Mood Disorder: Suicide

Mood Disorder: Suicide
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Introduction
Many of us experience moments of dejection and during such periods life seems grey and nothing appears worthy doing. On the other hand, some have experienced the opposite state that is a mood of euphoria, excitement, and recklessness where one becomes feverishly active and think we can accomplish anything. This is depression and mania that occur mildly and temporarily in our daily lives. However, in other individuals such shifts in mood are prolonged and extreme in that the individual’s life becomes extremely disrupted. Such conditions are mood or affective disorders (Yang, 2011).
Moods are the state of feelings that cover our coloring our psychological lives. Therefore, mood disorders are emotional disturbances of the emotions that spill over into almost every other aspect of life. Such disorders affect how people think, behave, care for themselves, and overall health. In this sense, mood disorders are total body disorders. Mood disorders are characterized by mood dysregulation that is pervasive and psychomotor activity and related biorhythmic and cognitive disturbances (Yang, 2011).
The rubric of affective disorder that in some European classifications that subsume morbid states of anxiety is being replaced by the nosologically and increasingly delimited concept of mood disorder. Therefore, today, mood disorder is the preferred term by the WHO’s ICD-10 and APA’s DSM-V. The major categories of mood disorders are bipolar disorders with characteristic manic or hypomanic (depressive, or mixed episodes of these) and depression and its respective attenuated variant of major depressive disorders such as cyclothymic and dysthymic disorders. However, this paper will focus on bipolar disorder (Yang, 2011).
Bipolar Disorder
Bipolar disorder describes a set of mood swing conditions with the most severe form being manic depressive form. There is a variability of moods within the population with the condition and bipolar disorders are classified per the severity and nature of mood variation (Geddes, 2010). Understanding psychological mechanisms underlying bipolar disorder are complicated by the multifaceted, dynamic, and always shifting nature of experienced symptoms by patients (Pavlickova et al., 2013). For example, although the term "bipolar disorder" inherently implies that depression and mania are at extreme ends to each other on the spectrum of affect. When cross-sectional comparison is made, the two sets of symptoms are on different dimensions in regards to psychopathology so that they can simultaneously depressed and manic. This is why patients may present with mixed episodes (Pavlickova et al., 2013).
In addition, reports indicate that mood in bipolar patients mood may chaotically fluctuate over short periods of time. Longitudinal studies indicate that individuals having manic and depressive symptoms independently vary with each other with a small positive correlation between them that are statistically significant which explains why mixed episodes are sometimes observed (Pavlickova et al., 2013). Therefore, studies on bipolar disorder should involve sophisticated designs that consider the complex cross-sectional and longitudinal structures of symptoms in that the symptoms and psychological processes involved are adequately detected (Pavlickova et al., 2013).
General Etiology of Bipolar Disorder
The etiology of bipolar is not entirely known. The probable cause is an interaction of genetic, neurochemical interactions at various levels that are responsible for the onset and progress of bipolar disorder. The current thinking is that bipolar disorder is predominantly biological disorder that occurs in a certain part of the brain due to neurotransmitter malfunctioning and may be dormant and spontaneously activated or triggered by a life stressor.
Lay people’s theories and beliefs about bipolar disorder and their ability identify the symptoms were used to study the causes of bipolar disorder. According to Furnham (1988), the term "lay" refers to those individuals who have no formal education, extensive knowledge, or had previous contact with the topic in question (Furnham & Anthony, 2010). The ability of a lay person to recognize specific mental disorders is part of the "mental health literacy" concept, for example, Jorm 2000 that includes cause and treatment conceptions from the public (Furnham & Anthony, 2010). Studies that employ lay theories of causes and treatments and the general level of mental offer explanations for the persistent negative and stigmatizing attitudes towards mental disorders, for example, Nunnally (1961) and Link et al. (1999). In addition, according to Link et al. (1999), it provides an explanation of why many of those people diagnosed with mental health do not seek the much needed help (Furnham & Anthony, 2010).
The existing theories regarding bipolar that currently exist can be classified into three that are biological, genetic, and psychosocial. Genetic studies have indicated that bipolar disorder is among the most inheritable of all mental disorders. The risk of bipolar in first-degree relatives of bipolar pro-bands approaches 10-fold to that of the general population (Fanous, 2010). This has been recently confirmed by a large Swedish population study and past studies that have estimated the heritability of bipolar being significantly high estimated to be approximately 80% - 90% with adoption studies being highly underpowered (Fanous, 2010).
Biological theories comprise of abnormalities in hypothalamic-pituitary-adrenal axis and the neurotransmitter system (Furnham & Anthony, 2010). According to Mayberg (1997) and Soares & Mann (1997), mood regulation is believed to involve two major neuroanatomical circuits that include the limbic-thalamic-cortical circuit and the limbic-striatal-pallidal-cortical circuit. Dysfunction in either of the two circuits results into mood disorder (Semeniken & Dudás, 2012). In addition, chemical imbalances in the brain have also been associated with the onset of bipolar. For example, serotonin, dopamine, glutamate, GABA, substance P, and Acetylcholine have all been linked as causes of bipolar disorder (Semeniken & Dudás, 2012).
Psychosocial theories here include the stressful life situations and the dysfunctional attempts geared towards avoiding depression. Self-esteem dysregulation and childhood trauma and abuse have been linked by Kendler et al. (1992) to bipolar disorder (Furnham & Anthony, 2010). Evidence clearly indicates that the current environmental contexts impact the onset, course, and expression of bipolar spectrum disorders. For example, four retrospective studies on medical charts assessments to assess life events in patients with bipolar disorder. The studies found out that approximately 22% to 66% of such patients experienced at least one stressful event that was rated as independent of their behavior in a period of 1 to 3 months to onset of a mood CITATION All \l 1033 (Alloy, Abramson, Urosevic, Walshaw, Nusslock, & Neeren, 2005).
Moreover, reasonable evidence exists supporting the importance of social support in achieving a positive course of bipolar disorder and negative support predicts a worse course of bipolar disorder CITATION All \l 1033 (Alloy, Abramson, Urosevic, Walshaw, Nusslock, & Neeren, 2005). Social support from family and friends buffers against deleterious consequences of stress or enhances functioning among bipolar individuals. On the other hand, over involvement emotionally and criticism from the same group may act as additional sources of stress hence worsen the cause of bipolar CITATION All \l 1033 (Alloy, Abramson, Urosevic, Walshaw, Nusslock, & Neeren, 2005). The etiological factors in bipolar disorder do not occur in isolation, and as indicated earlier, bipolar disorder emaciates from complex interactions of genetic, biological, and psychosocial factors which according to Nuechterlein & Dawson (1984), is known as the "diathesis-stress" model (Furnham & Anthony, 2010).
Bipolar Disorder among Children and Adolescents
In the last few years, of bipolar disorder among children and adolescents has become a subject of great interest, controversy, and public health significance. The lack of a specific definition of its early signs and clinical subtypes including the best management levels produces the inherent controversies (Abd El-Hay, Badawy, & El Sawy, 2010). Despite being common among children and adolescents, mania seemed difficult to diagnose and, therefore, typical and atypical clinical representations at such ages was considered vital. The commonest mood disturbance in this period of development is marked by irritability accompanied with affective storms and prolonged bursts of rage. Severe, persistent, and often violent irritability lead to misdiagnosis of a large number of cases as conduct disorder (Abd El-Hay, Badawy, & El Sawy, 2010).
Bipolar disorder occurs in children and adolescents. The controversy lies on how it is diagnosed, how it can be distinguished from the other commonly diagnosed psychiatric disorders that occur during childhood, and how its prevention and treatment approaches (Abd El-Hay, Badawy, & El Sawy, 2010). The clinical course in adults differs from that among the youth where it tends to be more chronic and continuous than acute and episodic with more rapid cycles and mixed mania in adults. Such differences generate considerable controversy within the professional field, however, despite such interest and controversy, relatively few studies that examine the clinical phenomenology of childhood and adolescent bipolar (Abd El-Hay, Badawy, & El Sawy, 2010).
Bipolar Disorders are among the psychiatric disorders that cause disability and have a suicide rate of about 20-30 times compared to the general population. The overall lifetime prevalence is approximately 4% with typical onset occurring in late adolescence and early adulthood. Its prevalence among children and adolescents alone is approximately 2% (Cox, Seri, & Cavanna, 2014).
Phenomenology
BD is characterized by recurrent, discrete episodes of mood fluctuations that possess negative consequences on functioning. In pediatrics, BD according to VOGEL (2000) is characterized by chronic, non-episodic, ultra-rapid cycling that contributes to the prevalent misdiagnosis of BD as among the disruptive behavioral disorders that include Oppositional Disruptive Disorder (ODD), Conduct Disorder or ADHD (Bradfield, 2010). BD presents itself in children with mixed dysphoria and lability without discreet episodes. The fluctuation frequency means that children with the condition are disabled if its course is inadequately managed (Bradfield, 2010).
Impairment in functioning at school and in peer and family relationships is seen in children with the condition. The mood rapidly oscillates from a depressive to manic state of excitation with the following observable symptoms persistent sadness, irritable mood, loss of interest, appetite changes, psychomotor agitation, low self-esteem, suicidal ideation (Bradfield, 2010). On the manic spectrum moods range from extreme irritability, elation, inflated self-esteem, grandiosity, increased energy with decreased need for sleep, extr...