Bipolar disorder is one of the mental health problems with considerable impacts on the global population. Bipolar disorder patients experience distressing symptoms that affect their health, well-being, and functioning. Healthcare providers must adopt treatment interventions that address the prioritized health needs of their patients and promote safety, quality, and efficiency outcomes. Evidence-based data inform the care interventions for patients with bipolar disorder. Therefore, this essay examines the prevalence and neurobiology of bipolar I disorder, its differences from bipolar II disorder, special considerations, clinical practice guidelines, side effects, and monitoring patients prescribed different treatments.
Prevalence and Neurobiology of Bipolar I Disorder
Bipolar I disorder is the selected disorder for analysis in this paper. Bipolar I disorder is one of the subtypes of bipolar disorder. Patients who are affected by bipolar I disorder experience episodes of neuropsychological deficits, severe mood disturbances, functioning impairment, and physiological changes. Data obtained from epidemiological studies reveal that the lifetime prevalence of bipolar I disorder is about 1% in the entire population. The overall lifetime prevalence of an individual being affected by bipolar I disorder is 0.6% and 2.4% for bipolar spectrum disorders. When compared to other bipolar spectrum disorders, bipolar I disorder has the lowest prevalence of all (McIntyre et al., 2020). However, the United States of America has a 1% higher prevalence rate of bipolar disorder when compared to other developed countries.
Bipolar I disorder has a neurobiological basis. Studies agree that an interaction between genetic factors and environmental factors precipitate bipolar I disorder. Environmental factors such as traumatic events and stress trigger the development of bipolar I disorder in individuals with a genetic predisposition. Besides the interaction, dysfunction in different intracellular cascades in the brain also contributes to bipolar disorder. This includes an imbalance in the different neurotransmitters that regulate emotions in the brain (Scaini et al., 2020). Mitochondrial dysfunction and oxidative stress also increase the risk of bipolar I disorder. The dysfunction and stress cause considerable impairment in neuronal plasticity, hence, the damage and loss of brain tissue. Studies have also revealed that patients with bipolar disorders have altered peripheral biomarkers related to inflammation, neurotrophins, hormones, and oxidative stress (Young & Juruena, 2021). The alteration explains the physiological, emotional, immunological, and functional impairments seen in patients with bipolar disorders.
Differences Between Bipolar I and Bipolar II Disorders
Bipolar I disorder differs from bipolar II disorder. According to DSM-5, a diagnosis of bipolar I disorder is reached if a patient presents to the hospital with symptoms of a manic episode. The symptoms include abnormally and persistently elevated irritable or expansive mood and abnormal engagement in goal-directed activity with high energy levels lasting at least a week. The symptoms persist most days almost every day (McIntyre et al., 2020). Patients have symptoms such as inflated self-esteem, insomnia, talkativeness, flight of ideas, easy distractibility, and increased involvement in harmful activities during this period.
Patients with bipolar II disorder present to the hospital with symptoms that meet at least a major depressive and hypomanic episode. They also do not have a history of manic episodes. Hypomania and depressive episodes cannot be attributed to other causes such as schizophrenia, schizoaffective disorder, or delusional disorder among other mental health problems. The symptoms of hypomania episodes are similar to those of mania in bipolar I disorder. However, a difference lies in their duration. In bipolar II disorder, the hypomania symptoms should last at least four consecutive days, most of the days, and almost every day (Angst et al., 2019). In both disorders, the symptoms should not be attributed to other causes such as substance abuse, medication use, or other mental health problems.
Special Populations and Special Considerations
Children, adolescents, pregnant and post-partum mothers, and older adults are special populations that must be treated with care when diagnosed with bipolar I disorder. Diagnosis of bipolar I disorder in children and adolescents is difficult because of the existence of comorbidities. Often, they present to the hospital with mixed or atypical features of bipolar spectrum disorders such as irritability, rapid cycling of symptoms, and labile mood. They might also have other coexisting problems such as substance abuse, which makes it challenging to diagnose bipolar affective
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