Bipolar nature or nurture

Bipolar disorder or as it was previously called Manic Depression is a mood disorder that affects about one in a hundred people (data from where?? ). The Royal College of Psychiatrists (2011) states that there are four? types of Bipolar these are Bipolar I in which a person has experienced at least one manic episode that has lasted for more than one week. It says that people usually experience depressive episodes although some only have the mania. Manic episodes if left untreated normally last 3-6 months whereas depressive episodes can go on for longer 6-12 months.

Bipolar II is categorised by only having a mild manic episode and more than one occurrence of major depression. Rapid cycling is categorised by having had more than 4 ‘episodes’ of mood swings which can happen in both type I and type II Bipolar. Lastly Cyclothymia in which the mood swings are not as acute as they are in full-blown Bipolar. Some of the symptoms experienced in Bipolar can be psychotic episodes in which the patient loses contact with reality, they may experience delusions, hallucinations, hear voices that aren’t there, their sense of smell may also be affected.

In a manic episode they experience racing thoughts and feelings of grandiosity. Owen & Saunders (2008) suggests that it may be due to the way that the brains cells communicate with each other and that the name ‘manic depression’ was first used by a German doctor Emil Kraepelin in 1896. However Fast and Preston (2006) states that the illness had been documented by Hippocrates more than two thousand years ago and his conjecture was that mood swings were the result of fluctuations in bodily fluids. The Royal College of Psychiatrists (2011) states that the disease seems to run in families rather than due to the way in which we are brought up.

On the other hand the way in which nature has an effect is talked about at length by Oliver (2007) who states that whilst this is the second most commom genetic disease it can be brought about by what happens in our childhood. He suggests that if a parent has been unresponsive to the child that he can develop a ‘hyper mode’ in which he may become forever on guard, lack sleep, and fretful of his surroundings. Which acts as a precursor to the manic depression. Similarly if the parenting is invasive or if the child is criticised then depression sets in.

Although he does point out that genes are a factor, childcare also plays an important role. This belief is also put forward by Kinsella & Kinsella (2006:28) who cite the work of Honig et al (1997) who says that whilst it has not been scientifically tested some doctors believe that a person with bipolar may have had overly judgemental and sheltered upbringings. Kinsella & Kinsella (2006:28) go on to cite the work of Garno et al (2005) who in current research have found that 50% of patients with Bipolar have described an abusive and anguished childhood.

On the other hand, having looked at the comments on the Action for Postpartum Psychosis website and taking into account that 1300 women each year experience ‘Postpartum Bipolar Disorder’ there are suggestions that lack of sleep is a major contributory factor for developing the illness. Kinsella & Kinsella (2006:26) cites the work of Craddock & Jones (2002) who tells us that the latest findings are that there is no single cause of bipolar disorder but that it is a combination of historic events, genetics, brain biology and life stress at work.

They go on to say that a person may be born with an inclination to develop the illness but that it is not from one specific gene and that it takes a number of factors to activate the illness. In a recent study Craddock & Forty (2006) reported that there is not one gene but that several are at play. On the other hand Hunt (2005) states that bipolar seems to happen in families and if a child of a person with bipolar is raised by another family the risk of developing the illnesss stays the same.

Hunt (2005:24) cites the work of Smoller & Finn (2003) who theorises that in twins the likelihood of identical twins developing the illness is greater than in fraternal twins which leads to the conclusion that genetics are an important factor. This is backed up by Mondimore (2006:39) who cites the work of Cassano et al (1992) stating that people from the same family often tend to show symptoms of Bipolar. Another way in which genetics can be said to be a major aspect is by looking at the relationship of how the brain reacts.

Delgado (2006) states that there is a large amount of evidence to support that bipolar comes from the relationship between serotonin receptors and that a decrease in the levels of serotonin 1A receptor has been shown in parts of the brain in bipolar patients. Studies are currently in progress to look at the way in which food and therefore the environment can lead to developing Bipolar. Owen & Saunders (2008) give details of how mental illness in this country has been on the increase for the past decade and that this correlates to the drop in the amount of fish we eat in this country.

They continue by saying that the less a country eats of fish then the higher the incidence rate of depression is. In particular they state that the fatty acids (Omega 3 and Omega 6) are essential fatty acids that can only be taken in as part of the diet and not made within the body and that they have a vital function in providing connections within the brain. The environment also plays a large part through looking at smoking Owen & Saunders (2008) tells us of a study in Dublin by Dr Corvin who has found that smoking increased the chances of having a psychotic episode twofold in bipolar patients.

Likewise Mondimore (2006:177) cites the research of Reger et al (1990) who reports that in a study there are more than 60% of people with Bipolar who have drug or alcohol addictions. In all then it appears to me that a persons genes play a huge part in the developing of Bipolar but that it is only on an interaction with stressors that the illness manifests itself and that it is a combination of all these things that work together and not a single gene. Word Count : 1019 References Cassano G et al (1992) Proposed subtypes of Bipolar II and Related disorders:

With Hypomanic episodes (or Cyclothymia) and with Hyperthymic Temperament In: Mondimore F (2006) Bipolar Disorder a Guide for Patients and Families, p39 Craddock N & Forty L (2006) Genetics of Affective Mood Disorders European Journal of Human Genetics 14 660-668 Craddock N & Jones I (2002) Molecular Genetics of Bipolar Disorder In: Kinsella C & Kinsella C (2006) Introducing Mental Health: A practical guide London Jessica Kingsly Publishers p 26 Delgado PL (2006) Depression: the case for a monoamine deficiency J Clin Psychiatry 61 (6) 7-11 Fast J & Preston J (2006) Take Charge of Bipolar Disorder New York Hathcett Book Group.

Garno J et al (2005) Impact of Childhood abuse on the clinical course of bipolar disorder In: Kinsella C & Kinsella C (2006) Introducing Mental Health: A Practical Guide London Jessica Kingsley Publishers p28 Honig A et al (1997) Psycho-education in bipolar disorder: effect on expressed emotion In: Kinsella C & Kinsella C (2006) Introducing Mental Health: A practical guide London Jessica Kingsley Publishers, p28 Hunt N (2005) Your Questions Answeres Bipolar Disorder London Elsevier Churchill Livingstone James O (2007) They F*** You Up London Bloomsbury Publishing.

Owen S & Saunders A (2008) Bipolar disorder The Ultimate Guide Oxford Oneworld Publications Reger D et al (1990) Comorbidity if Mental Disorders with Alcohol and Other Drug Abuse In: Mondimore F (2006) Bipolar Disorder A Guide for Patients and Famillies, p177 Smoller J & Finn (2003) family, twin & Adoption studies of Bipolar Disorder In:Hunt N (2005) Your Questions Answered Bipolar Disorder London Elsevier Churchill Livingstone p24 The Royal College of Psychiatrists (2011) Bipolar (Manic Depression) [online] Available from: http://www. rcpsych. ac. uk/ [Accessed on 30th May, 2011].

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