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Mariela Dagio's Paper

Created By: Jessica De anda
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A1: Bipoloar Disorder: The Whole Story
Q2: Report:(Required*) 
A2: About 5.7 million people 18 and older are affected by bipolar disorder a year. That's about 2.6% of the U.S population. After researching bipolar disorder, its symptoms, treatments, who it affects, role of genes, looking at journals of neuroimaging, and seeing what happens in the brains of patients with bipolar disorder I can say I have learned a lot and would like to share that knowledge on how I believe bipolar disorder is caused and what happens in the brain. (Suggestion: After researching bipolar disorder's symptoms, treatments, susceptibility rates, and the role of genes, along with looking at journals of neuroimaging, and observing the abnormal brain functions of patients, I would like to explain this information within my report. I believe bipolar disorder is caused by... and *this* happens in the brain.)

Bipolar disorder equally affects both women and men, as well as equally affects every race, age social class, and ethnic group (Anonymous 2013, 2; Bressert 2 2013, 3). Although it affects both genders equally, women have been proven to experience 3x more rapid cycling, which is experiencing four or more mania or depression episodes inside of a year. Mania episodes are when the patient starts experiencing rapid thoughts and loses all clarity due to overwhelming confusion, they start to think everything is funny and suddenly go to the worst where they are irritable, frightened, angry, and uncontrollable (Anonymous 2 2013, 2). This is one of the main symptoms of bipolar disorder along with other symptoms occurring daily such as sudden moodswings, racing thoughts, fast talking, making impulsive decisions, restlessness, increased energy, an inflated self-esteem, and high sex drive (Anonynous 2 2013, 1).
   
There are many questions on what causes bipolar disorder. The cause isn't entirely known though. There are beliefs that genetic, neurochemical, and environmental factors play a part in the onset and progression of bipolar disorder (Bressert 2013, 1). There are many thoughts bipolar disorder is a biological disorder that occurs in a specific part of the brain, and is due to malfunction of the neurotransmitters in the brain. Being a biological disorder means it may always be there active or not and caused to be active by being triggered by stressors (Bressert 2013, 14). (Suggestion :) - As a biological disorder, bipolar disorder will always be part of a person, whether it is active or not; Stressors are known to trigger bipolar activeness within one.)
    
There are studies done on patients with bipolar disorder (to see) if there is a connection between brain abnormalities such as an underdeveloped prefrontal cortex, which is the site where your emotions, personality, and decision making happen (Strakowki 2004, 4). Bipolar disorder is related to structural brain abnormalities (McIntosh et al. 2005, 1). There are studies on identical twins when (maybe use "where" instead of "when" but i dont think it really makes a difference :)) only one of them has bipolar disorder. Since they are identical twins they share 100% of their genes. Which means if it was relied on genes alone then both of them would get bipolar disorder but they only have a 28-96% of coordance which means it happens to both (Phillips 2005, 2). (Suggestion: This means that if the disorder relied on genes alone, then both of them would get bipolar disorder. Surprisingly, they only have a 28-96% of coordance, which means it happens to both) So the question remains, what causes bipolar disorder? 

After researching the causes of bipolar disorder I believe that bipolar disorder is caused by environmental and genetic factors. A person who has a long line of generations in their family with at least one family (member?) with bipolar disorder they (maybe take out "they") are (at a) higher risk of (developing) bipolar disorder than someone who does not have history of the disorder in their family. A life altering event in a negative way can trigger a mood episode in someone who has genetic depositor, bipolar disorder running the family, to bipolar disorder (Bressert 2013, 8). Also having excessive bad habits that lead to any psychological problems such as alcohol and/or drug abuse, hormonal problems, and illegal substance use can trigger a mania episode even in someone who does not have history of the disorder in the family (Bressert 2013, 9). 

Bipolar disorder is highly likely to be misdiagnosed in women as depression and in men as schizophrenia, (maybe change the comma to a ; and add "in other words,") it is a gender bias in diagnosis (Anonymous 2013,11). When being misdiagnosed and given medicine for that, such as anti depressants, it can trigger a medication-triggered mania (Bressert 2013, 12). Also having an effect on your brain when having bipolar disorder is a decrease in frontal cortex grey matter which is the regions of the brain involved in muscle control, sensory perception such as seeing and hearing, memory, emotions, and speech (Van Der Schot et al., 2010, 3).

Bipolar disorder affects everyone from adolescents to adults. It affects many families and it is the sixth leading cause of disability in the U.S (Anonymous 2013, 4; Asher 2010, 2). It also is one of the leading causes of suicide along with paranoid schizophrenia. Bipolar disorder has no cure but there are treatments to help keep the mania and depression episodes under control. There is no one medication that works for everyone, so many medications have to (be) tried out before having a rountine medication (Anonymous 3 2013, 1). Many medications are tries (use "tried" instead of "tries") out such as mood stabilizers, which are usually the first ones to be prescribed. Mood stabilizers usually stay in the rountine medication along with lithium ( Anonymous 3 2013, 2). Lithium is a medication used to prevent mania and depression episodes and controlling the symptoms of those episodes (Anonymous 3 2013, 3). Valproic acid is an alternative to lithium for treating mania and is usually as effective as lithium (Anonymous 3 2013, 4). Patients with bipolar disorder usually have thyroid gland problems, lithium may cause low thyroid function with the treatment (Anonymous 3 2013, 5). It causes hypothyroidism, which is when your thyroid makes too much thyroid hormone which can cause you to lose weight quickly, have a fast heartbeat, sweat a lot, or feel nervous and moody (Anonymous 4 2013, 1; 2). Good!!!!! (not the disease haha)
    
There are four basic types of bipolar disorder. Bipolar 1 disorder is mainly mania and depression episodes for at least seven days, or maniac symptoms that require hospital care (Anonymous 5 2013, 1). Bipolar 2 disorder is having a pattern of depressive episodes, and going back back and forth from hypomanic episodes but never going into full blown maniac or mixed episodes (Anonymous 5 2013, 2). Bipolar Disorder Not Otherwise Specified (BP-NOS) is when the patient has the symptoms of bipolar disorder but does not meet the full criteria od (of) bipolar disorder 1 or 2. The symptoms do not last long enough or do not have enough symptoms to be bipolar 1 or 2. You can tell that the characteristics of the behavior is not the person's normal personality (Anonymous 5 2013, 3). Cyclothymic disorder is a more mild sort of bipolar disorder. The patient experiences mild depression episodes along with hypomania but to meet the diagnostic requirements for bipolar disorder (Anonymous 5 2013, 4). If bipolar disorder is not treated it may get worse, and over a long period of time the patient starts suffering from more severe and frequent episodes (Anonymous 5 2013, 5). 
    
There was a recent study done where they found a genetic hotspot where depression and bipolar disorder are connected in a way. One gene that codes for a part that tells the gene when to turn on or off. It is over expressed in the brains of bipolar disorder patients (Asher 2010, 1). The gene they suspect is called PBRM1, (use ; instead of ,) it is in charge of coding for a protein that is very important for chromatin remodeling, which is a key process in regulating gene expression (Asher 2010, 3). The gene PBRM1 was found more in the prefrontal cortex of the brain, which is in charge of making decisions and controlling emotions, of patients of bipolar disorder than those without (Asher 2010, 4). Since bipolar disorder is most likely something to do with altered gene expression during brain development that makes PBRM1 a good explanation for the possible cause of mood disorders (Asher 2010, 5). 

The story behind bipolar disorder traces back to Ancient Greeks to a philosopher and physician of that time named Aretaeus of Cappadocia (Burton 2012,1). He described a group of people who were happy, dancing, and play all night and day. Then suddenly go to dull and sorrowful at other times (Burton 2012,12). The understanding we have now started in 1854, Jules Baillarger and Jean-Pierre Falret both presented independently descriptions of bipolar disorder to the Academie de Medicine in Paris (Burton 2012, 3). Baillarger called it dual-form insanity, while Falret called it circular insanity (Burton 2012, 5). Later in the early 1900s a German psychiatrist named Emil Kraepelin found a distinction from schizophrenia and the disorder, while leaving bipolar disorder untreated there were symptom free periods (Burton 2012, 67). Only recently was there a distinction between people with both manic and depressive episodes and people with depressive episodes with psychotic symptoms, which would be those with schizophrenia (Burton 2012, 7;8). Even though the most common term used for the disorder is bipolar disorder many people and psychiatrists still use manic-depressive illness because they feel it is a more accurate name for what it is (Burton 2012, 11). 

Even though bipolar disorder does not have a definite answer for why it happens scientists know there are many factors that contribute to it. Genetic factors seem to be the ones that pop out the most at scientists. It can run in the family and affect every person, and it might not. As I wrote earlier, even though identical twins share the exact same genes, not both of them always got the disorder. (Suggestion: As I wrote earlier, even though identical twins share the exact same genes, both did not always get the disorder.) There are also environmental factors such as stress, alcohol abuse, drug abuse, and  a life altering occurrence. There are also neurochemical factors with bipolar disorder such as the neurotransmitters not functioning properly with the chemicals (Bressert 2013, 7). And as said previously also medication-induced episodes are a factor in what cause bipolar disorder. 

There are many people bipolar disorder affects every year. It may hit a family hard when there are young adults with bipolar disorder that (who) take their own lives to to their condition. Bipolar disorder is highly connected to suicide (KR 2006, 1). 25- 50% of patients with bipolar disorder have tried to kill themselves at least once (KR 2006, 2). Lithium is also an effective treatment for suicide, because its mood-altering effects (KR 2006, 3). Suicide is a result of some form of mental illness (KR 2006, 4). Medication must be taken to prevent thought of suicide. If it is not the thoughts are always there. A boy by the name of Steven Hrabovsky-Kleine took his life after the third time of attempting suicide. He never took his medication. He hard a hard life and just wanted to go to Heaven with his grandmother who died when he was four.. After he dies his mother found eleven bottles of unopened bottles of medication. :'(
   
Many questions are asked when it comes to bipolar disorder that cannot be answered. Such as why people get it. Its a question that is asked for every mental illness. The main reason every scientist seems to come up with is that its in your genetics. There is no way to avoid it. It has to do with brain abnormalities as well (Van Der Schot et al. 2010, 1). Structural damages can also cause you to be diagnosed with bipolar disorder. There are many factors that cause the illness and there is not an exact way to know where it comes from. It's research is much like the illness; it has many ups and downs. 

Bipolar disorder is a very well known illness. It affects everyday people all the time. Being aware that you have bipolar disorder is a way too (to) make sure you keep it under control. Having bipolar disorder does not neccesarily (necessarily) make you disabled. You can live a normal life along with taking your medication. This was a very interesting topic and I am glad I chose to do a report on it. Not only did I learn a lot about mental illness, I also learned of the origin of bipolar disorder. That is the whole story of bipolar disorder.

Nice report!! :) 
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