Bipolar disorder: mind and body

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This guest blog is written by Dr Georgina Hosang, who is an ESRC/MRC Interdisciplinary Postdoctoral Fellow from the MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London. Her research focuses on understanding the role of life stress in bipolar disorder and major depression and their interaction with genetic factors. 

 

In the spirit of Mental Health Awareness Week from 21 to 27 May 2012 and new developments discussed at the international society of bipolar disorders earlier this year, bipolar disorder is the topic of discussion. This is a serious psychiatric illness characterised by extreme fluctuations in mood, ranging from depression to elation or irritability (hypomania or mania), sometimes accompanied by psychotic features (e.g. hallucinations and delusions).

Bipolar episodes are highly recurrent which can be extremely disabling and cause much distress to the individual and their families. For example, it is associated with impaired work performance and relationship dysfunction as well as premature mortality. Broadly defined bipolar disorder affects 2.4% of the population worldwide, including a number of successful public figures, such as Stephen Fry and Frank Bruno, who have spoken openly about their illness and experiences. They are good examples of individuals with bipolar disorder who successfully manage their illness and make a significant contribution to society.

Adding to such burden is the increasing recognition of the high rates of medical conditions among people with bipolar disorder (and other psychiatric illnesses). Suffering from mental and physical illnesses simultaneously can be stressful and traumatic, impacting on recovery and management of both conditions. This phenomenon creates many complications for practitioners, particularly for detection and diagnosis of physical illnesses. Providing effective treatment for both groups of disorders can be especially challenging for health care professionals. Against this background the high impact of the comorbidity between physical and mental illnesses has been acknowledged by the UK Government through their ‘No health without mental health’ strategy‘.

The factors which contribute to the comorbidity between bipolar disorder and physical illnesses are largely unknown. Side effects of long-term psychotropic medication use, genetic influences and unhealthy lifestyle choices (e.g. poor diet and lack of exercise) have been highlighted as likely culprits. Our limited understanding of the mechanisms and risk factors which lead to the co-occurrence of physical and mental illnesses heralds a new era of research. Researchers are investing much effort in this plight and upcoming results promise to progress the field and will hopefully lead to the development of more effective intervention and treatment strategies improving the lives of many bipolar disorder patients.



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