Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
NIMH - What are the risk factors for bipolar disorder?
Scientists are learning about the possible causes of bipolar disorder. Most
scientists agree that there is no single cause. Rather, many factors likely act
together to produce the illness or increase risk.
Genetics
Bipolar disorder tends to run in families, so researchers are
looking for genes that may increase a person's chance of developing the illness.
Genes are the "building blocks" of heredity. They help control how the body and
brain work and grow. Genes are contained inside a person's cells that are passed
down from parents to children.
Children with a parent or sibling who has bipolar disorder are four to six
times more likely to develop the illness, compared with children who do not have
a family history of bipolar disorder. However, most children with a family
history of bipolar disorder will not develop the illness.
Genetic research on bipolar disorder is being helped by advances in
technology. This type of research is now much quicker and more far-reaching than
in the past. One example is the launch of the Bipolar Disorder Phenome Database,
funded in part by NIMH. Using the database, scientists will be able to link
visible signs of the disorder with the genes that may influence them. So far,
researchers using this database found that most people with bipolar disorder
had:
Missed work because of their illness
Other illnesses at the same time,
especially alcohol and/or substance abuse and panic disorders
Been treated or
hospitalized for bipolar disorder.
The researchers also identified certain
traits that appeared to run in families, including:
History of psychiatric hospitalization
Co-occurring obsessive-compulsive
disorder (OCD)
Age at first manic episode
Number and frequency of manic
episodes.
Scientists continue to study these traits, which may help them find
the genes that cause bipolar disorder some day.
But genes are not the only risk factor for bipolar disorder. Studies of
identical twins have shown that the twin of a person with bipolar illness does
not always develop the disorder. This is important because identical twins share
all of the same genes. The study results suggest factors besides genes are also
at work. Rather, it is likely that many different genes and a person's
environment are involved. However, scientists do not yet fully understand how
these factors interact to cause bipolar disorder.
Brain structure and functioning
Brain-imaging studies are helping scientists
learn what happens in the brain of a person with bipolar disorder. Newer
brain-imaging tools, such as functional magnetic resonance imaging (fMRI) and
positron emission tomography (PET), allow researchers to take pictures of the
living brain at work. These tools help scientists study the brain's structure
and activity.
Some imaging studies show how the brains of people with bipolar disorder may
differ from the brains of healthy people or people with other mental disorders.
For example, one study using MRI found that the pattern of brain development in
children with bipolar disorder was similar to that in children with
"multi-dimensional impairment," a disorder that causes symptoms that overlap
somewhat with bipolar disorder and schizophrenia. This suggests that the
common pattern of brain development may be linked to general risk for unstable
moods.
Learning more about these differences, along with information gained from
genetic studies, helps scientists better understand bipolar disorder. Someday
scientists may be able to predict which types of treatment will work most
effectively. They may even find ways to prevent bipolar disorder.
NIMH - How is bipolar disorder diagnosed?
The first step in getting a proper diagnosis is to talk to a doctor, who may
conduct a physical examination, an interview, and lab tests. Bipolar disorder
cannot currently be identified through a blood test or a brain scan, but these
tests can help rule out other contributing factors, such as a stroke or brain
tumor. If the problems are not caused by other illnesses, the doctor may conduct
a mental health evaluation. The doctor may also provide a referral to a trained
mental health professional, such as a psychiatrist, who is experienced in
diagnosing and treating bipolar disorder.
The doctor or mental health professional should conduct a complete diagnostic
evaluation. He or she should discuss any family history of bipolar disorder or
other mental illnesses and get a complete history of symptoms. The doctor or
mental health professionals should also talk to the person's close relatives or
spouse and note how they describe the person's symptoms and family medical
history.
People with bipolar disorder are more likely to seek help when they are
depressed than when experiencing mania or hypomania. Therefore, a careful
medical history is needed to assure that bipolar disorder is not mistakenly
diagnosed as major depressive disorder, which is also called unipolar
depression. Unlike people with bipolar disorder, people who have unipolar
depression do not experience mania. Whenever possible, previous records and
input from family and friends should also be included in the medical history.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Panic attacks are sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. A person experiencing a panic attack may believe that he or she is having a heart attack or that death is imminent. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them. Most people with panic attacks experience several of the following symptoms: racing heartbeat, faintness, dizzyness, numbness or tingling in the hands and fingers, chills, chest pains, difficulty breathing, and a feeling of loss or control. There are several treatments for panic attacks.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
Schizophrenia is a disabling brain disorder that may cause hallucinations and delusions and affect a person's ability to communicate and pay attention. Symptoms of psychosis appear in men in their late teens and early 20s and in women in their mid-20s to early 30s. With treatment involving the use of antipsychotic medications and psychosocial treatment, schizophrenia patients can lead rewarding and meaningful lives.
Suicide is the process of intentionally ending one's own life. Approximately 1 million people worldwide commit suicide each year, and 10 million to 20 million attempt suicide annually.
Borderline personality disorder is a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This instability often disrupts family and work life, long-term planning, and the individual's sense of self-identity. Originally thought to be at the "borderline" of psychosis, people with borderline personality disorder (BPD) suffer from a disorder of emotion regulation.
Drug addiction is a chronic disease that causes drug-seeking behavior and drug use despite negative consequences to the user and those around him. Though the initial decision to use drugs is voluntary, changes in the brain caused by repeated drug abuse can affect a person's self-control and ability to make the right decisions and increase the urge to take drugs. Drug abuse and addiction are preventable.
Obsessive compulsive disorder (OCD) is an anxiety disorder that causes a person to suffer repeated obsessions and compulsions. Symptoms include irresistible impulses despite a person's realization that the thoughts are irrational, excessive hand washing, skin picking, lock checking, or repeatedly rearranging items. People with OCD are more likely to develop trichotillomania, muscle or vocal tics, or an eating disorder. Treatment for OCD includes psychotherapy, behavioral therapy, and medication.
A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. Not getting enough sleep can hurt memory performance, health, and your mood.
Antisocial personality disorder (ASPD) has many symptoms, signs, and causes. Therapy is one treatment option for antisocial personality disorder. It is closely related to other personality disorders (PD), such as borderline personality disorder and narcissistic personality disorder.
ADHD afflicts approximately 3 percent to 5 percent of school-age children and an estimated 60 percent of those maintain the disorder into adulthood. Symptoms of adult ADHD include chronic lateness, anxiety, low self esteem, employment problems, difficulty controlling anger, impulsiveness, poor organization skills, procrastination, chronic boredom among others.
Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder characterized by the symptoms hyperactivity, impulsivity, and inattention. Treatment for ADHD may involve behavioral therapy and psychostimulant or antidepressant medication.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Psychotic disorders are a group of serious illnesses that affect the mind. Different types of psychotic disorders include schizophrenia, schizoaffective disorder, schizophreniform disorder, brief psychotic disorder, shared psychotic disorder, delusional disorder, substance-induced psychotic disorder, paraphrenia, and psychotic disorders due to medical conditions.
Seasonal affective disorder is a type of depression that tends to occur as the days grow shorter in the fall and winter. Symptoms of seasonal affective disorder include tiredness, fatigue, depression, irritability, body aches, poor sleep and overeating.
Phobias are unrelenting fears of activities (social phobias), situations (agoraphobia), and specific items (arachnophobia). There is thought to be a hereditary component to phobias, though there may be a cultural influence or they may be triggered by life events. Symptoms and signs of phobias include having a panic attack, shaking, breathing troubles, rapid heart beat, and a strong desire to escape the situation. Treatment of phobias typically involves desensitization, cognitive behavioral therapy, and medications such as selective serotonin reuptake inhibitors and beta blockers.
Genetic disease is a disorder or condition caused by abnormalities in a person's genome. Types of genetic inheritance include single inheritance (for example, cystic fibrosis, sickle cell anemia, Marfan syndrome, and hemochromatosis), multifactoral inheritance, chromosome abnormalities (for example, Turner syndrome, and Klinefelter syndrome), and mitochondrial inheritance (for example, epilepsy and dementia).
Schizoaffective disorder is a mental illness that features schizophrenia and a mood disorder, either major depression or bipolar disorder. Symptoms include agitation, suicidal thoughts, little need for sleep, delusions, hallucinations, and poor motivation. Treatment may involve psychotherapy, medication, skills training, or hospitalization.
It's important to know whether you will breastfeed or bottle-feed your baby prior to delivery, as the breasts' ability to produce milk diminishes soon after childbirth without the stimulation of breastfeeding. Breast milk is easily digested by babies and contains infection-fighting antibodies and cholesterol, which promotes brain growth. Formula-fed babies actually need to eat somewhat less often since formula is less readily digested by the baby than human milk. This article explores the advantages and disadvantages of both forms of feeding.
Mental illness is any disease or condition affecting the brain that influence the way a person thinks, feels, behaves, and/or relates to others. Mental illness is caused by heredity, biology, psychological trauma and environmental stressors.
Compulsive gambling is a disorder that affects millions in the U.S. Symptoms and signs include a preoccupation with gambling, lying to family or loved ones to hide gambling, committing crimes to finance gambling, and risking importance relationships and employment due to gambling. Treatment may incorporate participation in Gamblers' Anonymous, psychotherapy, and medications like carbamazepine, topiramate, lithium, naltrexone, antidepressants, clomipramine, and fluvoxamine.
Postpartum depression is a form of depression that occurs within a year after delivery. It is thought that rapid hormone changes after childbirth may lead to depression. Symptoms of postpartum depression include crying a lot, headaches, chest pains, eating too little or too much, sleeping too little or too much, withdrawal from friends and family, and feeling irritable, sad, hopeless, worthless, guilty, and overwhelmed. Treatment typically involves talk therapy and medication.
Khat (Abyssinian tea, African salad, oat, kat, chat, and catha) is a flowering evergreen shrub native to East Africa and the Arabian Peninsula. Khat is usually chewed like tobacco, however, it can be smoked or sprinkled on food. Using Khat can cause a variety of health consequences. Khat is illegal in the United States.
Brief psychotic disorder is a short-term mental illness that features psychotic symptoms. There are three forms of brief psychotic disorder. The first occurs shortly after a major stress, the second has no apparent trauma that triggers the illness, and the third is associated with postpartum onset. Symptoms include hallucinations, delusions, unusual behavior, disorientation, changes in eating and sleeping, and speech that doesn't make sense. Treatment typically involves medication and psychotherapy.
Bipolar disorder, or manic-depressive illness, is a disorder that causes unusual and extreme mood changes. Symptoms of bipolar disorder in children and teens include having trouble concentrating, behaving in risky ways and losing interest in activities they once enjoyed. Treatment for bipolar disorder in children and teenagers incorporates psychotherapy and medications.
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