Bipolar I disorder is an axis 1 clinical disorder in the DSM-IV and is a serious mental illness that can lead to suicidal ideation or action. The history of bipolar disorder research is a long one, and understanding of the disease has deepened considerably over the last several generations. Diagnosis of bipolar disorder 1 is complicated by its resemblance to other mood disorders, mainly major depression but also psychotic disorders like schizophrenia. Research is revealing new treatment interventions that are targeted to the biological needs of bipolar patients, as antidepressants are often or usually contraindicated. A Christian worldview suggests that individualized treatment plans take into account the family history and patient's lifestyle when recommending a treatment plan.
History
Bipolar I disorder is a serious mental illness that affects between 1 and 2.5% of the general population in the United States (Ghaznavi & Deckersbach, 2012). The more conservative estimate, 1%, is generally reserved for Bipolar 1 disorder, the most severe on the bipolar spectrum (Hirschfeld, et al., 2000). Bipolar disorder has been written about in psychiatric and medical literature for centuries, and yet there is little progress in terms of finding an absolute cure. According to Angst & Sellaro (2000), two centuries of literature on bipolar disorder has shown mainly that the disease is "highly recurrent and considered to have a poor prognosis," (p. 445). Early historical evidence of bipolar existing in the general population stems back to ancient Greece, when Aretaeus of Cappadocia "first recognized some symptoms of mania and depression, and felt they could be linked to each other," ("A Brief History of Bipolar Disorder," 2012). That was in the first century after Christ, showing how deeply rooted manic-depressive disorder is in the human experience.
The coexistence of mania and depression in the same individual, manifesting collective symptoms exhibited intermittently, was again posited as a specific mental illness in the modern era. In 1854, French scientist Jules Farlet again linked depression and episodes of heightened mood, as well as suicide, referring to the phenomenon as "folie circulaire," or circular insanity ("A Brief History of Bipolar Disorder," 2012). In 1875, Falret and his contemporaries Francois Baillarger and Emil Kraepelin classified folie circulaire as a psychiatric illness and named it officially Manic-Depressive Psychosis ("A Brief History of Bipolar Disorder," 2012; Angst & Sellaro 2000). It was in 1899 that Kraepelin unified "all types of affective disorders," beneath one umbrella term. Kraepelin's concept of "mixed states" of affective disorder was a view that persisted as late as the 1960s (Angst & Marneros, 2001, p. 3). This early research showed that there was great awareness that depression and mania often went hand in hand. Furthermore, Falret and Baillarger were the first researchers to hypothesize a genetic component to Manic-Depressive Psychosis, now called bipolar disorder ("A Brief History of Bipolar Disorder," 2012).
German researchers also contributed to the first psychiatric classifications of manic-depression. In particular, Ewald Hecker (1843-1909) and Karl Ludwig Kahlbaum (1828-1899) "laid the groundwork for modern descriptive psychiatry," (Baethge, Salvatore & Baldessarini, 2003, p 377). In 1882, Hecker and Kahlbaum proposed the existence of a relatively benign form of manic-depressive illness," which the researchers called cyclothymia (Baethge, Salvatore & Baldessarini, 2003). The basic cyclothymia framework included "depressive (dysthymia), hypomanic (hyperthymia), and mixed hypomanic-depressive phases," a classification system that continues to underwrite today's Diagnostic and Statistical Manual (DSM) on bipolar disorder. In fact, cyclothymia is the term used in the current, fourth edition of the DSM (DSM-IV) to describe "a milder form of the bipolar II subtype" of bipolar disorder (DNS Learning Center, 2012).
The twentieth century saw revitalization in research on manic-depressive illness. Whereas the Falret, Baillarger and Kraepelin research, and even the Hecker and Kahlbaum classification system, of the late nineteenth and early twentieth centuries, were mainly theoretical and exploratory, empirical research would help psychiatrists and psychologists classify the disease with greater certainty. In the 1960s, Jules Angst, Carlo Perris, and George Winokur conducted independent empirical studies validating the concept of manic-depression (Angst & Marneros, 2001). Research was used to distinguish between unipolar (one state, such as depression) and bipolar (two states, mania and depression) affective disorders, therefore challenging the assumption made by Kraepelin that all affective disorders shared common roots and manifestations in symptoms (Angst & Marneros, 2001).
In fact, Kraepelin laid the groundwork for future research that showed that affective disorders do share certain features in common, but that there are several branches to the main trees of these disorders. Hecker and Kahlbaum's concept of cyclothymia has also made...
Bipolar Disorder Symptoms Bipolar disorder has been studied for more than a decade after remaining undiagnosed in children and adolescents for many years. Much literature such as that by Pavuluri, Birmaher, and Naylor (2005b), and Kowatch and Debello (2006) is available on diagnostic issues pertaining to paediatric bipolar disorder. In addition, many cases studies have also been published on the topic such as those by DuVaI (2005) and Hamrin and Bailey
Bipolar Disorder generally sets in during adolescence or early adulthood though it may also occur late in one's life or during childhood. It results in terrible mood swings ranging from mania and euphoria to depression and suicidal tendencies. The earlier a person is diagnosed with bipolar disorder the better. Medication is available for bipolar disorder, which helps control the mood swings and even treats the condition. Diagnosis of bipolar disorders
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