Bi-Polar Disorder Incidence and Prevalence

Bi-Polar Disorder

Incidence and Prevalence

Bipolar disorders are severe mental illnesses that cause significant morbidity and mortality. It is estimated that the disorder affects about 6 million adult Americans which translates to about 3% of the population aged 18 and older in each year. The illness may start in early childhood and occasionally in the late 50s, the median age for the onset is 25 years.

According to the National Institute of Mental Health, the disorder affects men and women equally and there is no prevalence for race, age, social class, and ethnic grouping (Culpepper, 2014). The Institute further indicates that more than 60% of people with bipolar disorder have a relative suffering from the illness or with unipolar major depression which is an indicator that the disorder has a heritage aspect (Geddes, & Miklowitz, 2013).

While the illness affects men and women equally, studies have indicated that three times as many females as males experience rapid cycling. Further studies have shown that ladies suffer more from depressive episodes as well as mixed episodes than men with the illness. The condition is ranked the sixth principal cause of disability in the globe. The illness also causes about 10 years in reduced life while at the same time 20% of the patients commit suicide (Culpepper, 2014).

Pathophysiology

It has been established that there could be a genetic component at play in the cause of the disorder. For instance, children of parents without the illness only have a 2% risk of suffering while those of parents affected have a high risk of more than 15%. It is thought that about 60% to 85% of all cases of bipolar disorder can be explained by the genetic influences (Craddock, & Sklar, 2013).

Glycogen, synthase kinase, ankyrin 3 and CACNAIC are some of the genes associated with the disorder. Besides genetics, environmental factors like sleep disturbances, hostile living situations, and stressors play a critical role in the manifestation and development of the disorder. Others include childhood experiences like sexual and physical and emotional abuse (Geddes, & Miklowitz, 2013).

Physical Examination

The disorder is characterized by sessions of deep and prolonged depression that occur alongside an irritable mood called mania. The symptoms include grandiosity, talking excessively, racing thoughts, increased pleasurable activities that may result in painful consequences, and distractibility (Geddes, & Miklowitz, 2013).

Hypomanic episodes like an elevated, irritable mood that lasts for 4 consecutive days are also evident. The above symptoms also suggest hypomanic except that the severity is not enough to cause social impairment (Craddock, & Sklar, 2013). Major depressive episodes that may be characterized by a depressed mood or diminished pleasure in many activities are also symptoms observed during the physical examination.

EBP Treatment and Patient Education

Pharmacologic therapy forms the foundation of treatment and maintenance. The use of lithium, Divalproex, and antipsychotics like asenapine and olanzapine are established treatments for manic symptoms. For depressive symptoms, quetiapine monotherapy, olanzapine when combined with fluoxetine are used to treat bipolar I depression. Quetiapine is the only medication used for bipolar II depression (Geddes, & Miklowitz, 2013). For mixed episodes, the first line treatment includes Divalproex and antipsychotics. A combination of therapies that includes antipsychotics and mood stabilizer are effective in treating mixed episodes (Craddock, & Sklar, 2013)

The psychosocial treatments which include patient education, family-focused therapy, and behavioral therapy play a critical role in the management. The education allows the patient to understand the effects of substance abuse, the ability to identify the early warning signs of relapsing while also advancing adherence to medication (Geddes, & Miklowitz, 2013).

Follow-Up

The physician and care providers at the primary healthcare facilities must ensure that they make follow-ups to ensure that the patient adheres to the medication plan (Geddes, & Miklowitz, 2013). It has been established that physical visits, phone calls, and other means of follow up help the patient realize that the caregivers care and that helps the patients adhere to the action plans for better health outcomes and avoidance of relapse.