Bipolar Disorder
History / Stereotypes/ Cultural Perspectives
www.healthclevelandclinic.org Historical & Contemporary Overview
Bipolar disorders are complex and unique to each person. Bipolar disorder can show up in many forms. People with bipolar disorder often have extreme shifts in moods and emotions. Extreme mood shifts have been a part of history for sometime and have been well documented. Early Greek philosophers and doctors were the first to document mood changes. Hippocrates are historically the first to explain extreme mood swings (Mason et al, 2016).These were described has great expressions of mood . The term melancholia (black bile) was used to described pathological state of severe sadness and low moods while mania was used to describe (yellow bile) (Mason et al, 2016). Credence was given in the 19th century to major circulating mood disease. Contemporaries Falret & Baillarger of the 19th century , chronicles two forms of the mood disorder which were mania and melancholia considering them two different disorders (Mason et al, 2016). Melancholia and mania were then later intertwined together through the work of Aretaeus of Cappadocia (Mason et al, 2016). Aretaeus explain the model of the disease symptoms being on a spectrum, variations of mood extremes, patterns.
Classification system was formed developing a framework to identify all mood dysfunction such as bipolar disorder along with schizophrenia. According to Mason et al (2016), "Early classification of the psychoses into a nosologiccal framework was first put forth by Karl Kahlbaum (1863), postulating a close correspondence between clinical symptoms, the disease course and outcome, brain pathology and etiology which suggested a natural disease entity." Through they years , different types of bipolar evolved and were understood. Through research it is now understood different causes of bipolar disorders and who can be at risk. There have been links to genetics along with environmental factors that may cause bipolar disorder. Recent research explores gene expression and how it links to bipolar disorder. According to Courtin et al (2023), "a chronobiological model has been proposed suggesting that core clock genes play a central role in the vulnerability to the disorder". Research continues to go on to further the understanding bipolar disorder.
Stereotypes & Stereotypical Thinking
There are many myths and stereotypes that surround bipolar disorder. Many people believe those affected with bipolar disorder are out of control, cannot live a normal live and have many up and down moods. Many people with bipolar disorder live within the community , never requiring hospitalization. With the right treatment plan, a person can live a normal ,successful life. It is thought that bipolar disorder is hard to treat. Although , people with bipolar disorder may experience problems in psychosocial functioning, cognitive impairment when left untreated , there has been much improvement in treatment plans taking in to account the well being and quality of life of a person (Bonnin et al , 2019). There have been very effective treatments that work well for those with bipolar disorder.
Some believe bipolar disorder is black and white. There are many forms of bipolar disorder. These are known as bipolar I disorder, bipolar II disorder, cyclothymic disorder , bipolar disorder not otherwise specified and other specified bipolar (Goldstein et al, 2017).The two most popular known is bipolar I and bipolar II. There are milder forms of bipolar disorder that are common. Every person is different. Some people may experience depressive episodes with milder mania or no mania. Some people may never experience depressive episodes while some experience mixed episodes.
Cultural Perspective
Bipolar disorder is a complex disorder with many variations. People are deep rooted in their beliefs and values. These values and beliefs affect a persons treatment plan. It is vital that when treating a patient that all aspects of their culture be respected and considered when creating a treatment plan as well as addressing key components of bipolar disorder. Some cultures may frown upon mental health disorders. It is important to address any cultural concerns as well as provide a proper education on bipolar disorder. Maintaining and developing interpersonal therapeutic relationship between professions and their patients warrants the use of a cultural framework including connection of culture and cultural competence (Warren, 2007). Professionals must always abide by ethical standards, respecting all cultural perspectives and differences.
References
Bonnin, C. D. M., Reinares, M., Martínez-Aran, A., Jiménez, E., Sanchez-Moreno,
J., Sole, B., Montejo, L., & Vieta, E. (2019). Improving functioning, quality of
life, and well-being in patients with bipolar disorder. The International Journal
of Neuropsychopharmacology, 22(8), 467–477. doi.org/10.1093/ijnp/pyz018
Courtin, C., Marie-Claire, C., Gross, G., Hennion, V., Mundwiller, E., Guegan, J.,
Meyrel, M., Bellivier, F., & Etain, B. (2023). Gene expression of circadian
genes and CIART in bipolar disorder: A preliminary case-control
study. Progress in Neuro-psychopharmacology & Biological Psychiatry, 122,
110691. doi.org/10.1016/j.pnpbp.2022.110691
Goldstein, B. I., Birmaher, B., Carlson, G. A., DelBello, M. P., Findling, R. L.,
Fristad, M., Kowatch, R. A., Miklowitz, D. J., Nery, F. G., Perez-Algorta, G.,
Van Meter, A., Zeni, C. P., Correll, C. U., Kim, H. W., Wozniak, J., Chang, K.
D., Hillegers, M., & Youngstrom, E. A. (2017). The international society for
Bipolar disorders task force report on pediatric bipolar disorder: Knowledge to
date and directions for future research. Bipolar Disorders, 19(7), 524–543.
doi.org/10.1111/bdi.12556
Mason, B.L., Brown, E.S., Croarkin, P.E. (2016). Historical underpinnings of
Bipolar disorder diagnostic criteria. Behavioral Sciences, 6(3),14.
doi.org/10.3390/bs6030014
Warren, B. J. (2007). Cultural aspects of bipolar disorder: Interpersonal meaning
for clients & psychiatric nurses. Journal of psychosocial nursing and mental
health services, 45(7), 32–37. doi.org/10.3928/02793695-20070701-09
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