Bipolar disorder is a brain-based disorder with many clinical manifestations and comorbidities, leading to severe disabilities in the patient. Mixed episodes characterize this condition, i.e. its symptoms swing between mania and depression. It is important to note that while depression has commonly been associated with the disorder, a bipolar diagnosis need not necessarily include depressive episodes, though it can.

Bipolar disorder is a complex medical state whose etiology involves genetic and epigenetic factors acting alongside environmental components in causing manifestation of the disease. Bipolar disorder affects virtually all areas of the human body, from energy levels and appetite to muscles and even libido.


What causes Bipolar disorder?

Millions of people in the world are affected by manic depression , however, it can take years to be properly diagnosed with the disease, depriving people of the assistance that they have . As the name reflects, people with bipolar disorder experience two extremes, or poles, with their mood: depression and mania.

Mania is the polar opposite of depression. A manic person can have an uplifted mood or experience feelings of grandiosity. They might be relentlessly talkative, hyperactive, or may claim to have special powers or express paranoia, anger, or anguish.

Bipolar disorder has traditionally been viewed as a purely biological one, but in reality the episodes of this complex condition are best understood within a biopsychosocial framework, which is interactions between genes, neural pathways, and socioenvironmental influences.


Pathophysiology of bipolar disorder

The behavioral and physiological manifestations of Bipolar disorder are complex, showing itself not only as profound changes in mood, but also in the form of a range of neurovegetative and psychomotor features. The pathophysiology is undoubtedly moderated by interconnected limbic, striatal and fronto-cortical neurotransmitter neuronal circuits, and the interacting cholinergic, catecholaminergic and serotonergic neurotransmitter systems thus represent very attractive candidates. Thus, it’s not surprising that clinical studies over the past 40 years have for the foremost part rested upon the conceptual foundation that monoamine signaling and hypothalamic-pituitary-adrenal (HPA) axis disruption are integral to the pathophysiology of both depression and mania .

A true understanding of the pathophysiology of manic depression must address its neurobiology at different physiological levels, i.e. molecular, cellular, systems, and behavioral. Abnormalities in organic phenomenon undoubtedly underlie the neurobiology of the disorder at the molecular level and this may become evident as we identify the susceptibility and protective genes for Bipolar disorder in the coming years.




Hippocampus and bipolar disorder

Interest in hippocampal volume stems from neuropsychological and neuropathological studies that implicate this structure within the pathophysiology of bipolar disorders. For instance, enlarged right hippocampal volume is claimed to be related to poor neuropsychological functioning in manic depression , and findings from a neuropathological study have indicated a discount and dysgenesis of varied neuronal cell lines in entorhinal and hippocampal cortex of bipolar patients.

Also, in people with bipolar disorder, certain parts of the hippocampus are smaller than they are in both people with major depressive disorder and in people without mood disorders.




Bipolar disorder and neurotransmitter imbalance

The brain uses a variety of chemicals as messengers to speak with other parts of the brain and systema nervosum . These chemical messengers, referred to as neurotransmitters, are essential to all or any of the brain’s functions.

There are many various sorts of neurotransmitter chemicals within the brain. The neurotransmitters that are said to be involved in manic depression include dopamine, norepinephrine, serotonin, GABA (gamma-aminobutyrate), glutamate, and acetylcholine.

Measuring neurotransmitters, their chemical variations, and their effects is central to the study of bipolar disorder. For example, GABA is lower within the blood and cerebrospinal fluid of patients with manic depression while oxytocin-active neurons are more in those with manic depression .



Which hormone causes bipolar disorder?

Neurotransmitters aren’t the only chemical messengers within the body. Hormones are also used by the body as chemical messengers. The thyroid is an endocrine organ located within the neck that produces hormones . It has been the main target of much mood disorder research. Depression is usually related to low levels of hormone , a condition referred to as Hypothyroidism. Mood elevation is usually related to high levels of hormone (Hyperthyroidism). Treating hypothyroidism by supplementing or replacing hormones may sometimes alleviate depression. Similarly, reducing levels of high hormone with lithium may ease manic symptoms. Given that up to half patients with a rapid cycling sort of bipolar disease even have hypothyroidism, the involvement of the thyroid in producing or enabling bipolar disorders for some patients is a strong possibility.


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