Bipolar disorder is also known as manic depression, a brain disorder that causes mood shifts and affects a person’s energy and ability to function daily. Bipolar disorder comprises a broad spectrum of symptoms and the American Psychiatric Association’s DSM-V separates the disorder into two major subcategories: bipolar I (BP I) and bipolar II (BP II). It is quite common for patients to experience mixed symptomatology that often causes a dilemma in diagnostic assessment.
The diagnosis of BP I requires the occurrence of a manic episode of at least one-week duration that leads to hospitalization or significant impairment in social or occupational functioning that is not caused by another medical illness or substance abuse. Manic episodes are reflected by at least one week of intense mood disturbance frequented by any three of these symptoms – elation, irritability, grandiosity, reduced need for sleep, excessive talking, racing thoughts and ideas, distraction, increased focus on goal-oriented activities and excessive indulgence in pleasurable activities. Depressive episode remains for a minimum of two weeks.
However, if the intensity of the elevated mood creates only mild to moderate interference with social and occupational functioning and the mood swings are less extreme, then it is referred to as hypomania (a less severe form of mania), diagnosed as BP II. According to the National Alliance on mental Illness (NAMI), approximately 2.6 percent American adults experience bipolar disorder at some stage in their lives. Along with depression and dysthymic disorder, bipolar is the third most common reason for hospitalization for adults aged 18-44.
The boundaries of current diagnostic classifications of psychiatric disorders are constantly being challenged basis new and emerging evidence. To examine the etiological differences between the two major subcategories of bipolar, a Swedish study published in Biological Psychiatry explored the prospective genetic distinctions between the two.
The study conducted by Dr. Jie Song and his team, from the department of clinical neuroscience, Karolinska Institute, Sweden, helps to bring clarity to the otherwise common notions regarding the relationship between BP I and II, that BP II is merely the milder subtype. The research is a first massive family study of 15 million people to investigate the differences between the two major sub-categories. The researchers took into account details from Swedish national registers and identified relatives with various biological relationships. Their correlations with other mental disorders such as schizophrenia, depression, attention-deficit/hyperactivity disorder, autism, eating disorders, substance use, anxiety and personality disorders were also assessed.
Although traditionally, the two sub-types have been viewed as adaptations of the same clinical condition, this study has established that there are crucial differences in the risk of inheriting them. Genetic similarities overlap but new findings reveal that they have different origins. The occurrence of each subtype in families was more consistent than co-occurrence between the subtypes, emphasizing that BP I and II are hereditary traits but occur separately rather than together.
Although no marked differences were observed between males and females afflicted with BP I, the proportion of females to males was much higher with regard to BP II. Also, BP I was observed to exist in families with schizophrenia although this was not the case for BP II. Clear distinctions between subtypes of mood disorders would help in robust diagnosis and treatment strategies for patients. Discovery of new biomarkers would not only improve the health outcomes but also help remove the stigma surrounding mental illnesses.
Treatment for BP typically entails a combination of mood-stabilizing drugs and antipsychotics along with psychotherapy. If you or a loved one is showing symptoms of bipolar disorder or any other mental illness, contact the Arizona Mental Health Helpline where qualified medical representatives can decide on a treatment plan that best suits your needs. You can call us at our 24/7 helpline 866-606-7791 or chat with our representatives to know more about some of the finest mental health treatment centers in Arizona.