Bipolar Disorder

Welcome to PT 635 Pathophysiology of Complex Patient Problems This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editors - Michael Thompson from Bellarmine University's Pathophysiology of Complex Patient Problems project.

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Definition/Description

Bipolar disorder, also known as manic-depressive illness, is a disorder that deals with the human brain. The brain causes unusual shifts in mood, liveliness, activity levels, and the ability to carry out daily activities. People that suffer from this disease can experience mood swings that occur as few as a couples times throughout a year or up to multiple times within a day.  

[Photo courtesy of Bipolar Disorder Symptoms. Available at http://cureanxiety.com/bipolar-disorder-symptoms.]

Prevalence

The Depression and Bipolar Support Alliance has estimated that close to 6 million Americans are affected by bipolar disorder every year. Bipolar disorder can affect anyone at any age and is found in all races, ethnic groups and social classes with the typical onset being 25 years old. Patients may be diagnosed in their early childhood to as late as the 4th and 5th decades of life. Bipolar disorder is not gender based and can affect men and women equally. Although, studies have shown that women with Bipolar disorder have more depressive and mixed episodes than men with the disorder. More than 66% of people diagnosed with Bipolar disorder have at least one primary family member with the illness.

The incidence of Bipolar disorder in other countries is notable as well. In Australia it is approximately 238,957 people, in the United Kingdom it is approximately 723,248 people, in Germany it is approximately 989,095 people, in Canada it is approximately 390,094 people, in Iran it is approximately 810,038 people and for both India and China it is approximately 12-15 million people.

Characteristics/Clinical Presentation

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Associated Co-morbidities

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Medications

There are many medications that a physician may prescribe to a patient diagnosed with Bipolar disorder. One of the most popular medications that is prescribed is Lithium. It is a mood stabilizing drug and has been shown to significantly reduce the amount of hospitalizations in patients with Bipolar disorder. It has an effectiveness of up to 80% on all hypomanic and manic episodes. Valproate and Carbamazepine are the first and second most used anti-epileptic medications by many Bipolar disorder patients. These medications work well in treating symptoms such as mania, rapid-cycling and mixed states. Atypical antipsychotics, which are typically used to treat schizophrenia, have been proven to help in the treatment of Bipolar disorder. These include Clozapine, Olanzapine, Risperidone, Quetiapine, Aripiprazole and Ziprasidone. Since patients with Bipolar disorder typically have depression, they will at times be treated with anti-depressants. Although, anti-depressants have been shown to cause mania in 10-30% of patients. Anti-depressants typically prescribed for these patients are Bupropion, Fluoxetine, Citalopram, Sertraline and Proxetine.

Diagnostic Tests/Lab Tests/Lab Values

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Etiology/Causes

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Systemic Involvement

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Medical Management (current best evidence)

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Physical Therapy Management (current best evidence)

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Alternative/Holistic Management (current best evidence)

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Differential Diagnosis

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Case Reports/ Case Studies

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Resources

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Recent Related Research (from Pubmed)

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References

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