Table of Contents
Introduction
To understand the role of interpersonal relationships and drug therapy in the curing process of bipolar disorder it is essential to understand the disorder itself. Bipolar disorder also known as manic depression is a mental health condition that causes the patient to feel unusual shifts in mood/energy (mood swings), activity levels, concentration and ability to carry out day-to-day tasks. There are three types of bipolar disorder.
All the three types involve shifts in mood, energy and activity levels. These moods can range from extreme “highs”, elated, irritable or energized moods to extreme “lows”, feeling of hopelessness, sad or indifferent moods (also known as depressive episodes). Other symptoms may include lack of need to sleep or trouble falling asleep, racing thoughts or trouble making decisions and loss of appetite or sudden gain of weight,etc.
First type of bipolar disorder is Bipolar I – This type involves manic episodes lasting for at least 7 days, or can also involve severe manic symptoms that need immediate hospital care. But there may be depressive episodes as well that occur which may last for approximately two weeks at least. In some cases there can also be mixed depressive episodes (which be a combination of manic and depressive symptoms). Then the second type is Bipolar II — This type involves a combination of depressive and hypomanic episodes (not-full blown manic episode symptoms). Even though this type is less dangerous than Bipolar I does not mean it does not still the patient suffering from it.
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Lastly the third type is Cyclothymic disorder (Cyclothymia) – This type involves intervals of hypothermic episodes as well as intervals of depressive episodes last for longer periods of time (about a year or two). However, in rare cases some patients experience symptoms of bipolar disorder that do not fit any of these three types and are usually referred to as “other specified and unspecified bipolar and related disorders”.
Bipolar disorder is usually diagnosed in late adolescents years or early adulthood. In some cases initial symptoms might appear in children and during pregnancy of women or following childbirth.
Impact of Bipolar Disorder on the Patient’s Lifestyle
To further understand Bipolar disorder it is essential to understand the impact it has on the lifestyle of a patient. An indispensable feature of this disorder is that it causes psychosocial distress as it constantly affects the people around the patient and its surroundings especially immediate family and workplace environment are two most common places and people to be affected by the patient’s disability.
A study by Das AK, Olfson M, Gameroff MJ, et al., conducted in a primary care practice revealed that individuals who screened positive for bipolar disorder on the MDQ (Mood Disorder Questionnaire used as survey to investigate patients with disorders) experienced significant disability in health, social, family, and occupational functioning.
Even after adjusting to the presence of their mental condition various patients screened positive for the disorder still showed impairment in health-related quality of life, social activities, and family life remained. Moreover, nearly one fifth or 19% of those who screened positive for bipolar disorder in this study reported having suicidal thoughts at least some days during the previous 2 weeks compared with 4% of those who screened negative.
Indicating even after the intensity of their manic episodes may have reduced, many would still show signs of impaired functioning as many patients do not fully recover the ability to work and engage in social activities therefore remaining impaired even during the stable phases of their illness.
Research by Judd LL, Akiskal HS, Schettler PJ, et al. indicates that bipolar depression (not mania) shows life long effects of this disorder. In addition several other studies by Hirschfeld rm, Calabrese jr, Frye ma, Wagner kd, Reed m. show that depressive symptoms are more persistent than manic symptoms and are deemed as more probable to disrupt work life as well as social and family life functioning of the patient compared to manic symptoms.
Also that bipolar depressed patients are often more likely to express worse depressive symptoms as well as being impaired all or most of the time in their ability to maintain their work and social interactions in comparison to unipolar depressive patients. In spite of the significant importance of depression in overall symptoms of bipolar patients, this integral part of the illness still remains much uninvestigated till date.
