Causes Of Bipolar Disorder

Causes of bipolar disorder 
One frequently asked questions about bipolar disorder if it is hereditary. As with most other mental disorders, bipolar disorder is not directly passed from one generations to another genetically. Rather, it is the result of a complex group of genetic, psychological and environmental factors.Stress has been found to be a significant contributor to the development of most mental illness, including bipolar disorder. for example, gay, lesbians and bisexual people are thought to experience increased emotional struggles associated with coping with reactions to their homosexuality or bisexuality in society.

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For bipolar disorder I, the (probandwise) concordance rates in modern studies have been consistently put at around 40% in monozygotic twins (same genes), compared to 0 to 10% in dizygotic twins. A combination of bipolar I, II and cyclothymia produced concordance rates of 42% vs 11%, with a relatively lower ratio for bipolar II that likely reflects heterogeneity.
The overall heritability of the bipolar spectrum has been put at 0.71. There is overlap with unipolar depression and if this is also counted in the co-twin the concordance with bipolar disorder rises to 67%  in monozigotic twins and  19% in dizygotic twins brought up together suggests that shared family environmental effects are limited by small sample sizes.


bipolar disorder

Genetic
Genetic studies have suggested many chromosomal regions and candidate genes appearing to relate to the development of bipolar disorder, but the results are not consistent and often not replicated
Although the first genetic linkage finding for mania was in 1969, the linkage studies have been inconsistent. Meta-analyses of linkage studies detected either no significant genome-wide findings or, using a different methodology, only two genome-wide significant peaks, on chromosome 6q and 8q21 Genome-wide association studies neither brought a consistent focus-each has identified new loci.
    Findings point strongly to heterogeneity, with different genes being implicated in different families. A review seeking to identify the more consistent findings suggested several genes related toserotonin (SLC6A4 and TPH2), dopamine (DRD4 and SLC6A3), glumate (DAOA and DTNBP1), and cell growth and/or maintenance pathways (NRG1, DISC1 and BDNF), although noting a high risk of false positives in the published literature. 
    It was also suggested that individual genes are likely to have only a small effect and to be involved in some aspect related to the disorder (and a broad range of "normal" human behaviour) rather than the disorder per se.
    Advanced paternal age has been linked to a somewhat increased chance of bipolar disorder in offspring, consistent with a hypothesis of increased new genetic mutations.

Physiological
Abnormalities in the structure and/or function of certain brain circuits could underlie bipolar. Two meta-analyses of MRI studies in bipolar disorder report a increase in the volume of the lateral ventricles, globus pallidus and increase in the rates of deep white matter hyperintensities.
The "kindling" theory asserts that people who are genetically predisposed toward bipolar disorder can experience a series of stressful events, each of which lowers the threshold at which mood changes occur. Eventually, a mood episode can start (and become recurrent) by itself. There is evidence of hypothalamic -pituitary-adrenal axis (HPA axis) abnormalities in bipolar disorder due to stress.
     Other brain components which have been proposed to play a role are the mitochondria and a  sodium ATPase pump, causing cyclical periods of  poor neuron firing (mania). This may only apply for type one, but tpe two apparently results from a large confluence of factors. Circadian rhythms and melatonin activity also seem to be altered.

Environmental 
Evidence suggests that environmental factors plays a significant role in the development and course of bipolar disorder, and that individual psychosocial variables may interact with genetic dispositions. There is fairly consistent evidence from prospective studies that recent life events and interpersonal relationships contribute to the likelihood of the onsets and recurrences of bipolar mood episodes, as they do for onsets and recurrences of unipolar depression.
   There have been repeated findings that between a third and a half of adults diagnosed with bipolar disorder report traumatic/abusive experiences in childhood, which is associated on average with earlier onset, a worse course, and more co-occurring disorders such as PTSD.
   The total number of reported stressful events in childhood is higher in those with an adult diagnosis of bipolar spectrum disorders compared to those without, particularly events stemming from a harsh environment rather than from the child's own behaviour.
    Early experiences of adversity and conflict are likely to make subsequent developmental challenges in adolescence more difficult, and are likely a potentiating factor in those at risk of developing bipolar disorder.

Treatment and Therapies
To date, there is no cure for bipolar disorder. But proper treatment helps most people with bipolar disorder gain better control of their mood swings and related symptoms. This is also true for people with the most severe forms of the illness.
An effective maintenance treatment plan includes medication and psychotherapy for preventing relapse and reducing symptom severity.

Medications
Bipolar disorder can be diagnosed but not everyone responds to medications in the same way. Several different medications may need to be tried before the best course of treatment is found.
      Keeping a chart of daily mood symptoms, treatments, sleep patterns and life events can help the doctor track and treat the illness most effectively. Sometimes this is called a daily life chart. If a person's symptoms change or if side effects become serious the doctor may switch or add medications. Some this types of medications generally used to treat bipolar disorder include;

  • Mood stabilizer are medications usually the first choice to treat bipolar disorder. In general, people with bipolar disorder continue treatment with mood stabilizers for years. Except for lithium, many of these medications are anticonvulsants. Anticonvulsants are usually used to treat seizure, but they also help control moods.
  • Atypical antipsychotic medications are sometimes used to treat symptoms of bipolar disorder. Often these medications are taken with other medications. Atypical antipsychotic medications are called "atypical" to set them apart from earlier medications, which are called "conventional" or "first generation' antipsychotics.
  • Antidepressant medications are sometimes used to treat symptoms of depression in bipolar disorder. People with bipolar disorder who take antidepressants often take a mood stabilizer too. Doctors usually require this because taking only an antidepressants can increase a person's risk of switching to mania or hypomania, or of developing rapid cycling symptoms.


What are the side effects of these medications
  • Before starting any of the new medication, people with bipolar disorder should consult their doctor about the possible complications and benefits.
  • If the patient happens to notice any effects from the medication, he or she should talk to the doctor who prescribed it as soon as possible. The doctor may change the dosage or prescribe a different medication.
Psychotherapy
In addition to medication, psychotherapy or "talk" therapy can be an effective treatment for bipolar disorder. It can provide support, education and guidance to people with bipolar disorder and their families.
Some psychotherapy treatments used to treat bipolar disorder include:

  • Cognitive behavioral therapy (CBT) helps people with bipolar disorder learn to change harmful or negative thought patterns and behaviours.
  • Family-focused therapy includes family members. It helps enhance family coping strategies, such as recognizing new episodes early and helping their loved one. This therapy also improves communication and problem-solving.
  • Interpersonal and social rhythm helps people with bipolar disorder improve their relationships with others and manage their daily routines. Regular daily routines and sleep schedules may help protect against manic episodes.
  • psychoeducation teaches people with bipolar disorder about the illness and its treatment. This treatment helps people recognize signs of relapse so they can seek treatment early, before a full blown episode occurs. Usually done in a group. psychoeducation may also be helpful for family members and caregivers.
Other treatments

  • Electroconvulsive therapy (ECT)- For cases in which medication and/or psychotherapy does not work, electroconvulsive therapy may be useful. ECT, formerly known as "shock therapy", once had a bad reputation. But in recent years, it has greatly improved and can provide relief for people with severe bipolar disorder who have not been able to feel better with other treatments.
  • Sleep medications People with bipolar disorder who have trouble sleeping usually sleep better after getting treatment for bipolar disorder. However, if sleeplessness does not improve, the doctor may suggest a change in medications. If the problems still continue, the doctor may prescribe sedatives or other sleep medications.
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Causes Of Bipolar Disorder  Causes Of Bipolar Disorder Reviewed by Gregory on November 18, 2018 Rating: 5

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