PATHOPHYSIOLOGY

Predisposing Factors: Precipitating

Factors:

 Genetic - Life events and experiences

 Neural Processes - Stress
 Melatonin Activity - Substance abuse
 Psychological Processes

Neurochemical abnormalities have been implicated

as contributing to the development of Bipolar Disorder.
Specifically, a paucity or elevation of the “inhibitory” neurotransmitter
γ-aminobutyric acid, or GABA.

Paucity of GABA, the chief inhibitory Elevation of GABA, the chief inhibitory
neurotransmitter may neurotransmitter may results in the
result in the elevation of the activity depletion of activity of neurotransmitters
of neurotransmitters norepinephrine, serotonin and dopamine
norepinephrine, serotonin at the synapses.
and dopamine at the synapses.

Depleted levels of the neurotransmitters

elevated levels of the neurotransmitters norepinephrine, serotonin and dopamine
norepinephrine, serotonin at the synapses between neurons in the
and dopamine at the synapses between the brain’s limbic system—
neurons in
the brain’s limbic system—
which regulates mood and emotions—
have been implicated as facilitating
the excessive transmission
of neuronal impulses resulting in a manic
episode.
Manic episodes results in an increase
in energy and a decreased need for sleep.
A person's speech may be pressured,
with thoughts experienced as racing.
As the episode progresses, attention span
becomes low, and a
person in a manic state may be easily
distracted. Judgment may become impaired,
and sufferers may go on spending sprees or
engage in behavior that is quite abnormal
for them.
Individual may indulge in substance abuse,
particularly alcohol or other depressants,
cocaine or other stimulants, or sleeping pills.
Their behavior may become aggressive,
intolerant, or intrusive.
which regulates mood and emotions—
have been identified as hindering
neuronal transmission
resulting in a depressive episode.
Depressive episodes causes decrease
in energy and fatigue.
Feeling of sadness, guilt, isolation and
hopelessness is present with
thoughts that may be disturbed.
As the phase progresses, activities
that are usually enjoyable becomes
uninteresting, and the individual
may have problems concentrating.
Sleep pattern is disturbed and there is
lack in motivation.
The person may indulge in substance
abuse most specifically alcohol or
sleeping pills. The behavior
may become passive, shy and
isolated. The patient may become
irritable.
At more extreme phases, a In severe cases, a person in

person in a manic state can begin to a depressive state can become

experience psychosis, or a break with psychotic, a condition known

reality, where thinking is affected as sever bipolar depression with

along with mood. psychotic features. Patient may

experience chronic pain with

or without a known cause.

There may also be a morbid suicidal

ideation.