Bipolar disorder (depression & mania) – causes, symptoms, treatment & pathology

 Maybe you’ve heard the term “bipolar” used to describe someone who’s moody, or who has mood swings, but this colloquial use of the term is different from bipolar disorder. Bipolar disorder, which used to be called manic depression, is a serious mental illness that causes a person to have dramatic shifts in emotions, mood, and energy levels: moving from extreme lows to extreme highs. But these shifts don’t happen moment to moment, they usually happen over several days or weeks. There are a few different types of bipolar disorders, but there are some common features. First, the low moods are identical to those in a related disorder – major depressive disorder, also known as unipolar depression. Individuals with this can feel hopeless and discouraged, lack energy and mental focus, and can have physical symptoms like eating and sleeping too much or too little. But along with these lows, the thing that sets bipolar disorders apart from unipolar depression is that individuals can have periods of high moods, which are called manic episodes or hypomanic episodes, depending on their level of severity. In a manic state, people can feel energetic, overly happy or optimistic, or even euphoric with really high self-esteem. And on the surface, these might seem like very positive characteristics, but when an individual is in a full manic episode, these symptoms can reach a dangerous extreme. A person experiencing mania might invest all of their money in a risky business venture or behave recklessly. Individuals might talk pressured speech, where they talk constantly at a rapid-fire pace, or they might have racing thoughts and might feel ‘wired,’ as if they don’t need sleep. Manic episodes can also include delusions of grandeur, for example,, they might believe that they are on a personal mission from god, or that they have supernatural power. And they might make poor decisions without any regard for later consequences. One way to understand these swings is by charting them on a graph. So let’s say the y-axis is mood, with mania and depression being on the far ends of the axis, and the x-axis is time. The average healthy individual might have normal ups and downs throughout their life, and they might even have some pretty serious lows once-in-awhile, maybe after losing a job or moving to a new place and feeling lonely. An individual with unipolar depression though might have the normal highs, but they might have some crushing lows that last for a long period and may not have an obvious trigger. Now, for the bipolar disorders, the first one is called Bipolar 1, and these are people that have some major lows that last at least 2 weeks, and some major highs that last at least a week or require hospitalization. That said, untreated manic episodes can last as long as 3-6 months. Depression is seen in most cases but is not required for a diagnosis. The second one is called Bipolar-2, and this is when a person experiences similar lows and has additional highs called “hypomania”, which are less severe manic episodes than we see in Bipolar 1. To qualify for a diagnosis, these hypomanic states need to last at least four days. Once again though, these symptoms generally last a few weeks to a few months. Alright the third one is called cyclothymia, or sometimes cyclothymic disorder, and these individuals have milder lows as well as the milder highs or “hypomania” like you see in Bipolar-2, and they cycle back and forth between these two over a period lasting at least 2 years. Sometimes, people with Bipolar disorder can show other, less common symptoms as well, for example having what is referred to as mixed episodes—experiencing symptoms of both depression and mania at the same time. Another symptom they might have is rapid cycling, which describes a situation where a person has 4 or more episodes of depression or mania within a given year. Like most mental health conditions, the exact the underlying cause of the bipolar disorder isn’t known, and there is no single “bipolar gene” identified, but it’s thought that there are genetic and environmental factors that play a part. For example, one interesting clue is that people with family members who have bipolar disorder are 10 times more likely to have it themselves. Another clue is that some drugs and medications can trigger manic episodes, like selective serotonin reuptake inhibitors (or SSRIs). It’s also worth mentioning that people with bipolar disorder often have other disorders like anxiety disorders, substance use disorders, ADHD, and personality disorders as well, making diagnosis and treatment a real challenge. Even though there’s no cure for bipolar disorder, identifying and treating individuals is important, since there’s a real danger that the person could harm themselves or commit suicide. One of the oldest treatments is also one of the most effective treatments, and that’s lithium salts. Lithium acts as a mood stabilizer—smoothing out the highs and lows they experience. That said, it is much better at treating manic rather than depressive episodes, and so individuals who take it often have to take other medications as well, which can be problematic since some antidepressants (like the SSRIs) can trigger manic episodes in individuals who are predisposed to them. Other treatment options include antipsychotics, anticonvulsants, and benzodiazepines, but many of these—including lithium—have side effects that can be severe and lead to non-adherence which can be dangerous for an individual. Now, unlike certain disorders like unipolar depression, psychological interventions, like talk therapy, or cognitive-behavioral therapy are not particularly effective in treating the manic episodes of bipolar disorder. Having said that, they can still be very helpful tools to help individuals with bipolar disorder in general—especially after a manic episode has ended. They can also help an individual handle stressful situations that might otherwise lead to a manic episode, thereby helping to prevent a potential manic episode in the first place. Alright, so super fast recap: bipolar disorder is a mental disorder characterized by depression, periods of lowered mood, as well as mania, and periods of heightened mood. Thanks for watching, you can help support us by donating on Patreon, subscribing to our channel, or telling your friends about us on social media.As found on YouTubeFUNNELIFY is a new, first-of-its-kind, groundbreaking app ➯➱ ➫ ➪➬ which finally allows you to deliver separately auto-generated mobile pages with unheard before lighting speed. Plus it skyrockets ➯➱ ➫ ➪➬ After using the Funnelify product, you will recognize a great increase in your leads and sales. 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Depressive and Bipolar Disorders: Crash Course Psychology #30


American psychologist and professor of psychiatry, Kay Redfield Jameson, It is one of the most important references for bipolar disorder in the world. She has spent her career researching and teaching this disease and writing groundbreaking books about it. It is a disease that she personally suffered throughout her adulthood. In her diary, "Restless Mind," Jameson described bipolar disorder in detail. She wrote about not sleeping for days on end, and about feeling high for long periods of time And filling it in notebooks full of successive and great ideas. And while she was going through these obsessive states, she felt a very inflated significance for herself. He committed reckless acts that made her happy at the time, but which led to dire consequences, Like uncontrollable shopping or indulging in promiscuous behavior Or accumulating credit card debt and consuming all of the money in her accounts. But these episodes were followed by a severe depression, including severe depressive episodes Makes her think of suicide. At 28 years old, Jameson committed suicide By taking an overdose of lithium, she fell into a coma, but thankfully she regained consciousness Then she decided to search for a solution in medication and psychotherapy.


With her research and writing, Dr. Jameson has paved the way for our understanding For bipolar disorder, depression, and interconnected mental disorders What we today call mood disorders. And you may be one of the best ambassadors and representatives of the people Who lead a successful and fruitful life despite their mental illnesses. Like the anxiety disorders we talked about earlier, mood disorders are damaged by misconceptions. And it is underrated by portraying depression as something that can be cured A day at a resort, or people stigmatized with bipolar disorder Just because they were sad yesterday and not back today. As psychologists, it is our job to understand mood disorders for what they are. And find out how it appeared and possible causes. As you probably guessed, this is not an easy task. These disturbances knock people down from steep heights to dark slopes That seems to have no end.


But, in between this and that, there is what Jameson has called "a rich and imaginative life." Moods create them. Many of the concepts mentioned have different meanings Than we thought, but the term "temperament" is not one of them. Psychology defines mood as we define it: More personal emotional states and harder definition than the emotions themselves. Psychology defines roughly 10 basic emotions, moods They fall into two broad categories with endless possibilities: good moods and bad moods. Perhaps the most obvious difference between mood and emotion Mood is a long-lasting emotional state, while emotion is a rapid transit. The mood disorders characterized by the intensity of emotions Difficulty controlling mood is a longer-lasting disorder. Such as depressive disorders represented by prolonged periods of hopelessness and lethargy. And bipolar disorder, the most famous of which is a disorder in which a person switches between mania and depression.


Depression is sometimes called a "mental illness" because it is common, and that does not mean It is not a serious disease, but it is common, pervasive, and the main cause People search for psychological care. Depression is a feeling we all have experienced, and it often follows a loss, such as separation from a partner Or the loss of work or the death of someone dear to us.


In fact, the feeling of depression is the natural feeling in these situations, and it may be Useful for the mind and body to calm down and absorb the loss that we have experienced, But unhappiness is generally temporary. However, when sadness and grief extend beyond what is socially acceptable, Or reach a level that causes real dysfunction, We have entered the world of depressive disorders. Diagnostic and statistical manual of mental illness, which is useful even if it is full of deficiencies, It states that individuals are diagnosed with a depressive disorder only when they have passed Five signs of depression in less than two weeks. These symptoms, apart from a depressed mood, include significant loss or significant increase Appetite or weight, lack of or excessive sleep, loss of interest in activities, Feeling worthless, tired or lethargic, difficulty concentrating or making decisions, And repeated thoughts of death or suicide.


And since everyone feels miserable sometimes, depression is both a physiological and psychological illness. It disrupts sleep, appetite, energy, and neurotransmitter levels And hinder the organization of the body for itself. To be consistent with our definition of mental illness, and to be considered a true disorder, This behavior should cause prolonged distress for the person or those around him That is, the feeling of having something real. For example, people with severe generalized anxiety disorder refuse Leaving the home, people with clinical depression often feel very hopeless To the point where they are unable to lead a normal life. And unlike bipolar disorder, Depressive disorders mean a persistent depressed mood.


You may have heard of manic depression, the old name for bipolar disorder. This disease leads to severe depressive episodes, followed by adverse episodes as well From extreme obsession if the situation worsened. People with bipolar disorder have mood swings Between normal, depression and mania in a day, week, or month. A manic episode doesn't just mean feeling happy or energized, it is a period From extreme, raging, overheating activity that is usually positive, with your self-esteem Your capabilities and ideas are disturbed. Very real dysfunctional. In some people with the disorder, manic episodes are rare but devastating. Kay Jameson has testified to this. Once, during a manic episode, she bought all her snake bite resistance kit in the pharmacy, This is because she was convinced that only rattlesnakes would launch an attack. On another shift, she bought 20 books for the Penguin publishing house, and the reason, she says, is: "It would be nice for penguins to form a colony." In other words, people's judgment of things gets hurt, and it can get worse. Severe manic episodes may lead a person to enter a mental hospital, because it is so dangerous On himself and others it may become severe.



After these manic episodes end, it usually follows Dark bouts of depression. If the injured are not treated, suicide or attempted suicide is common. This is another aspect of the disorder that Jameson attests. The cause of mood disorders, like many other things in psychology, A mixture of biological, genetic, psychological and environmental factors. We know, for example, that mood disorders It is passed on through generations, so genes are important. It also increases your risk of developing bipolar disorder Or a depressive disorder if your family or siblings suffer from it.


Identical twin studies have shown that one of the twins has bipolar disorder Leads to a 7 in 10 chance of infecting another. Even if they were not raised together. Life's stress cannot lead to bipolar disorder But it can trigger a seizure in a person Have it or trigger a major depressive episode In someone who has never had depression before. in other word, The misery of someone who has lost a loved one can turn into depression or have a bipolar seizure. But that event will not be the primary cause of the disruption. For most people with depressive disorders, after weeks, months, or years, Their depression may subside, and they may return to life as normal human beings.


More women than men are diagnosed with depression worldwide. But many psychologists attribute this to the fact that women seek help more. Another possible reason for this is that depression in men usually manifests itself in a form Anger and violence rather than misery and hopelessness. This is one example of how depression is more than just sadness Lack of purpose and recognized despair may manifest itself in different ways. If we look at mood disorders from a neurological angle, we find depressed and obsessive brains They show very different activities on neuroscopy images compared to normal brains.


The depressed brain, as you'd expect, gets slower. As for the obsessed brain, it shows excessive activity. This makes it difficult to concentrate, calm down, or sleep. The chemistry of the brain's neurotransmitters also changes with the state. We find norepinephrine, which increases agitation and concentration Too little in depressed brains, and too much during manic episodes. In fact, alleviating drugs for mania They work by reducing levels of norepinephrine. You may have also heard that your serotonin levels are low Linked to depressive states. Aerobic exercise, such as running, dancing, or anything else Serotonin levels increase, which is why exercise is recommended To combat depression. Most anti-depressants also work By increasing serotonin or norepinephrine. There is, of course, another way of looking at the topic, the social perceptual angle You look at the relationship of our thinking and behavior to depression. People with depression often view bad events with a mind or eye Affect their interpretation of it, and our interpretation of events Negative or positive is what influences whether or not we skip it.


Let's say you were exposed to an embarrassing situation in the cafeteria, where someone hindered you and broke the soup It was all over, and then you sat on a chocolate cake … in short, it was a bad day. The depressed brain would immediately think that the insult would haunt it forever And that no one will forget it, and that you may have brought it upon yourselves, You are not doing anything well. It is this negative thinking, educated despair, self-blame and overthinking More of the same could kill the happiness of the brain And it creates a vicious circle that reverts to confirming the original negative view. Fortunately, this episode can be done with the help of a professional Or directing the attention to something outside and the practice of enjoyable activities And maybe move to a better environment. But this sociocognitive angle is part of the complex puzzle. Positive thinking is important, but it alone is not enough To counteract neurological or genetic factors. So, mood disorders are complex conditions and rarely go away with one treatment. And you often have to live with it. As Dr. Jameson has proven, Success with her is possible.


Today we talked about mood disturbances between fact and fiction. You also learned about the symptoms of depressive disorders and bipolar disorders As well as biological, genetic and environmental causes Potential social and cognitive mood disorders. Thank you for watching this episode sponsored by Marshall Scott and crediblefind.com And thanks to all of those who support us. To find out how you can support us, visit suppable.com/crashcourse. This episode was written by Kathleen Yale and edited by Blake De Pastino. Counsel was provided by Dr. Ranjit Bagwat. Director and Editor is Nicholas Jenkins. Michael Aranda is the script Supervisor and Sound Designer. The graphics are designed by Thought Café.



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Understanding the DSM-5: What every teacher needs to know

Greg Neimeyer, PhD, APA Education Directorate associate executive director for continuing education, reviews changes in the DSM-5 in this lecture. These changes include the elimination of the traditional multiaxial system and the reorganization of numerous disorders previous held under different categories, among others. The DSM-5 is a publication of the American Psychiatric Association.This video was supported by a grant from the American Psychological Foundation, thanks to generous support from Lee Gurel, PhD.