Etiologies of Bipolar disorders. Power Point Presentation ptx

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Bipolar disorder, formerly known as manic-depressive illness, is a complex psychiatric condition characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). The etiology of bipolar disorder involves a combination of genetic, biological, and environmental factors. Here's a breakdown of these etiologies:

Genetic Factors:

Family History: Bipolar disorder tends to run in families, suggesting a genetic component. Studies indicate that having a close relative with bipolar disorder increases the risk.
Genetic Studies: Research has identified specific genetic variations associated with bipolar disorder. These include genes involved in neurotransmitter signaling, ion channel function, and circadian rhythms.
Neurobiological Factors:

Neurotransmitter Imbalance: Imbalances in neurotransmitters such as dopamine, serotonin, and norepinephrine are implicated in bipolar disorder. For example, elevated dopamine levels during manic episodes and decreased levels during depressive episodes.
Neuroendocrine Factors: Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and abnormal cortisol levels have been observed in individuals with bipolar disorder.
Neuroanatomical Factors:

Brain Structure and Function: Structural and functional abnormalities in certain brain regions are linked to bipolar disorder. These include the prefrontal cortex, amygdala, and hippocampus, which are involved in emotional regulation and cognition.
Environmental Factors:

Stress: Stressful life events, such as trauma, loss, or significant life changes, can trigger or exacerbate episodes of bipolar disorder.
Substance Abuse: Substance use, particularly stimulants or drugs that affect neurotransmitter systems, can precipitate manic episodes or worsen the course of the disorder.
Developmental Factors:

Early Life Experiences: Adverse childhood experiences, including abuse, neglect, or chronic stress, may increase susceptibility to developing bipolar disorder later in life.
Trajectories: Some individuals may have a prodromal phase marked by subthreshold symptoms or other behavioral indicators before full-blown episodes manifest.

1. ETIOLOGIES OF BIPOLAR DISORDERS TOTAL SLIDES 35

2. BIPOLAR DISORDERS Bipolar can be defined as Mania or Depressive illness or manic depression, it is a mental illness that causes unusual shifts in a person’s mood, energy, activity level, and concentration. TOTAL SLIDES 35 3 /35

3. TYPES OF BIPOLAR AND RELATED DISORDERS Bipolar-I Bipolar-II Cyclothymic Substance/Medication Induced Bipolar and Related Disorders Bipolar and Related Disorders Due to Another Medical Condition Other Specified Bipolar and Related Disorders Unspecified Bipolar and Related Disorders 4 /35

4. BIPOLAR-I At least one Manic Episode. Preceded/followed by Hypomanic or Major Depressive episode. 5 /35

5. BIPOLAR-II Never had a Manic Episode. At least one Hypomanic, and one Major Depressive episode. 6 /35

6. MANIC EPISODE A manic episode is a period of time, usually lasting at least a week, when a person with bipolar disorder experiences an extremely elevated or irritable mood. They may have an excessive amount of energy, engage in impulsive or risky behaviors, and have rapid, uncontrollable thoughts and speech. During this episode, their judgment may be impaired, leading to poor decision-making and potentially harmful actions. Manic episodes significantly impact a person's daily life, relationships, and functioning. It is important to seek professional help if someone is experiencing symptoms of a manic episode. 7 /35

7. ETIOLOGY The exact cause of bipolar disorders is unknown, but several factors such as; genetics, environmental, and biological factors may be included. 8 /35

8. TWIN AND FAMILY STUDIES Twin studies have shown that there is a strong genetic component to bipolar disorder, with a heritability rate of approximately 80%. Family studies have demonstrated that first-degree relatives of individuals with bipolar disorder are more likely to have the disorder than those without a family history. Studies have also shown that bipolar disorder is more common in monozygotic (identical) twins than in dizygotic (non-identical) twins, suggesting a strong genetic component .   Twin and family studies have also shown that there may be shared environmental factors that contribute to the risk of developing bipolar disorder. 9 /35

9. CHROMOSOME LINKAGE STUDIES Chromosome linkage studies have identified several chromosomal regions that may be associated with an increased risk of bipolar disorder. These regions include chromosomes 6, 11, 15, 18, and 21. Variations in genes located in these regions have been shown to be associated with the risk of bipolar disorder. 10/35

10. NEUROBIOLOGY FACTORS Abnormalities in neurotransmitter systems, such as dopamine, serotonin, and norepinephrine. Abnormalities in the brain’s reward system, which is responsible for regulating motivation and pleasure. Abnormalities in the brain’s stress response system, which may lead to an increased sensitivity to stress. Abnormalities in the brain’s circadian rhythm, which could lead to disturbances in sleep. Abnormalities in the brain’s inflammatory response system, which may lead to an increased risk of inflammation-related illnesses . Abnormalities in the brain’s neural circuitry, which may lead to disruptions in communication between different parts of the brain. 11/35

11. BRAIN CHEMICALS Serotonin : Serotonin is a neurotransmitter that helps regulate mood, sleep, and appetite. Imbalances in serotonin levels can lead to symptoms of bipolar disorder, such as extreme mood swings, depression, and anxiety. Dopamine : Dopamine is a neurotransmitter that is involved in reward and motivation. Imbalances in dopamine levels can lead to the extreme highs and lows associated with bipolar disorder. Gamma-Aminobutyric Acid (GABA): GABA is a neurotransmitter that helps regulate brain activity. Imbalances in GABA levels can lead to symptoms of bipolar disorder, such as anxiety, depression, and mood swings. 12/35

12. ABNORMAL FUNCTIONING OF BRAIN CIRCUITS Dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) Axis: This is a system in the body that regulates stress and emotion. When this system is dysregulated, it can lead to an imbalance in hormones, which can cause mood swings and other symptoms associated with bipolar disorder. Dysregulation of Neurotransmitters: Neurotransmitters are chemical messengers that help relay signals between neurons. When certain neurotransmitters are not functioning properly, it can lead to an imbalance in the brain, which can cause the symptoms of bipolar disorder . Abnormal Brain Structure: Abnormalities in the brain structure, such as the size and shape of certain parts of the brain, can lead to a disruption in the way the brain processes information, which can lead to bipolar disorder. 13/35

13. ABNORMAL FUNCTIONING OF BRAIN CIRCUITS Genetic Factors: Bipolar disorder can be inherited, so if someone in your family has it, you may be more likely to develop it as well. 14/35

14. NEUROLOGICAL CHANGES IN THE BRAIN 15/35

15. NEUROLOGICAL CHANGES IN THE BRAIN Abnormalities in the prefrontal cortex: This brain region is involved in decision-making, impulse control, and emotion regulation. Abnormalities in this region can lead to difficulty in controlling impulsive behavior, which can result in manic episodes. Abnormalities in the hippocampus: This brain region is responsible for memory formation and storage. Abnormalities in this region can lead to difficulty in forming and retrieving memories, which can contribute to difficulty in regulating mood. Abnormalities in the basal ganglia: This brain region is responsible for controlling movement. Abnormalities in this region can lead to difficulty in controlling movement, which can result in restlessness and agitation, which are common symptoms of mania. 16/35

16. NEUROLOGICAL CHANGES IN THE BRAIN Abnormalities in neurotransmitter levels: Neurotransmitters are chemical messengers in the brain that are involved in regulating mood. Abnormalities in neurotransmitter levels can lead to difficulty in regulating mood, resulting in mood swings between mania and depression. 17/35

17. ENVIRONMENTAL FACTORS 18/35

18. ENVIRONMENTAL FACTORS Environmental factors are believed to play a role in the development of bipolar disorder. These factors can include: Stressful life events: Stressful life events, such as the death of a loved one, a divorce, or a job loss, can trigger episodes of depression or mania. Traumatic experiences: Traumatic experiences, such as physical or sexual abuse, can increase the risk of developing bipolar disorder. Substance abuse: Substance abuse, such as alcohol or drug use, can trigger episodes of mania or depression. 19/35

19. ENVIRONMENTAL FACTORS Genetics: People with a family history of bipolar disorder are more likely to develop the disorder Sleep disturbances: People with bipolar disorder often experience disruptions in their sleep patterns, which can trigger episodes of mania or depression. Social isolation: People who are socially isolated or lack meaningful relationships may be more likely to develop bipolar disorder. 20/35

20. OTHER FACTORS Medical conditions Medical conditions can cause bipolar disorder in a variety of ways. For example, certain medical conditions can cause changes in hormone levels, which can lead to changes in mood. Examples of medical conditions that can cause bipolar disorder include: Thyroid disorders: Thyroid disorders can lead to changes in hormone levels, which can lead to changes in mood . Hypothyroidism : This is a condition in which the thyroid gland does not produce enough hormones, leading to symptoms such as fatigue, weight gain, depression, and difficulty concentrating. This can cause bipolar disorder by causing an imbalance in brain chemistry, leading to mood swings and other symptoms of bipolar disorder. 21/35

21. OTHER FACTORS Autoimmune disorders: Autoimmune disorders can cause inflammation in the brain, which can lead to changes in mood. Brain injury or trauma: Brain injury or trauma can cause changes in neurotransmitter levels, which can lead to changes in mood. Sleep disorders: Sleep disorders can lead to changes in hormone levels, which can lead to changes in mood. Substance use disorder: Substance use disorder can cause changes in neurotransmitter levels, which can lead to changes in mood. 22/35

22. PSYCHOSOCIAL FACTORS 23/35

23. PSYCHOSOCIAL FACTORS No one knows exactly what causes bipolar disorder. Research suggests that a combination of factors could increase your chance of developing it. This includes physical, environmental and social conditions. This covers: Childhood trauma Stressful life events Brain chemistry Family links Medication, drugs and alcohol 24/35

24. CHILDHOOD TRAUMA Some experts believe that experiencing a lot of emotional distress as a child can cause bipolar disorder to develop. This could be because childhood trauma and distress can have a big effect on your ability to manage your emotions. This can include experiences like: Neglect Sexual, physical or emotional abuse Traumatic events Losing someone very close to you, such as a parent or carrier. 25/35

25. STRESSFUL LIFE EVENTS Some people also find that stress can trigger a mood episode . Or it may make symptoms feel more intense or difficult to manage. Things that can cause stress include: A relationship breakdown Money worries and poverty Experiencing trauma Losing someone close to you Being abused, bullied or harassed, including experiencing racism Feeling lonely or isolated Lots of change or uncertainty Feeling under pressure while working , studying or looking for work Big events, such as weddings or holidays 26/35

26. FAMILY LINKS If you experience bipolar disorder, you're more likely to have a family member who also experiences bipolar moods and symptoms . But they might not have a formal diagnosis. This suggests that bipolar disorder can be passed on genetically through families. 27/35

27. MEDICATION, DRUGS AND ALCOHOL Medication, drugs and alcohol may cause you to experience some bipolar moods and symptoms . For example: Medication . Some medications can cause hypomania or mania as a side effect. This can happen when you're taking them, or as a withdrawal symptom when you stop taking them . This includes medications for physical conditions and psychiatric medications – including some antidepressants . Alcohol or recreational drugs . Using these can cause you to experience symptoms similar to mania, hypomania or depression . It can often be difficult to distinguish the effects of alcohol and drugs from mental health symptoms. 28/35

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