Disorder’4. The Possible Causes of Bipolar Disorder5. 5 The Feelings an Individual May Have When ExperiencingBipolar Disorder6. An Individual’s Bipolar Disorder and How It May Affect Others7. The Demands of Daily Life That May Influence Symptoms ofBipolar Disorder8. Bipolar Disorder and How the Demands of Daily Life MayInfluence Symptoms9. Examples of the Symptoms That May Occur in a Manic andDepressive Episode10. Medical Intervention for Bipolar Disorder11. The Ways That an Individual with Bipolar Disorder Can Help toManage Their Illness When Entering a Manic and DepressiveEpisode12. The Ways That Others Can Help the Individual with BipolarDisorder to Manage Their Illness13. The Local Resources and Treatments Available to an IndividualExperiencing Bipolar Disorder14. Unit Summary2
INTRODUCTIONIn this unit you will gain an understanding of bipolar disorder, its causesand the effect it can have on individuals and their daily lives. You will gainan understanding of ways in which bipolar disorder can be managed.3
LEARNING OUTCOMESThis unit will teach you to: Understand the term 'bipolar disorder' Understand the causes of bipolar disorder Understand how bipolar disorder can affect the individual andothers Understand how the demands of daily life can influence thepresentation of symptoms of bipolar disorder Understand how to recognise the symptoms of bipolar disorder Understand how bipolar disorder may be managed4
UNDERSTANDING THE TERM ‘BIPOLAR DISORDER’Bipolar disorder, formerly known as ‘manic depression’, is a seriousmental illness that is characterised by extreme changes in mood andbehaviour that cause individuals to go from feeling severely depressed toextremely elated, often in a very short space of time. It is thought that upto 3% of the UK’s population will experience bipolar disorder at somepoint in their life.The actual clinical definition of bipolar disorder, as defined by theDiagnostic and Statistical Manual for Mental Disorders (DSM), is:“depressed mood and/or loss of interest or pleasure in lifeactivities for at least two weeks and at least five symptoms thatcause clinically significant impairment in social, work, or otherimportant areas of functioning almost every day.”A less clinical and more accessible definition is: “a mental illness thatbrings severe high and low moods and changes in sleep, energy,thinking and behaviour.”Contrary to popular belief, there are actually four types of bipolardisorder which will dictate how much someone’s life is affected by thecondition:BIPOLAR I At least one high or manic episode which has lasted for longer thanone week Individual may only have manic episodes, although most peoplewith bipolar also have periods of depression Untreated, a manic episode will generally last 3 to 6 months Depressive episodes last rather longer – 6 to 12 months withouttreatment5
BIPOLAR II Characterized by more than one episode of severe depression, butonly mild manic episodes – these are called ‘hypomania’RAPID CYCLING Characterised by more than four mood swings in a 12-monthperiod. This affects around 1 in 10 people with bipolar disorderand can happen with both types I and IICYCLOTHYMIA The mood swings are not as severe as those in full bipolardisorder but can be longer. This can develop into full bipolardisorder.6
THE POSSIBLE CAUSES OF BIPOLAR DISORDERAs with most mental illnesses, the cause of bipolar disorder is difficult toidentify as a combination of factors are likely to contribute towards itsdevelopment. These factors can be categorised as: Genetic Chemical Personality EnvironmentalGENETIC FACTORSGenetic factors are those which mean that the likelihood of developing adisease depends on whether certain genes of an individual are passeddown from one generation to the next. This means that an individualwho has a close relative, such as a parent or sibling, who has bipolardisorder is much more likely to develop it themselves. Research hassuggested that the type of bipolar disorder that someone has can be afactor in determining whether or not it is passed down with bipolar II; themost common type identified with a possible genetic cause.CHEMICAL FACTORSChemical factors are those where an individual has a chemicalimbalance in their brain, meaning that they have too much of somehormones and not enough of others. Many hormones, such asserotonin, dopamine and norepinephrine (noradrenaline), areresponsible for mood regulation and when they are not balanced thismay be the cause of the extreme mood swings that characterise bipolardisorder. For example, when levels of serotonin are too low, this cancause depressive episodes whilst too much norepinephrine can causeepisodes of mania.7
Further evidence for chemical imbalance as a cause of bipolar disordercomes from the fact that some medications that are used to treat it will‘re-balance’ chemicals in the brain and, as such, reduce the symptomsof the condition quite successfully. Additionally, some women have theirfirst experience of bipolar disorder after the birth of a child whenhormones are known to fluctuate wildly – the brain’s inability torebalance them may cause the onset of bipolar disorder or some otherform of related mental illness such as postnatal depression or postnatalpsychosis.No one has yet discovered why brain chemistry seems to play such abig part in the onset of bipolar disorder, nor has cause and effect beenestablished. What this means is that no one is sure if chemicalimbalance causes bipolar disorder or whether bipolar disorder causeschemical imbalance.PERSONALITY FACTORSPersonality factors in developing bipolar disorder are not exclusive tothis particular condition, as it is thought that someone’s personality candetermine how able they are to deal with stressful events, and thereforehow likely they are to experience a mental illness because of this ability.For example, someone who is very introverted and does not like to talkabout themselves or to make a fuss or feel like they are burdeningsomeone, is far less likely to admit to or discuss any problems that theymay be experiencing in their life that may contribute towards a mentalillness, such as a bereavement or a troubled relationship. This meansthat they may ignore the signs of a mental illness and so make it farmore difficult to diagnose and treat.Contrary to this, someone who is open and less worried about theimpact of discussing their problems is more likely to seek advice andguidance if they have an issue and this can lead to them beingsupported and treated more quickly. This is likely to stop the mentalillness before it has had time to affect their life, or they will recover fromit more quickly.8
ENVIRONMENTAL FACTORSEnvironmental factors concern anything that is happening in anindividual’s current and previous circumstances, so this will include anyprevious childhood experiences as well. Some individuals find that theonset of their bipolar disorder coincided with a time where they wereexperiencing some very stressful life events. Such events may include: Abuse Divorce Relationship problems Bereavement Unemployment Serious illnessAny of these factors alone can contribute to the onset of mental healthissues but some people may find that they face more than one at thesame time. For example, someone may go through a period of ill health,which means that they have to give up their job. This can lead to financialdifficulties and issues within a relationship as well. When all these factorscombine together, the individual may feel unable to cope and, as a result,the onset of a mental illness (such as bipolar disorder) begins.Abuse in childhood is often a trigger for bipolar disorder because thememories of it may have been repressed into the individual’ssubconscious where they have since laid dormant until being triggeredby an incident that occurred in their adult life. For example, someonewho was routinely beaten by a parent may have repressed the memoriesof the abuse as they were too painful to deal with. However, as an adultthey may find themselves in a relationship that also has an element ofabuse and the entire scenario is made worse because all the repressedmemories from childhood are suddenly brought back into the consciousmind.9
Traumatic childhood events such as losing a parent or being involved ina serious accident can also trigger a mental illness because such anupheaval in the life of a child can make it difficult for them to regulatetheir emotions in the future. Some children may not actually deal with theafter-effects of their traumatic incident until they are an adult. They mayonly become aware of it in the future when their behaviour changes andthey cannot identify why this is.10
THE FEELINGS AN INDIVIDUAL MAY HAVE WHENEXPERIENCING BIPOLAR DISORDERThe feelings or symptoms that an individual who has bipolar disorder willexperience will be unique to them. Some may have one type of symptommore than another or some individuals may never have one particularsymptom that someone else may have consistently.Whilst symptoms will vary, there are some that are characteristic ofbipolar disorder which help health professionals to diagnose it accurately.When an accurate diagnosis is made, this can help to ensure thatappropriate support and treatment is put into place to enable theindividual to manage or recover.There are two main types of symptoms that individuals will feel whenexperiencing bipolar disorder: depression and mania. The symptoms ofthese two, as the name bipolar suggests, are very different. Symptoms ofone or the other will usually be followed by a period of normality before anew episode occurs.Depressive and manic symptoms cause changes in feelings andbehaviour. We will first look at depressive symptoms, which are outlinedin the following table:DEPRESSIVE SYMPTOMSHow the Individual Might FeelHow the Individual Might Behave Unhappy and tearful Useless and worthless Eating more or less than usual Not ding things that wouldnormally bring enjoyment Not sleeping (insomnia) or sleepingtoo much (hypersomnia) Withdrawing from socialinteractions Abusing drugs or alcohol Inadequate Irritable and tense Fatigued Low in self-esteem andconfidence Unable to make decisions Unable to concentrate Self-harming Unable to think positively or see hopefor the future Like a burden to others Pessimistic and self-doubting11
Untreated, depressive episodes tend to last more than manic ones,typically averaging around 6-12 months. Depressive symptoms do notonly occur in people with bipolar disorder but also in someone who hasunipolar depression, which is where the individual does not have manicepisodes. As such, their life is likely to be impacted in many ways, not justat home but possibly at work and in any other activity that they wouldnormally carry out.Firstly, an individual may find that they are eating more or less thanusual to try and cope with their feelings. Food can be used as a comfortto get them through the phase, or they may feel unable to summon theenergy to eat or prepare meals and, consequently, their energy levelsmay become lower still.Not sleeping or sleeping too much are also common behaviouralchanges that may affect the individual’s daily routine. Someone who hasdepressive symptoms can often find it difficult to get out of bed becausethey cannot face the day ahead, and so sleeping is a way of avoiding it.Conversely, someone who is depressed may also be experiencing anepisode of severe anxiety and this will keep them awake because theyare constantly worrying about everything in their life.During this period, it is common that individuals who are prone toaddictive behaviours may start to abuse drugs or alcohol, which isanother self-coping mechanism to try and get through this period in theirlife. Whilst the individual may feel better in the short term, using drugs oralcohol to cope in the long term will likely have negative consequencesbecause both are stimulants that can make feelings of stress and anxietyeven worse.12
Self-harm is also a possibility during a depressive episode where theindividual feels as though they need to retain control over their life. Someindividuals feel that they cannot do this any other way than by hurtingthemselves. Others go through such a devastating depressive period thatthey hurt themselves just to try and feel some kind of emotion, even if it ispain.Finally, a withdrawal from social occasions and not doing activitiesthat were once pleasurable are also symptomatic of depression.Individuals sometimes do not want to socialise as they cannot face beingwith other people, perhaps because they do not have the energy to do soor because they are too embarrassed or ashamed to tell people abouttheir condition. Not wanting to do activities is common because often itjust feels like too much effort; alternatively, the individual may be in sucha depressed state that they don’t feel anything is worth doing becausenothing will lift their mood. This can severely affect their ability to formand maintain relationships and may also mean that they cannotattend work whilst experiencing a depressive episode.MANIC SYMPTOMSHow the Individual Might FeelHow the Individual Might Behave Very happy, elated and overjoyed More active Uncontrollably excited Talking quickly and perhaps notmaking sense Easily distracted and unable toconcentrate Being overly friendly Full of energy Behaving out of character More important than they usuallywould Spending money recklessly More confident and with higherself-esteem Losing social inhibitions Making grand or unrealistic plans Less inhibited Making risky decisions thatcompromise safety Adventurous Risky sexual behaviour Being rude or aggressive Not sleeping13
If untreated, a manic episode is likely to last between 3 and 6 months.When someone is experiencing a manic phase, their behaviour canappear very different to what it might normally be and especially whencompared to the experience of a depressive phase.Individuals are likely to be full of energy and will find it difficult to staystill. They may also talk rapidly, sometimes not making sense to anyoneelse. They may seem overly friendly towards others and are moreinclined to indulge in risk-taking behaviours, which include riskysexual practices as well. These types of behaviour during this phaseoccur because the individual’s mood is so elevated that they feelinvincible, which can lead them to making grand plans, often with noregard for their physical or financial ability to carry them out. Manyindividuals during this phase will spend money recklessly whether theycan afford to or not and they may come across to others as rude andaggressive during this time as well.In common with a depressive episode, the individual may be unable tosleep and may not eat. This is because they cannot concentrate forlong enough to do so or because they are doing other things and do notconsider sleeping and eating to be that important.OTHER TYPES OF SYMPTOMSAs well as experiencing episodes where the individual feels eitherdepressed or manic, some individuals experience phases of ‘mixedepisodes’, which is where they will exhibit both depression and maniasimultaneously. For example, they may be overactive and very talkativebut with a depressed mood. Many individuals report that these periods ofsymptoms are the most difficult to cope with as they do not know what toexpect and they cannot figure out what kind of help they need. It is duringthis type of episode that an individual is more likely to act on thoughts ofself-harm.They may also experience ‘rapid cycling’, which is where theindividual will repeatedly go from mania to depression with no ‘normal’phase in between. Phases are thought to last approximately threemonths and so an individual will have four episodes of them per year.This is thought to happen to around 10% of individuals who have bipolardisorder. Sometimes, in extreme cases of bipolar disorder the individualmay experience a ‘psychotic episode’, which is more common whenthe individual is experiencing mania but can occur when they aredepressed as well. Someone who has an episode of psychosis will likelyhave hallucinations and delusions that are very real to them. Thesesymptoms can cause them to see things that are not there or to hearvoices that no one else can. Delusions can make people extremelyparanoid, which can lead to reckless or dangerous behaviour, as well asleading some individuals into believing that they are a famous person, agod or even an animal.14
AN INDIVIDUAL’S BIPOLAR DISORDER AND HOWIT MAY AFFECT OTHERSIt can be very difficult for other people to watch and understand thebehaviour of someone who has bipolar disorder. They may be at a loss todescribe why the individual goes through phases of such wild moodswings but then can appear to be ‘normal’ when there is a break in thesymptoms. It is, therefore, important that those people who knowsomeone who has bipolar disorder are educated about its symptomsso that they can better understand what is happening to the individualand why it is happening.The condition puts demands on other people who may end up caring forthe individual if they are affected so much by its symptoms that it affectstheir ability to carry out day-to- day activities. Many carers find theirresponsibilities difficult to cope with and, as such, begin to feel resentfultowards the person who needs care because of the impact that theircondition has had on their own life. Carers need to ensure that they takecare of themselves and do not neglect their own lives; they shouldcontinue carrying out activities that bring them enjoyment. Also, theyshould monitor themselves for any signs of deterioration in their ownmental or physical health, which can easily happen when they are soconsumed by caring for someone else.Partners and children of the individual can be especially affected,because through either a manic or a depressive episode the individual’sbehaviour is likely to have an impact on their life. For example, during adepressive episode, the individual may be socially unresponsive and theymay not want to even interact with their children on some days. In starkcontrast to this, during a manic phase, families may feel that they cannotkeep up with the energy levels of the individual and may be concernedabout the risky behaviour that they may indulge in. They may also fearfinancial instability if the individual is prone to spending large amountsof money on things that they cannot really afford. All children needstability in their lives and it can be very distressing for them to try andunderstand what is happening to their mum or dad whose behaviourchanges so wildly.Parents of the individual who has bipolar disorder may find that they feelguilty about their child’s diagnosis of bipolar disorder because they feel insome way responsible, questioning if they have passed on a faulty geneor if it was how they raised their child.15
Friends of the individual who has bipolar disorder may find it difficult torelate to the individual because the person who they know changes somuch when they are manic or depressed. This can put a strain onfriendships and many will be lost, which can be very difficult for theperson who has bipolar disorder to live with, especially if they are relianton those friends for support.There is still much stigma associated with mental illness and this meansthat individuals with bipolar disorder may be subject to discriminationbecause of their condition, which can be difficult for others around themto cope with. For example, people with mental illnesses are oftenportrayed as violent and out of control, which, whilst certainly possible forsome, does not accurately reflect the majority of people. Despite this,many individuals will find themselves shunned by others when they admitto having a mental illness. Even though there is legislation in place toprotect individuals who have a mental illness against discrimination, thiscan still happen because some individuals will not feel as though theycan report what is happening to them to the relevant people. This mayhappen at work, where someone has their role terminated because theyhave taken so much time off. Some employers will do this stating that it isbecause they are no longer capable of carrying out their job effectively,but the reason behind it may be the individual’s mental illness and theway in which the employer now perceives them.Finally, it is important for the individual and others around them that they16
can accept the diagnosis of bipolar disorder and be supported inmanaging its symptoms. Whilst there is no cure for the condition, it maybe managed to a point where its affects are rarely felt, and incidents ofmania and depression become fewer and fewer. The individual must bereassured that having bipolar disorder is not their fault and that theyshould be able to ask for help when they need it. Simply knowing thatthey have a support network may be enough for individuals to feel lessanxious, which may have a positive effect in reducing environmentaltriggers that could cause an episode to begin.17
THE DEMANDS OF DAILY LIFE THAT MAYINflUENCE SYMPTOMS OF BIPOLAR DISORDERSomeone’s daily life can be full of potential demands that may influencethe symptoms of bipolar disorder. The severity of their influence will bedetermined by the individual’s ability, or their perceived ability, to copewith the demands.Some demands will be common to everyone and many will find themmore difficult to cope with than others. Examples of these demandsinclude: Relationship problems Work stress Unemployment Poor housing Health problems Raising children Experience of lossRelationship problems may mean that the individual feels out of controlwith what is happening in a big part of their life. They may be too afraidto end a relationship, even if they feel as though it is not going well andthe future will not change that status. They may live with a domineeringor abusive partner who threatens to harm themselves if the relationshipends or who dictates every aspect of how they live their lives.18
Work stress is a very common cause of anxiety that can be a trigger formental illness. Being overworked or feeling underappreciated can affectsomeone’s self-esteem, which is another factor in the onset of sometypes of mental illness. When someone works in an organisation that ispoorly managed and where individuals do not feel as though they arebeing treated equally it can be a big factor in causing someone to feelunnecessarily stressed. Many individuals who have financial problemsoften find that they have to work more than one job and this can have avery negative impact on their ability to have time for themselves and fortheir family, which may lead to relationship problems.In contrast to being overworked, individuals who are experiencingunemployment may also find that they are subject to a lot of stress andanxiety. Unemployment can lead to a lowering of self-esteem becausemany individuals’ sense of worth is tied into their job role. Whensomeone is unemployed, there is more chance that they will get behindwith paying bills and this can lead to debt and financial difficulties, whichthe individual may feel is overwhelming. If someone has a chronic(long-term) health problem, they can experience mental illness as aby-product of this. If the health problem causes someone’s quality of lifeto be impaired, this often results in them experiencing depression, and,for some people, this can be experienced alongside periods of mania,giving rise to bipolar disorder. These two things, when combined, cancause a cycle of ill health because of the fluctuation in hormones thatoccur because of the health problem. For example, someone who isundergoing extreme stress is more susceptible to further illnessbecause their body produces large amounts of the hormone cortisol totry and alleviate the stress. Raised cortisol levels are known to reducethe effectiveness of the immune system and have been linked to heartproblems and raise the risk of strokes.19
Whilst raising children can be a very challenging yet rewardingexperience, many individuals find the demands of children to becompletely overwhelming. This is especially prevalent for people whosechildren have an illness of their own, either mental or physical. Parentsmay feel hopeless in the face of illness or they may feel guilty becausethey think that it is, in some way, their fault. Children with some issuessuch as attention deficit hyperactive disorder (ADHD) can be verydemanding and their behaviour can cause severe upset within a family.When an individual feels that the demands of this are too much, thenmental illness may occur as a result.Finally, whilst it might not necessarily be a daily demand, an incident ofloss such as bereavement or even a divorce can have effects thatimpact the life of the individual far after the incident of loss has takenplace. Loss can even be considered to be a traumatic incident, andbecause of this it has a significant impact on someone’s physical,emotional and mental stability.20
BIPOLAR DISORDER AND HOW THE DEMANDS OFDAILY LIFE MAY INflUENCE SYMPTOMSWhen someone is undergoing a period of stress in their life, theirhormone levels are liable to fluctuate more than they would in normalcircumstances. For someone who is susceptible to mental illness, thiscan mean that the likelihood of their condition being triggered is severelyincreased.DEPRESSIVE EPISODESHormone levels that are raised or lowered over a consistent period oftime have a big impact on an individual’s coping abilities because theconstant stress of their daily life means that levels are never able toreturn to normal. Therefore, if someone’s ‘feel good’ hormones areconsistently low, this can lead to a depressive episode as their normalhormone levels are not being raised back to where they should be.A depressive episode is characterised by low mood, where the individualis likely to be subject to withdrawal and isolation. A sign that someoneis entering a depressive episode is that they are hypersensitive tocriticism, something that may be difficult to avoid if they are in a difficultrelationship or having problems at work. When a depressive episode ishappening, the individual may also have problems communicating. Thismay make it difficult for them to attend appointments if they know that theyneed to speak with their GP or a member of a community mental healthteam. Additionally, they may have problems opening up to others abouthow they are feeling in general, which worsens their feelings of isolation.Any type of daily demand that causes stress is likely to negatively impactthe individual because it is known that, in up to 50% of individuals, bipolardisorder often occurs alongside another mental illness such as ananxiety disorder, a phobia or a panic disorder. Trying to cope with anotherillness, as well as bipolar disorder, can magnify the effects of dailydemands and intensify the symptoms caused by bipolar.Dealing with the effects of a depressive episode may make thetemptation of turning to drugs or alcohol difficult to resist. Studieshave indicated that up to 60% of individuals who experience bipolardisorder also have some form of substance abuse problem as well, andthis can mean that when they feel as though they can no longer cope that21
drinking or taking drugs is their only alternative. Not only is this dangerousfor their overall physical and mental health but it can also mean thatsometimes their mood is misdiagnosed. For example, someone who istaking a lot of cocaine will exhibit the symptoms of someone who is goingthrough a manic episode but they are just acting in response to the drug.In contrast, someone who experiences a ‘crash’ after a drug or alcoholbinge may be mistaken as being in a depressive phase when they arenot.Someone who is in a depressive phase may also be more susceptible tonegative thinking patterns, which means that they cannot see anypositives in any given situation and have most likely given up hope fortheir future as well. They may not be able to seek help from their supportnetwork or summon the energy to visit their GP because they do notbelieve there is any point as everything in their life has become hopeless.MANIC EPISODESJust as hormones can cause depressive episodes, they are also thoughtto be linked to manic ones as well. Many people who know someone whohas bipolar disorder will maintain that manic episodes are moredangerous for the individual because this is when they are most likely toexhibit risky behaviours. This might mean that they: Spend money extravagantly Have unprotected sex Drive recklessly Behave inappropriately in social situationsOnce their manic episode has passed, their behaviour during this phasewill often cause the individual to feel guilt and shame about what theydid during that time. They may also have been insulting to people,spoken to them tactlessly and have left many others upset by the waythat they have interacted with them, especially if that type of behaviour isout of character.A manic episode is when someone is also likely to behave aggressively,and signs that this may be about to happen need to be closelymonitored. Carers or family members of someone who is susceptible toaggression when they are in a manic episode may need to seek adviceabout how to deal with the individual when they are behaving in this way.22
Alcohol and drugs are a problem in a manic episode but in a differentway to when the individual is experiencing depression. Instead of usingthem as a support mechanism, the individual may drink and take drugsas part of risk-taking behaviours. Therefore, they are likely to indulge indoing this more and taking in more subst
3. Understanding the Term 'Bipolar Disorder' 4. The Possible Causes of Bipolar Disorder 5. 5 The Feelings an Individual May Have When Experiencing Bipolar Disorder 6. An Individual's Bipolar Disorder and How It May Affect Others 7. The Demands of Daily Life That May Influence Symptoms of Bipolar Disorder 8.
Subthreshold Bipolar. Disorder. Bipolar II Disorder. Bipolar I Disorder. Psychiatrist. General Medical. No Treatment. Adapted from: Merikangas, et al.1 in Arch Gen Psychiatry. 2007;64(5):543552- The proportion of individuals with bipolar I disorder, bipolar II disorder or subthreshold bipolar disorder
Some children and teens with these symptoms may have . bipolar disorder, a brain disorder that causes unusual shifts in mood, energy, activity levels, and day-to-day functioning. With treatment, children and teens with bipolar disorder can get better over time. What is bipolar disorder? Bipolar disorder is a mental disorder that causes people to experience . noticeable, sometimes extreme .
What is bipolar disorder? Bipolar disorder is a mental health problem that mainly affects your mood. If you have bipolar disorder, you are likely to have times where you experience: manic or hypomanic episodes (feeling high) depressive episodes (feeling low) potentially some psychotic symptoms during manic or depressed episodes
the neurobiology of bipolar disorder. A further aim was to draw attention to new ther-apeutic targets in the treatmen t of bipolar disorder. To accomplish these goals, an elec-tronic search was undertaken of the PubMed database in August 2015 of literature pub-lished during the last 10 years on the path ophysiology of bipolar disorder. A wide-rang-
Bipolar disorders are a category of mood disorders - with a broad range of severity. Bipolar disorder is eminently treatable. o But requires treatment to be ongoing Collaboration between treatment team and patient Bipolar disorder is a serious illness. o Lives, families, and careers are affected o People can die from it.
Bipolar disorder is a chronic or episodic (which means occurring occasionally and at irregular intervals) mental disorder. It can cause unusual, often extreme and fluctuating changes in mood, energy, activity, and concentration or focus. Bipolar disorder sometimes is called manic-depressive disorder or manic
9417 Depersonalization disorder SOMATOFORM DISORDERS 9421 Somatization disorder 9422 Pain disorder 9423 Undifferentiated somatoform disorder 9424 Conversion disorder 9425 Hypochondriasis MOOD DISORDERS 9431 Cyclothymic disorder 9432 Bipolar disorder 9433 Dysthymic disorder 9434 Major depres
Homework #4 - Answer key 1. Bargaining with in–nite periods and N 2 players. Consider the in–nite-period alternating-o er bargaining game presented in class, but let us allow for N 2 players. Player 1 is the proposer in period 1, period N 1, period 2N 1, and so on. Similarly, player 2 is the proposer in period 2, period N 2, period 2N 2, and so on. A similar argument applies to any .
