Bipolar I andBipolar IIJenna Blevens, Tiffany Cruz, SamanthaGonzalez, Paris Graves, VivianaMiramontes
Jenna BlevensHistory of Bipolar Disorder Bipolar Disorder is a mental illness consisting of increased intensity of commonemotions. Those with Bipolar disorder often experience severe mood swingsfrom heightened manic states consisting of happiness and often times impulsivebehavior, to low depressive, confused states.The rates of individuals with Bipolar disorder in the United States is nearlydouble the rates found in other countries around the world
Jenna BlevensBipolar I and Bipolar IIIn Bipolar I, the manicepisodes are moredangerous, but thedepressive episodes aretypically shorter.In Bipolar II, thehypomanic episodes areless severe, but thedepressive episodes canbe much more lengthyIn a study conducted by Alloy et al. (2012), they looked into thehistory of bipolar disorder, and evaluated how it is progressing.The researchers conducted a longitudinal study to evaluate ifBipolar I could evolve into Bipolar II and vice versa. It was foundmore participants who suffered from Bipolar II worsened intothe state of Bipolar I. The researchers discovered that the twotypes of Bipolar disorder interact, and can even overlap. Bothtypes of Bipolar disorder are very severe mood disorders, andshould be treated properly to ensure the best outcome forpatients.
Symptoms Type I Bipolar Disorder: Experience episodes ofdepression with at least one episode offull-blown mania. Some of the symptoms of a manic episodemay be so severe that it would requirehospitalization and could trigger psychosis.Type II Bipolar Disorder: Experience severallong episodes of depression and at least onehypomanic episode, but never a manic episode. The long episodes of depression could leadto signiﬁcant impairment and is moredetrimental than the hypomanic episodes.Manic episodes experienced in BpI are moresevere than hypomanic episodes found in BpII;and although BpI and BpII are two differenttypes of episodes, they share the samesymptoms.Samantha GonzalezSymptoms found in a Manic / Hypomanic state:· Abnormally upbeat, happy, jumpy.· Talking faster than normal.· Increased activity, energy, or agitation.· Overconﬁdence and exaggerated sense of well-being.· Poor sleep.· Irritability.· Racing thoughts and distractibility.· Behaving impulsively.· Engaging in high-risk behaviors and having poor decisionmaking abilities.Symptoms found in a Depressive state:· Feelings of sadness, hopelessness, or worthlessness.· Irritability.· Low self-esteem.· Having difﬁculty concentrating or remembering.· Experiencing unusual sleep habits such as sleeping too much ortoo little.· Loss of interest or feeling no pleasure in almost all activities.· Signiﬁcant weight loss.· Fatigue or loss of energy.· Thinking about death or suicide.
EtiologyViviana MiramontesThe exact cause(s) of bipolar disorder is unknown, however, research has suggestedthat there is no single cause but rather a combination of factors that may causebipolar disorder. Genes Symptoms During this time, diagnosis is based on symptoms rather than brain tests or imaging.A chemical imbalance in the brain Although those with parents or sibling with bipolar disorder are at higher risk, most people witha family history will not develop the illnessThis cause is widely believed to be the cause of bipolar disorderIf there’s an imbalance in the levels of 1 or more neurotransmitters, a person is at high risk fordeveloping some symptoms of bipolar disorderSleep Disturbance
Viviana MiramontesRisk FactorsPossible risk factors that may increase the development of bipolardisorder I and II or might act as a trigger for the ﬁrst episode include: Genetics a parent or sibling with bipolar disorder family history is known to be the strongest and mostconsistent risk factorPeriods of high stress the death of a loved one a traumatic eventEnvironmental drug or alcohol abuseBrain structure certain ﬁndings on brain scans, such as fMRI and PET, couldpossibly be associated with bipolar disorder
The Physiological EffectsTiffany CruzRemember: The main difference between bipolar I and bipolar II is the severity of the manic episode.Hypomania tends to be less serve, cause no major problems, and people are able to function normally(Parekh, 2017) compared to an individual that experiences a mania episode, or has bipolar I.According our text, there are brain anatomy changes whenan individual experiences bipolar disorder. For instance,individuals will exhibit enlarged ventricles (Breedlove et.al, 2010) in the brain. This was further explored byStephen M. Strakowski and his colleagues (2002) wherethey found thatBIPOLARthe larger Ithe ventricle, manic episodesbecame more frequent. They also concluded that betweenﬁrst episode vs multiple-episodic patients of bipolardisorder Those with more episodes have a smallercerebral volume! Hence, why there is more brain activityin MRI scans. On the right hand side there is a comparisonof brain regions when an individual experiences bipolarepisode(s)! As the textbook mentions the, “more manicepisodes the greater reduction in gray matter”(Breedlove, 498). As we’ve learned, gray matter isimportant for neural connections and functioning!
Tiffany CruzThe Physiological Effects: Current ResearchIN THE LAST 5 YEARS RESEARCHERS HAVE FOUND.D.P Hibar and his colleagues (2016) conducted a study between thedifferences of intracranial volume of the eight subcortical brain regions inboth bipolar I and bipolar II disorders. Their results concluded that theetiology and the individual’s genetics did not show any signiﬁcantdifference in brain volume, except bipolar 1 had larger lateral ventricleand smaller hippocampus amygdala than the control group (no bipolardisorder).NOTE:BRAINSCANIMAGESARENOTPART OFTHESTUDY.JUSTSHOWNFORFUN!Sara Poletti and her colleagues (2016) tested whether or not if high levels ofbrain derived neurotrophic factor (BDNF) is associated with gray mattervolumes in bipolar patients companted to their control group (non bipolarpatients, but has had at least one major depressive episode). Their studyconcluded that bipolar patients had reduced gray matter in the followingstructures: caudate head, superior temporal gyrus, and many more than thecontrol group.What is the BDNF? According to our text, it is a protein that is encoded by theBDNF gene that is suggested to be the key to the heritability of bipolardisorder (Breedlove, pg 498). It helps nerve cells survive (Breedlove, pg189).bipolar Ibipolar IIThe following picture on the right is provided byFlávio Kapczinski and his colleagues (2008) studiedthe neuroplasticity of BDNF’s role in bipolardisorder where he summaries how certainlevels of this protein inﬂuences braincognition and development.
TreatmentParis GravesBackground: Until the late 20th century, people with bipolar disorderswere destined to spend their lives on an emotional roller coaster.Psychotherapists reported almost no success, and early antidepressantdrugs were of limited help. In fact, the drugs sometimes triggered amanic episode (Stovall, 2017; Bobo & Shelton, 2016). Past versions ofECT only sometimes relieved either the depressive or the manicepisodes of bipolar disorders (Kellner, 2016).Today:A little less than half of all persons with bipolar disorder seek treatmentin a given year but treatment options are much more effective. Patientswith Bipolar disorder can beneﬁt from drug therapy including lithiumand mood stabilizers, psychotherapy, and modern ECT in extreme cases.Lithium and other mood stabilizers have become a largepart of the modern treatment of Bipolar disorders. Moodstabilizers however are rarely sufﬁcient alone. 30% or moreof patients do not respond, don’t receive the correct doseand/or may relapse while taking these drugs. Clinicians oftenuse psychotherapy in addition to medication based therapy.Both Psychotherapy and Drug therapy alone have provenrarely helpful for patients with Bipolar disorder. Peoplewhose symptoms don’t lessen may also beneﬁt fromelectroconvulsive therapy.
Treatment cont.The correct dosage is key to patient outcomes.Too small of a dose has no effect and Lithiumintoxication or poisoning can occur at too highof a dosage. Research has found lithium andother mood stabilizers caused improvement in60% of patients with mania. Further researchsuggests these drugs work prophylactically,helping to prevent symptoms from developingin addition to treating present symptoms.Researchers do not fully understand how moodstabilizing drugs operate but they suspect thatthe drugs change synaptic activity in neurons ina different way than antidepressants do. Thisaffects a neuron’s second messengers andincreases production of a neuroprotectiveprotein, BDNF, which may increase neuronhealth and reduce bipolar symptoms. A secondtheory relates to correcting bipolar functioningby directly changing sodium and potassium ionactivity in neurons.Paris Gravesd be py!luohants s chotherematsyg tre with purDdbinemocClinicians often use psychotherapy in additionto medication based therapy. Psychotherapyalone is rarely helpful for patients with Bipolardisorder. Therapy focuses on medicationmanagement, social skills and healingrelationship issues. Research points to theaddition of psychotherapy doubling thelikelihood that patients keep up withmedication regimens. Even further researchsuggests reduced hospitalizations, improvedsocial functioning, and increased ability to holda job.
Samantha GonzalezAn Overview of Bipolar DisorderBipolar Disorder is a type of mental disorder that can cause abnormal shifts in mood, energy, concentration, and the ability tocarry out daily tasks. In Bipolar Disorder Type I, people may experience dangerous manic episodes and shorter depressiveepisodes. In Bipolar Disorder Type II, people may experience less dangerous hypomanic episodes, but the depressive episodescould be more severe. There is no exact cause for Bipolar Disorder, however, a person’s genes, chemical imbalance of the brain,and sleep disturbance, could be leading factors that may cause it. We do know that genetics, high stress, environmental abuse,and brain structure are what causes an increase in the development of bipolar disorder. It was found that the brain anatomyalso changes when someone is undergoing bipolar symptoms and that the treatment for Bipolar Disorder can be found in drugtherapy including lithium and mood stabilizers, psychotherapy, and modern ECT in extreme cases.
y, L. B., Urošević, S., Abramson, L. Y., Jager-Hyman, S., Nusslock, R., Whitehouse, W. G., & Hogan, M. (2012). Progression along the bipolar spectrum: Alongitudinal study of predictors of conversion from bipolar spectrum conditions to bipolar I and II disorders. Journal of Abnormal Psychology, 121(1), 16–27.https://doi.org/10.1037/a0023973Breedlove, S. M., Watson, N. V., & Rosenzweig, M. R. (2010). Biological psychology: An introduction to behavioral, cognitive, and clinical neuroscience. Sunderland,MA: Sinauer Associates, Inc. Publishers.“Bipolar Disorder.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 31 Jan. r-disorder/symptoms-causes/syc-20355955.Comer, Ronald J., and Jonathan S. Comer. Abnormal Psychology. 10th ed. New York: Worth Publishers, 2018. Print.Herndon , Jaime. “Risk Factors for Bipolar Disorder.” Health Line, 9 Feb. 2018, -risk-factors.Hibar, D., Westlye, L., van Erp, T. et al. Subcortical volumetric abnormalities in bipolar disorder. Mol Psychiatry 21, 1710–1716 ki, F., Frey, B. N., Kauer-Sant’Anna, M., & Grassi-Oliveira, R. (2008). Brain-Derived Neurotrophic Factor and Neuroplasticity in Bipolar Disorder. Expert Reviewof Neurotherapeutics, 8(7), 1101–1113. doi: 10.1586/14737184.108.40.2061Kazdin, A. E. (2000). Encyclopedia of psychology. Oxford: Oxford Univ. Press. doi: gas, K. R., Jin, R., He, J. P., Kessler, R. C.,, Lee, S., Sampson, N. A., Viana, M. C., Andrade, L. H., Hu, C., Karam, E. G., Ladea, M., Medina-Mora, M. E., Ono,Y., Posada-Villa, J., Sagar, R., Wells, J. E., Zarkov, Z. (2011) Arch Gen Psychiatry, 68(3):241-251. doi:10.1001/archgenpsychiatry.2011.12Parekh, R. (2017). What Are Bipolar Disorders? . Retrieved May 13, 2020, from: ar-disorders/what-are-bipolar-disordersPhillips, Mary L, and David J Kupfer. “Bipolar Disorder Diagnosis: Challenges and Future Directions.” The Lancet, vol. 381, no. 9878, 2013, pp. etti, S., Aggio, V., Hoogenboezem, T., Ambrée, O., Wit, H. D., Wijkhuijs, A., Benedetti, F. (2016). Brain-Derived Neurotrophic Factor (Bdnf) and Gray MatterVolume in Bipolar Disorder. European Psychiatry, 40, 33–37. doi: 10.1016/j.eurpsy.2016.06.008Roland, James. “Bipolar 1 vs. Bipolar 2: Know the Difference.” Healthline, Healthline Media, 10 Jan. polar-1-vs-bipolar-2.Strakowski, Steve & DelBello, Melissa & Zimmerman, Molly & Getz, Glen & Mills, Neil & Ret, Jennifer & Shear, Paula & Adler, Caleb. (2002). Ventricular andPeriventricular Structural Volumes in First- Versus Multiple-Episode Bipolar Disorder. The American Journal of Psychiatry. 159. 1841-7. 10.1176/appi.ajp.159.11.1841.Shirley, Glynn M., et al. “Recognizing the Signs of Bipolar Disorder.” American Psychological Association, American Psychological Association, 1 Feb. er.
· Engaging in high-risk behaviors and having poor decision making abilities. Symptoms found in a Depressive state: · Feelings of sadness, hopelessness, or worthlessness. . people may experience dangerous manic episodes and shorter depressive episodes. In Bipolar Disorder Type II, people may experience less dangerous hypomanic episodes, but .
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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.
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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.