Comparing Mood Disordersby Shaheen E Lakhan, MD, PhD, MEd, MS, FAAN | July 24, 2006
Of all the mental health disorders, the two most common, and perhaps the most disruptive and distressing, are schizophrenia and bipolar. Even though the two share few similarities in symptoms and characteristics, they are both treated and medicated very differently.
Schizophrenia is the most devastating mental health disorder diagnosed. It typically emerges in adolescence, but can be diagnosed in males between the ages of 16-25. In females, diagnoses generally occur between 25-30. Both male and female are affected equally.
It is thought that schizophrenia develops when several factors are acting together. When genetic influence is combined with brain trauma at birth, social isolation and stress, an individual is at a greater risk for schizophrenia. The disease affects between 1and 2% of the worlds population at some point during their lifetime.
Contrary to popular belief, schizophrenia is not a split personality. However, for individuals who suffer from the disease, their perception of reality is extremely different. They suffer from terrifying internal voices not heard by others around them. They often believe that other people are reading their mind, controlling their thoughts or are trying to control them. They continually live in a world that is distorted by hallucinations and delusions. Their speech and behavior is often disorganized and are frightening to others around them. They are often distant, detached or preoccupied or may be very restless and fidgety.
Fortunately, these symptoms are not present all of the time. A psychotic episode will occur when an individual suddenly begins to suffer from one or more of the symptoms. With the proper medication and treatment, the symptoms can be controlled and the individual can live a productive life.
Onset of the initial episode of bipolar disorder typically occurs when an individual is in their late teens to mid 20’s. The disorder has two distinctive forms; Bipolar I disorder and Bipolar II disorder.
Bipolar I disorder, previously called manic-depression, is characterized by a single episode of mania, depression or a combination of both. Mania is described as ones mood as being elated or irritable. Individuals have racing thoughts, inflated self-confidence, excessive spending, reckless driving and impulse traveling. For a diagnosis of mania, there is no required duration of the illness. However, for a diagnosis of depression, the individual must have symptoms for at least two weeks.
Bipolar I occurs in about 1% of the population and impacts men and women equally. Although women are more likely to suffer depressive episodes. Usually, episodes of illness are followed by periods of wellness that can be as long a several years.
Bipolar II disorder is mainly depressive episodes with very few manic episodes and is more common in women.
Bipolar disorder is a recurring illness and the average person experiences more than ten episodes. Some experience chronic depression and between 15-20% of bipolar diagnosed individuals experience rapid cycling. This is defined as four or more episodes of mania, depression or both on one year.
There is no doubt that bipolar is a familial disorder. Studies show that two-thirds of bipolar individuals have a positive family history of the disorder. There have also been reports of individuals suffering from biochemical, neurophysiologic and sleep abnormalities.
As with schizophrenia, bipolar disorder is a mental illness that can be controlled with medication. However, the most important key to successful treatment is to continue the treatment and medication. Many individuals who are taking mood stabilizers, anti-depressants and anti-psychotic medications, may believe they are getting better or are actually cured. This is not the truth. Their symptoms are being controlled, not cured, therefore making their life manageable.
Studies show that one-third of the individuals who stop taking their medication will suffer a relapse with two years. More alarming is that of the total individuals with a mood disorder; one-quarter to one-half will attempt suicide. Anywhere from 9-15% will succeed. This exemplifies the need for medication compliance in mood disorders.
By: O. “Chip” Robinson
Editor: Shaheen Lakhan
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