Bipolar I Disorder

Bipolar disorders fall into two categories, Bipolar I Disorder and Bipolar II Disorder. According to the DSM-5 (2013), “for a diagnosis of Bipolar I Disorder, it is necessary to meet the following criteria for a manic episode. The manic episode may have been preceded by and may be followed by hypomanic or major depressive episodes” (p. 123). While a diagnosis for Bipolar II Disorder needs to meet the criteria for a current or past hypomanic episode and criteria for a current or past major depressive episode. It is very difficult for individuals with bipolar disorders to control their moods and emotions because they often experience elevated highs and lows in each. According to a study conducted by Rusner, Carlsson, Brunt, & Nystrom (2009),
“living with Bipolar Disorder (BD) greatly affects the whole life of individuals affected by this illness as well as their families and close friends. Issues such as care, health, need for support and social interaction together with ethical questions are important parts of life with BD” (p. 159). These individuals are greatly affected by this disorder and it is difficult for them to not only take care of themselves, but often times it is also difficult for their family members who they often have to lean on for support and care. This would in turn make it difficult for an adult living with bipolar disorder because then their family would have to continue to take care of them, even as adults. The age onset for this disorder is typically around 18 years of age, according to the DSM-5 (2013).
A study conducted by Inder, Crowe, Moor, Luty, Carter, & Joyce (2008), looked into the early onset of Bipolar Disorder, ages 15-19 years, and found that, “early onset BD has been associated with increased severity and psychosocial impairment and also with a more severe course of the illness as characterized by greater comorbidity, greater chronicity, and greater risk of suicide attempts” (p. 123). They also have poorer global functioning and have higher rates of academic failure, distributed interpersonal relationships, and multiple hospitalizations. What this study shows that is that there are multiple implications for the field’s ability to study and understand this condition because minimal attention has been applied to researching the developmental implications of early onset in Bipolar Disorder. If researchers were able to focus their attention more on the diagnosis of this disease and how early onset occurs, then many adolescents would not be mistakenly diagnosed with Bipolar Disorder just based on their irritability alone, when they could in fact suffer from Disruptive Mood Dysregulation Disorder, or
DMDD. Along with mistaken diagnoses, a study conducted by Youngstrom (2009), looked at the definitional issues in Bipolar Disorder and found that, “the definition of bipolar I creates complexity for both research and practice.
At the research level, there is considerable heterogeneity in terms of phenotype, genetic predisposition, treatment response, and course of illness that all gets bundled together into a single diagnostic category” (p. 144). When it comes to Bipolar II Disorder, it was found that, “persons affected by bipolar II are most likely to seek treatment during depressed states, and they may not spontaneously report hypomanic events unless specifically probed by clinicians. However, such queries are not part of routine clinical training or practice, contributing to the under-recognition of bipolar II” (p. 145). The implication that this article raises is that there are not only strong issues with diagnosis both Bipolar I and Bipolar II Disorder, but that there are also implications on how each disorder is defined. It also raises the issue that Bipolar II Disorder often goes unrecognized by clinicians because not only do not many people seek treatment after some of their symptoms have occurred, but also many routines to check for this specific disorder are not part of the normal clinical routine practice done by
clinicians. In conclusion, these articles raise not only many interesting points, but also many implications in not only issues with these disorders, but also in the field’s ability to study and understand these conditions. There needs to not only be more research conducted for these disorders, but also, since many adolescents are showing signs of bipolar disorder, then they should be further evaluated and correctly diagnosed before there symptoms increase into adulthood. How these disorders are also defined needs to be more specific, as well as letting individuals know that they should seek treatment as soon as any abnormal symptoms start so that they can receive the right form of care. Clinicians should also practice adding more clinical routines into their facilities, so these disorders do not go unrecognized and therefore misdiagnosed. All in all, these articles not only brought up interesting points that I was unaware of before concerning these disorders, but they also proved why further research into these disorders are necessary.