What is bipolar disorder Helen M. Farrell

What is bipolar disorder?

The word bipolar means two extremes.

For the many millions experiencing
bipolar disorder around the world,

life is split between
two different realities -

elation and depression.

Although there are many variations
of bipolar disorder,

let’s consider a couple.

Type 1 has extreme highs
alongside the lows,

while Type 2 involves briefer,
less extreme periods of elation

interspersed with long periods
of depression.

For someone seesawing between
emotional states,

it can feel impossible to find the balance
necessary to lead a healthy life.

Type 1’s extreme highs are known
as manic episodes,

and they can make a person range from
feeling irritable to invincible.

But these euphoric episodes exceed
ordinary feelings of joy,

causing troubling symptoms
like racing thoughts,

sleeplessness,

rapid speech,

impuslive actions,

and risky behaviors.

Without treatment, these episodes
become more frequent,

intense,

and take longer to subside.

The depressed phase of bipolar disorder
manifests in many ways -

a low mood,

dwindling interest in hobbies,

changes in appetite,

feeling worthless or excessively guilty,

sleeping either too much or too little,

restlessness or slowness,

or persistent thoughts of suicide.

Worldwide, about one
to three percent of adults

experience the broad range of symptoms
that indicate bipolar disorder.

Most of those people are functional,
contributing members of society,

and their lives, choices,
and relationships

aren’t defined by the disorder,

but still, for many, the consequences
are serious.

The illness can undermine educational
and professional performance,

relationships,

financial security,

and personal safety.

So what causes bipolar disorder?

Researchers think a key player is
the brain’s intricate wiring.

Healthy brains maintain strong connections
between neurons

thanks to the brain’s continuous efforts
to prune itself

and remove unused or faulty
neural connections.

This process is important because our
neural pathways serve as a map

for everything we do.

Using functional magnetic
resonance imaging,

scientists have discovered that the brain’s
pruning ability is disrupted

in people with bipolar disorder.

That means their neurons go haywire

and create a network
that’s impossible to navigate.

With only confusing signals as a guide,

people with bipolar disorder develop
abnormal thoughts and behaviors.

Also, psychotic symptoms,

like disorganized speech and behavior,

delusional thoughts,

paranoia,

and hallucinations

can emerge during extreme phases
of bipolar disorder.

This is attributed to the overabundance
of a neurotransmitter called dopamine.

But despite these insights, we can’t pin
bipolar disorder down to a single cause.

In reality, it’s a complex problem.

For example, the brain’s amygdala
is involved in thinking,

long-term memory,

and emotional processing.

In this brain region, factors as varied
as genetics and social trauma

may create abnormalities and trigger
the symptoms of bipolar disorder.

The condition tends to run in families,

so we do know that genetics have
a lot to do with it.

But that doesn’t mean there’s
a single bipolar gene.

In fact, the likelihood of developing
bipolar disorder

is driven by the interactions between
many genes

in a complicated recipe we’re still
trying to understand.

The causes are complex,

and consequently, diagnosing and living
with bipolar disorder is a challenge.

Despite this, the disorder
is controllable.

Certain medications like lithium can help
manage risky thoughts and behaviors

by stabilizing moods.

These mood stabilizing medications work by
decreasing abnormal activity in the brain,

thereby strengthening the viable
neural connections.

Other frequently used medications
include antipsychotics,

which alter the effects of dopamine,

and electroconvulsive therapy,

which works like a carefully controlled
seizure in the brain,

is sometimes used as
an emergency treatment.

Some bipolar patients reject treatment

because they’re afraid it will
dim their emotions

and destroy their creativity.

But modern psychiatry is actively
trying to avoid that.

Today, doctors work with patients
on a case-by-case basis

to administer a combination of treatments
and therapies

that allows them to live
to their fullest possible potential.

And beyond treatment, people with
bipolar disorder can benefit

from even simpler changes.

Those include regular exercise,

good sleep habits,

and sobriety from drugs and alcohol,

not to mention the acceptance
and empathy of family and friends.

Remember, bipolar disorder
is a medical condition,

not a person’s fault,

or their whole identity,

and it’s something that can be controlled

through a combination of medical
treatments doing their work internally,

friends and family fostering acceptance
and understanding on the outside,

and people with bipolar disorder
empowering themselves

to find balance in their lives.

什么是双相情感障碍?

双极这个词意味着两个极端。

对于全世界数以百万计的
双相情感障碍患者来说,

生活被分为
两种不同的现实——

兴高采烈和抑郁。

尽管
双相情感障碍有很多变体,但

让我们考虑几个。

类型 1
在低点旁边有极端高点,

而类型 2 涉及更短暂、
不那么极端的兴高采烈时期,并夹杂

着长时间
的抑郁。

对于在情绪状态之间摇摆不定的人来说

很难
找到过上健康生活所必需的平衡。

类型 1 的极端高潮被
称为躁狂发作

,它们可以使人从
易怒到无敌。

但这些欣快的情节超出了
普通的快乐感,

导致了
诸如思绪奔腾、

失眠、

语速快、

冲动行为

和冒险行为等令人不安的症状。

如果不进行治疗,这些发作
会变得更频繁、更

剧烈,

并且需要更长的时间才能消退。

双相情感障碍的抑郁期
表现在许多方面

——情绪低落、

对爱好的兴趣减少

、食欲改变、

感觉一文不值或过度内疚、

睡得太多或太少、

烦躁或迟钝,

或持续的自杀念头。

在全球范围内,大约 1
% 到 3% 的成年人会

出现
表明双相情感障碍的广泛症状。

这些人中的大多数都是功能性的,
为社会做出贡献的成员

,他们的生活、选择
和关系

并没有被疾病定义

,但对许多人来说,后果仍然
很严重。

这种疾病会破坏教育
和职业表现、

人际关系、

财务安全

和人身安全。

那么导致双相情感障碍的原因是什么?

研究人员认为一个关键因素
是大脑错综复杂的线路。

健康的大脑
在神经元之间保持强大的连接,

这要归功于大脑不断
地自我修剪

和移除未使用或有缺陷的
神经连接。

这个过程很重要,因为我们的
神经通路可以作为

我们所做的一切的地图。

使用功能性
磁共振成像,

科学家们发现双相情感障碍患者的大脑
修剪能力被

破坏。

这意味着他们的神经元失控

并创建了
一个无法导航的网络。

只有令人困惑的信号作为指导

,双相情感障碍患者会发展出
异常的思想和行为。

此外,精神病症状,

如杂乱无章的言语和行为、

妄想、妄想

和幻觉,

可能会在
双相情感障碍的极端阶段出现。

这归因于
称为多巴胺的神经递质过多。

但尽管有这些见解,我们不能将
双相情感障碍归结为单一原因。

实际上,这是一个复杂的问题。

例如,大脑的杏仁核
参与思考、

长期记忆

和情绪处理。

在这个大脑区域,
遗传和社会创伤等各种因素

可能会造成异常并引发
双相情感障碍的症状。

这种情况往往会在家庭中发生,

所以我们确实知道遗传
与它有很大关系。

但这并不意味着存在
单一的双极基因。

事实上,发展
双相情感障碍的可能性

是由

我们仍在试图理解的复杂配方中许多基因之间的相互作用驱动的

原因很复杂

,因此,诊断和
患有双相情感障碍是一项挑战。

尽管如此,这种疾病
是可控的。

锂等某些药物可以通过稳定情绪来帮助
管理危险的想法和行为

这些情绪稳定药物通过
减少大脑中的异常活动来发挥作用,

从而加强可行的
神经连接。

其他常用的药物
包括抗精神病药,

它可以改变多巴胺的作用,

而电惊厥疗法

的作用类似于大脑中精心控制的
癫痫发作

,有时用作
紧急治疗。

一些双相情感障碍患者拒绝接受治疗,

因为他们担心这会
削弱他们的情绪

并破坏他们的创造力。

但现代精神病学正在积极
尝试避免这种情况。

今天,医生
根据具体情况

与患者合作,实施治疗和疗法的组合

,使
他们能够最大限度地发挥自己的潜力。

除了治疗之外,
躁郁症患者还可以

从更简单的改变中受益。

这些包括定期锻炼、

良好的睡眠习惯、

远离毒品和酒精的清醒,

更不用说
家人和朋友的接受和同情了。

请记住,双相情感障碍
是一种疾病,

不是一个人的错,

也不是他们的整个身份

,它可以

通过在内部发挥作用的医学治疗

、在外部促进接受和理解的朋友和家人

以及人们的结合来控制 双相情感障碍
使自己

能够在生活中找到平衡。