Bipolar disorder often runs in families, and research suggests that this is mainly explained by heredity: People with certain genes are more likely to develop bipolar disorder than other people. There are many genes involved, and no gene can cause the disorder. But genes aren't the only factor. Bipolar disorder is widely believed to result from chemical imbalances in the brain.
Scientists believe bipolar disorder is the result of a complicated relationship between genetic and environmental factors. Research suggests that a person is born with a vulnerability to bipolar disorder, which means they are more likely to develop the disorder. However, this is not the only factor in determining if a person will get sick. Environmental factors, such as stressful life events, also seem to play a role in that they can cause the onset of the disease or trigger a relapse of symptoms.
Nobody knows exactly what causes bipolar disorder. Research suggests that a combination of factors could increase the chances of developing it. This includes physical, environmental and social conditions. Some experts believe that experiencing a lot of emotional distress in childhood can lead to the development of bipolar disorder.
This could be because childhood trauma and distress can have a big effect on their ability to control their emotions. But this does not strictly mean that there is a “bipolar gene”. Family ties are likely to be much more complex. Depression in Patients With Bipolar Disorder (BE) Presents Significant Clinical Challenges.
As a predominant psychopathology, even in treated EB, depression is associated not only with excess morbidity, but also with mortality from concurrent general medical disorders and a high risk of suicide. In EB, the risks of medical disorders, such as diabetes or metabolic syndrome and cardiovascular disorders, and the associated mortality rates are several times higher than those of the general population or with other psychiatric disorders. The SMR for suicide with EB reaches 20 times higher than the rates of the general population and exceeds rates with other major psychiatric disorders. In EB, suicide is strongly associated with mixed (agitated-dysphoric) and depressive phases, depressed time and hospitalization.
Lithium May Reduce Suicide Risk in EB; Clozapine and Ketamine Require More Testing. The treatment of bipolar depression is much less researched than unipolar depression, particularly for long-term prophylaxis. The short-term efficacy of antidepressants for bipolar depression remains controversial and they are at risk of clinically worsening, especially in mixed states and with rapid cycles. Evidence for the effectiveness of lithium and anticonvulsants for bipolar depression is very limited; lamotrigine has long-term benefits, but valproate and carbamazepine are not adequately tested and carry high teratogenic risks.
Evidence is emerging of the short-term efficacy of several modern antipsychotics (such as cariprazine, lurasidone, olanzapine-fluoxetine and quetiapine) for bipolar depression, even with mixed characteristics, although they are at risk of adverse metabolic and neurological effects. Treatments for BD considered for possible suicide prevention include antidepressants, anticonvulsants and lithium, antipsychotics, ECT, and psychosocial interventions (Table. In addition, future excess depression in EB can be anticipated through initial episodes of anxiety or mixed states, as well as depression (Baldessarini et al. While bipolar disorder affects people assigned as female at birth (AFAB) and those assigned as male at birth (AMAB) in equal numbers, the condition tends to affect them differently.
MDD, and leaves bipolar depression as a major challenge for psychiatric therapy (Goodwin et al. To determine what type of bipolar disorder a person has, mental health professionals evaluate the person's symptom pattern and degree of disability during their most severe episodes. Double-Blind Placebo-Controlled Study (EMBOLDEN I) of Quietapine and Lithium Monotherapy in Adults in the Acute Phase of Bipolar Depression. In particular, there is ongoing controversy over the value and risks of antidepressant drugs in bipolar depression (Pacchiarotti et al.
Case-control analysis of the impact of pharmacotherapy on prospectively observed suicide attempts and completed suicides in bipolar disorder. That's why it's essential to seek medical attention and stay committed to treatment for bipolar disorder. The defining sign of bipolar I disorder is a manic episode that lasts at least a week, while people with bipolar II disorder or cyclothymia experience hypomanic episodes. Perhaps 80% of patients with IS experience some loss of work, and between 30 and 40% experience prolonged unemployment during adult working years, much of that disability associated with depression (Zimmerman et al.
It seems prudent that antidepressants, especially tricyclic and some SNRIs, are used with great caution for bipolar depression, especially in patients with BD-I, and may be avoided altogether with a history of mood swings during antidepressant treatment, mixed symptoms occur (Tondo et al. People with certain types of bipolar disorder, such as bipolar II disorder, experience hypomania, which is a less severe form of mania. . .
