Causes and Symptoms (Magill’s Medical Guide, Sixth Edition)
Although the causes of bipolar disorders are not known definitively, research indicates that some persons may be genetically predisposed to respond readily with manic or depressive episodes to internal and external influences. While changes in brain metabolism are thought to be significant in the development of bipolar disorders, both psychological and nonpsychological stresses are known to precipitate the onset of problems. It is often not possible to find one precipitating factor, however, because there is presumably a complex interaction between the effects of internal and external influences in persons suffering from this illness.
Bipolar disorders are illnesses that often occur in attacks, or episodes, lasting several days to a week or longer. They may be attacks of mania (periods of extreme elation and increased activity), hypomania (notably elevated mood and heightened activity), or depression (periods of abnormal sadness and melancholy). Recent work indicates that many variants of this disorder exist. Bipolar I is a variant of bipolar disorder in which individuals experience at least one episode of depression and one episode of mania. Bipolar II is a variant in which individuals experience at least one episode of depression and one episode of hypomania. For some individuals, these episodes signifying the presence of a disorder may be time limited and singular occurrences. For others, there may be repeated bouts of...
(The entire section is 1133 words.)
Treatment and Therapy (Magill’s Medical Guide, Sixth Edition)
Lithium is the drug frequently used for the treatment of bipolar disorders. A metallic element discovered by a Swedish chemist in 1818, lithium is produced from minerals such as spodumene, amblygonite, lepidolite, and petalite. As a drug, lithium is always used in the form of one of its salts—for example, lithium carbonate or lithium citrate. It is the lithium portion of these salts that is effective medically. Lithium was introduced into medicine in 1850 for the treatment of gout, and during the following century many medical uses of the element were proposed. It was used as a stimulant, as a sedative, for the treatment of diabetes, for the treatment of infectious diseases, as an additive to toothpaste, and for the treatment of malignant growths. The efficacy of lithium in these conditions was not proved, however, and lithium treatment never became widespread.
In 1949, an Australian psychiatrist, John Cade, published an article that forms the basis of all later lithium treatment. The prophylactic action of lithium in manic-depressive type illnesses was debated in the psychiatric literature for some years, but extensive trials in many countries have fully documented the efficacy of the drug. Its prophylactic action is exerted against both manic and depressive relapses. One of the characteristic features of lithium is that it removes manic symptoms without producing sedation, unlike treatment with neuroleptics, which...
(The entire section is 1239 words.)
Perspective and Prospects (Magill’s Medical Guide, Sixth Edition)
Bipolar disorders are among the most consistently identifiable of all mental disorders, and among the oldest. They are discernible in descriptions in the Old Testament, and they were recognized in clinical medicine almost two thousand years ago. The medical writers of ancient Greece (the Hippocratic school) conceived of mental disorders in terms that sound remarkably modern. They believed that melancholia was a psychological manifestation of an underlying biological disturbance—specifically, a perturbation in brain function. Early conceptions of “melancholia” and “mania” were, however, broader than those of modern times. These two terms, together with “phrenitis,” which roughly corresponds to an acute organic delirium, comprised all mental illnesses throughout most of the ancient period.
As they did with other illnesses, the Hippocratic writers argued forcefully that mental disorders were not caused by supernatural or magical forces, as primitive societies had believed. Their essentially biological explanation for the cause of melancholia, which survived until the Renaissance, was part of the prevailing understanding of all health as an equilibrium of the four humors—blood, yellow bile, black bile, and phlegm—and all illness as a disturbance of this equilibrium. First fully developed in the Hippocratic work Nature of Man (c. 400 b.c.e.), the humoral theory linked the humors with the...
(The entire section is 1039 words.)
For Further Information: (Magill’s Medical Guide, Sixth Edition)
Castle, Lana R., and Peter C. Chybrow. Bipolar Disorder Demystified: Mastering the Tightrope of Manic Depression. New York: Avalon, 2003. A layperson’s guide to the disorder, written by a bipolar disorder patient. Provides an understanding of the true nature of bipolar disorder, the factors that complicate its diagnosis, and numerous strategies for successfully coping with the illness.
Depression and Bipolar Support Alliance. http://www .dbsalliance.org. Offers information on mood disorders, support groups, referrals for mental health professionals, research links, and discussion forums.
Geller, Barbara, and Melissa P. DelBello, eds. Bipolar Disorder in Childhood and Early Adolescence. Rev. ed. New York: Guilford, 2006. An examination of the little-studied occurrence of the disorder in children, including its epidemiology, diagnosis, natural history, neurobiology, genetics, and treatment.
Goodwin, Frederick K., and Kay Redfield Jamison. Manic-Depressive Illness. 2d ed. New York: Oxford University Press, 2007. Drawing on their extensive clinical and research experience, the authors have analyzed and interpreted the literature on manic-depressive illness and presented a unique synthesis of information for the acute and chronic management of manic-depressive patients.
Jamison, Kay Redfield. An Unquiet Mind: A Memoir of Moods and Madness. New York: Alfred A....
(The entire section is 337 words.)