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Biology 202
2002 Second Paper
On Serendip

Bipolar Disorder and Drug Treatment

Joan Steiner

The advances made by science are greatly benefiting the lives of people today. Not only are the discoveries making people healthier and live longer and better lives, but helping the world understand the nature of and behavior of a human being and the brain. Emotional and mental well being has become more of a focus in the past few years. It seems that as society progresses and increases in its modernism; the delicate balance of an individual‚s emotional and mental well being is being thrown off. More people seem to be suffering from a lack of balance in this area of their health and stability, and from this their quality of life and ability to merely carry on with their daily activities is hindered. Many of these cases, due to the complex nature of a human being especially when dealing with emotion, are very complicated and abstract, yet several other concrete discoveries have been made concerning an individual‚s mental condition. One of these discoveries is Bipolar Disorder, the medical term for manic depression. Even though depression is a common emotion among humans, there are those who experience depression in a unique way that inadvertently affects the way they think and influences some of their outward behavior. To some Bipolar Disorder is a brain disorder that physiologically affects the individual suffering from it to experience dramatic shifts in their mood, energy, and ability to function. Statistics state that at least one million people over the age of eighteen have been diagnosed. This condition differs from the typical ups and downs experienced by many individuals due to the severity of the symptoms. Typically Bipolar Disorder begins to surface during adolescence, although symptoms can begin as early as childhood and progress on into the adult years. Usually an individual suffers with this condition for years before they are properly diagnosed, and once that is done then it must be carefully monitored and managed, as this is a lifetime illness. Bipolar disorder is unique in that its origins are biological, yet the experience of it is psychological. Common symptoms of this disorder are dramatic mood swings; from extremely "high" to low, irritable, sad and hopeless, then back again. At times there will be episodes of normal mood in between. With the change of moods comes the change of behavior and energy. The periods of highs and lows are known as "episodes" or "mania (high)" and "depression(lows)". Symptoms of mania include: increased activity and energy, restlessness, an excessively "high" good or euphoric mood, extreme irritability, racing thoughts and fast speech, lack of concentration, little sleep is needed, unrealistic beliefs in one‚s power or abilities, poor judgment, lasting period of unusual behavior, abuse of drugs or alcohol, provocative or aggressive behavior, denial that anything is wrong. Symptoms of depression are: lasting sad or empty mood, feeling hopelessness or pessimism, feelings of guilt or helplessness, lost of interest in activities once enjoyed (including sex), decreased energy or fatigue, difficulty concentrating or making decisions, restlessness or irritability, sleeping too much or can‚t sleep, change in appetite and unintended weight loss/gain, Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury, thoughts of death or suicide, suicide attempts.(1) Looking at the biological roots of Bipolar Disorder to reach the roots of it's cause, there lies factors such as genetics, which play a role as the building blocks to how the brain of one who suffers from Bipolar Disorder is structured. A most common way of treating this illness is psychological therapy along with prescribed medications from trained psychiatrists, medical doctors, and psychopharmacologists. Since Lithium is the first mood-stabilizer drug approved by the FDA for treatment(1) , it seems to be the drug of choice in these matters. The drug is effective in treating the mania and in preventing some future episodes. Lithium works in the brain to stabilize signals being transmitted throughout the brain. It exherts a push/pull effect on the neurotransmitter glutamate, the primary excitatory neurotransmitter, carrying messages instantaneously from one nerve cell to another in 85 percent of the brain. In a brain not suffering from Bipolar disorder, an impulse from a nerve cell releases a flood of message-bearing glutamate aimed at a neighboring neuron across the synapse. A structure on the end of the releasing nerve cell, called a reuptake transporter, then shuts off the signal by reabsorbing the glutamate, pumping it back into the cell for reuse. If this malfunctions, inappropriate concentrations of neurotransmitter remain in the synapse. Low levels of glutamate usually cause feelings of depression while the high levels cause the mania. Lithium raises the glutamate level by slowing its tendency to get backed up. The higher the lithium dose, the greater the inhibition, studies show.(5) When an individual begins drug treatment for their Bipolar Disorder, Lithium is one of the first medications tried. However, Lithium does carry with it some short term and long term side affects. Some of the early symptoms can include muscle weakness, tremors, upset stomach, increased thurst, increased urination, and difficulty concentrating. Some long term problems include weight gain, thyroid problems, kidney problems, and acne. Lithium toxicity also runs a risk. The symptoms are nothing unusual, which include severe tremor, nausea, and confusion. An overdose can be confused with dehydration.(2) There are some who praise Lithium for its antisuicidal benefits, pointing out that studies of suicidal rates and mood-stabilizer drugs show a constant lower rate when Lithium is involved.(3) However, the effectiveness of Lithium is being questioned overall, especially concerning long term affects. Some studies have shown that long term results to not significantly differ than from those who underwent a different type of treatment without medication. That overall, Lithium did not appear to be an effective means at stabilizing the individual in the long run.(4) Even though Bipolar disorder has many biological factors to it, there are many in the school of thought that believes using chemical alterations or influence is not the way to go about for an affective treatment and stabilizing plan. That a more psychotherapy and counceling approach be taken. Overall, this is a field still being explored by researchers and scientists. It is one of those instances, like most areas of scientists, where it is difficult to really decide which is the best approach. Although the use and study of the effects of medications on the brain may help the world come to a better understanding of how the brain itself operates and how human behavior is greated and/or altered and influenced from both internal and external inputs.

1)NIMH-Bipolar Disorder
2)Dr. Ivan's Depression Central
3)Antisuicidal Effects of Lithium
4)British Journay of Psychiatry
5)Doctor's Guide - Lithium and it's Anti-Depressive Effect

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