Psychology and the Bipolar Disorder
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Bipolar disorders are often confused with other symptoms, and there are many myths surrounding the cause and effects of this mental illness. The purpose of this research is to present a deeper analysis on how the biology and environment affect bipolar disorders. It also takes a look at the relationship between early child hood traumas and risk of personality disorders and the biological explanations pertaining to that. This paper analyses an essential link between recognizing the warning signs, and initiating a suitable treatment for the patients. The Nature vs Nurture angle is also discussed in this paper. Psychology and the Bipolar Disorder Bipolar disorder is also known as ‘manic depressive illness’, and it is an affective disorder that causes extreme mood swings that veers from depression to mania. It is always accompanied by severe disturbances in thought patterns and behaviors. It is a complex genetic disorder in which the core symptom is pathological disturbance in mood, behaviour and normal routine. A depressed patient loses motivation and shirks form doing difficult tasks. Their attention span decreases, they suffer form crying spells, loss of appetite, and a marked change in sleep patterns also occurs. Either the person loses sleep or sleeps for abnormally long hours.
In extreme cases, the depressed persons are prone to excessive self-harm or suicide. There are examples of families where a single gene plays a major role in determining the susceptibility of a person in inheriting the disease, but the majority of bipolar disorder involves the interaction of multiple genes (epitasis) or more complex genetic mechanisms (e.g. dynamic mutation or imprinting). The molecular genetic positional and candidate gene approaches are being used for the genetic dissection of bipolar disorder. No gene has yet been found, but the research on this subject is going on. Bipolar disorders are basically depressive disorders bordering on mania and depression. Mania is frenzied activity and depression is cessation of activity. A manic person often suffers from heightened sense of self and deludes himself with grandiose thoughts. In depression certain apathy and listlessness occurs, and it often leads to thought of suicide and acute worthlessness. A combination of both or one following the other is the indication of bipolar disorder.
Mania is bifurcated into two types: Hypo mania and Full Mania. Mania can be characterized by a decreased need for sleep, decreased self control, over spending, increased sexual activity, irritability, irrepressible rage, risk taking behaviors, and in extreme cases a person reaches a psychotic state. Hypomania has the same symptoms but is less severe in its impact. Both the manias bring a surge of energy and euphoria. It is like the brain creating its own high. Depression is the low period, the exact opposite of mania, and some symptoms like decreased sleep, mood swings, irritability and poor judgment are common to both. Feelings of prolonged sadness and thoughts of death and suicide accompany the depressive phases. There is no test for bipolar disorder. The diagnosis is made either from observing a client or by verbal history and discussion of symptoms by the doctor with either the client or their relatives. Speaking of bipolar disorders, there exists inconvertible evidence that bipolar disorders are genetically linked. Studies have shown that there is an integral relation between mind body and environment, in developing a person’s psyche.
A balanced combination of these three is the decisive factor in maintaining a healthy mind and stable personality. It has been widely known that physical disease or damage, especially of the brain, is greatly associated with an increased risk for psychological disorders. However, the latest study shows that it is an understanding of biological factors, which decide the individual differences in response. The role of certain genetic factors, like prenatal brain damage, sex hormones, allergy, drugs and environmental influences are largely responsible for the Psychological disorders in an individual. Biology plays a greater role in the development of mental health, along with certain environmental factors. According to the specialists, an individual’s genetic and biological predispositions play a large role in the psychological influences on the bipolar disorders. In fact the genetic, biological and social factors combine together to bring about episodes of mood disorders and other personality defects. Certain aspects of brain activity such as neurotransmission and neuroanatomy relate to some cognitive behaviors such as language and learning, and other psychological factors such as sexual behaviour, anxiety, aggressive behaviour, depression and schizophrenia.
Studies have shown that children of bipolar parents are at a higher risk of having bipolar disorders. If a person’s genetic and /or biological vulnerability is high, meaning one or several members of the family tree suffer form this affliction, or if that person has certain structural or functional brain abnormality then even a minimum level of stress can trigger bipolar disorder in that person. Environment also plays a very significant role in such persons who already have genetically induced bipolar disorders. Something as small as family argument, missing a cab or facing a stressful situation as standing in a long queue, can send such persons in a state of panic and overreaction. Likewise for a person with low genetic and /or biological vulnerability stress must be quite severe to trigger a frenzied response. Stressors such as divorce, death or unexpected family feuds may induce a response that a person of high genetic or biological vulnerability might have in a less stressful situation. The vulnerability, stress mode is a useful way to judge episodes of bipolar disorders.
It helps in detecting the biological, environmental and genetic severity in a client, and makes it easier for the specialist to decide upon the treatment. In the studies of psychological provoking agents, these underlying factors play a significant role in pointing out the ways in which these agents interact with underlying biological predispositions. In deciding the line of treatment, a specialist may decide to bring down the symptoms with drugs such as lithium, and while drugs provide a remarkable improvement, in most cases of bipolar disorders, psychological intervention is absolutely essential. Since bipolar disorders have a great link with biology and environmental triggers, drug only suppress or control the symptoms while working on biological levels. In his book ‘ Biological Psychology’, James W. Kalat accurately portrays biopsychology as a dynamic and empirical field where fascinating discoveries are constantly made. His book also points out towards the latest biological findings, such as how gingko claims to aid memory, thus enforcing the biological effects, and he covers the hypothesis that many of human’s choices such as the choice of mate are influenced by natural selection.
It is found by researchers that stress factors, including those within the family might draw out incidents of bipolar disorder, especially when they are joined with the family background of the patient’s preexisting biological vulnerabilities. The need of psychological intervention is meant to augment the efficacy of drugs along with a focused attempt to improve the environmental issues. For example if a deliberate attention is paid upon improving the family environment and promote the use of the skills necessary for coping with stressful life situations then a marked change in the behavior of the patient can be seen. However, this does not mean that a patient suffering form bipolar disorder can be fully cured. There is no cure for this illness, just treatment. In order to augment the treatment a conducive environment acts as a supplementary medicine for such persons. It is essential to note, that episodes of mania or depression usually lasts for weeks or months. In some adults it can be shorter in length, but in children and adolescents these episodes can be much shorter and a kid or teen can even go back and forth between mania and depression throughout the day.
Sometimes the episodes have seasonal patterns. For example, Mania in the spring may be flowed by depression in the winter, as environment plays its particular role. Some people with bipolar disorder turn to substance abuse and this also triggers severe responses in an individual. The drug or substance abuse has disastrous results in a person already suffering form bipolar disorder. It often turns the symptoms worse and makes it difficult for the doctor to diagnose the illness. Along with biological factors environmental stressors increase the risk of suicide and attempted suicide in those suffering form bipolar disorders. In girls menstrual period can be the vulnerable phase when bipolar disorder is triggered. In teens the divorce of parents and death in the family are environmental activators of such disorder, and sometimes the changes that occur during puberty also has close links with bipolar disorder. Since this is a severe and complex illness, any environmental change can trigger the reaction in a patient and if his biological vulnerabilities are low then the treatment becomes prolonged and intensive.
Bipolar disorders makes life pretty difficult for the person suffering from it, and along with the patient the family and near and dear ones go through extreme trauma. The social, economical and biological conditions of a person goes through extreme changes and often such patients are ostracized due to their inability to confirm to the normal course of things. Writing about the role of genes and mental disorders in his book ‘Genes and Behaviour- Nature- Nurture Interplay Explained’, Rutter points out a very interesting fact about flamingos. It says, “ Flamingos everywhere are famous for their spectacularly beautiful pink color. It is known that this is entirely dependent on a particular diet of shrimp and plankton. If flamingos do not have access to their usual diet for any reason they are white, not pink. Their color is entirely dependent on the environmental influence of diet. On the other hand flamingos’ ability to turn pink is entirely dependent on their genes. The color is the joint action of genes and environment” . (Ch. 2. Pg.24).
This is a very astute example and human beings are no exception in having genes and environment as the deciding factor in behaviour. The ‘Nature versus Nurture’ is also the determining factor in deciding a person’s physical and behavioral traits. Nature is what a person is born with, and this includes the hereditary factors. It is basically the innate qualities a person has since birth and due to his genetic makeup. Nurture is the ‘blank state’ where the environment in which he is brought up, influences a person’s behavior and mental development. Steven Pinker in his book, ‘The Blank State- The Modern Denial of Human Nature’ cites ‘ Man has no nature; what he has is history’ and he further elaborates about the doctrines that the mind is a blank state and a lot depends on his nurture and the social constructions that decide his further behaviour. Roughly speaking it is gene and environment that secure a balanced state of mind for an individual. Just like a person’s eyes and hair color is decided by the gene pool of his parents, the nature of a person is also decided by the hereditary factors. Some specialists think that people behave according to their genetic predispositions, however a recent study of human genome has made it clear that both sides , ‘Nature’ and ‘Nurture’, are equally important in deciding a person’s behavior and general characteristics.
While Nature gives us inborn qualities and traits; Nurture takes along these genetic tendencies and molds them into the kind of person we become later. One cannot deny that a dynamic interplay of ‘nature and nurture’ is essential in deciding the behavior and mental development of an individual. However this is not end of the story as this debate is still raging on and scientists are still debating on the facts, whether our intelligence quotient, personality and sexual orientations are also the outcome of our nature. In deciding the mental disorders like schizophrenia, bipolar disorders and various other psychological illnesses, the debate keeps skirting around the hereditary traits. While it cannot be ruled out that genes and biological make up is the decisive factor in transferring this illness, environment or ‘nurture’ as we call it is equally significant. While the causes cannot be detected easily in a patient, and neither can it be reined in completely, the effects and symptoms can be harnessed by the environmental control.
Here nurture comes into play. Mostly it happens that when a person is suffering from bipolar disorders or any other personality disorders, there is always a speculation about their genetic makeup. Often a layman would link the disorder to family background or genetic factors. There is much truth in such conjectures, as scientists have also discovered the connection of genes in the person along with environmental triggers that increase the vulnerabilities. In speaking about ‘nurture’ one can speculate that controlling the stressors can help a lot in bringing down the episodes of bipolar disorders. Biology and environment are major generators of bipolar disorders. The genetic makeup and hereditary traits also decide if a person can have a well rounded and balanced personality, or will have always have to live with some missing parts. While one cannot control the genetic factors, one can help a person live with the affliction with as much dignity as possible, by controlling the environment. Thus, it can be told that Nature cannot be controlled or decided, but Nurture can certainly be worked at and controlled to some extent, and provide an effective biological and psychological treatment to the patient.
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