Introduction:
Psychological stability is an important factor in our day-to-day communication. It helps to maintain the balance in the human response and is important for emotional well-being. However, conditions like anxiety disorders may hamper such psychological balance. Moreover, this may lead to other psychological disorders. Recently, researchers have found a correlation between anxiety and bipolar disorder.
What Is Bipolar Disorder?
Bipolar disorder is a major mental illness characterized by major or rapid shifts in emotions and mental conditions. This condition is also known as manic-depressive illness or manic depression. This is one of the major causes of disabilities in the world, along with mental problems.
Pathophysiology:
The exact causative factors involved in bipolar disorder are not known. According to some researchers, the neurobiological changes in the brain are responsible for such pathologies. In most cases, genetic factors are involved in such conditions—changes in genes like CACNA1C, ODZ4, and NCAN. Also, chromosomal changes and changes in the DNA are associated with it. Such changes often have a familial history. Apart from this, the effects of external factors like stress, trauma, and drugs play a pivotal role in the pathogenesis of this disorder. All these factors lead to changes in the body. Changes like increased inflammation and oxidative stress lead to neural function abnormalities. Also, changes like neurotransmitters and the functioning of the neurons. Also, changes in the other factors like brain-derived neurotrophic factor, nerve growth factor, neurotrophin-3,
What Is Anxiety Disorder?
Anxiety disorders are the most common type of mental health disorder. Such conditions are generally seen in early teenagers or patients in their early adulthood. It is characterized by the presence of phobias, which lead to constant feelings of worry and fear. It is considered a type of emotional disorder. Almost 350 million people around the world and 4 percent of the general population worldwide suffer from this condition.
Based on clinical types and nature of the condition, anxiety disorders can be of the following types. These are;
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Separation Anxiety Disorder: This is mainly caused by childhood trauma due to separation from human beings or substances.
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Selective Mutism: This is seen in young individuals who fear social interactions.
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Specific Phobia: In this condition, the person is fearful about specific situations and conditions.
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Generalized Anxiety Disorder: This is the most common type of anxiety, which is characterized by excessive worrying about various things. Persons often suffer from irritability, stress, and lack of concentration.
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Panic Disorder: In this condition, the patient experiences an abrupt surge of fear and discomfort. Fear of unknown or upcoming events leads to palpitation, sweating, and shortness of breath.
Causes:
The causes associated with anxiety disorders can be numerous. In cases of children or young adults with childhood trauma, bad parenting, abusive parenting, and improper conditions may be responsible for such situations. Also, systemic disorders, health conditions, and hormonal changes in the body can be considered risk factors. Apart from this, trauma, familial conditions, stress, and financial crisis may play a major role. Also, in some cases, variations in the genes like TMEM132D, HTR2A, NPSR1, and MAOA are with such changes. All these factors lead to changes in the activity of the emotional centers of the brain. The limbic structures such as the amygdala and hippocampus are closely associated with the pathogenesis of this condition.
The hippocampus exerts inhibitory control over the hypothalamic stress-response system and contributes to negative feedback for the hypothalamic-pituitary-adrenal (HPA) axis. It is involved in stress sensitivity and resilience, particularly in mood and anxiety disorders. On the other hand, the amygdala processes emotionally significant external stimuli and is responsible for fear expression, aggression, species-specific defensive behavior, and the formation and retrieval of emotional and fear-related memories. The amygdala receives input from the hippocampus. During anxiety, the hypothalamus-pituitary-adrenal system (HPA system) is activated and cortisol is secreted. As a result, the functioning of the hippocampus and amygdala is hampered.
Symptoms:
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Continuous feelings of fear lead to sorrowness and hollowness.
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Constant feeling of negativity.
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Lack of patience with constant irritability.
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Individuals frequently experience frustration, remorse, and insignificance.
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Decreased focus accompanied by reduced enthusiasm for any work is seen.
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In most cases, people keep themselves away from other people. They are usually talkless or talk about irrational things. Symptoms like self-talking can also be observed.
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Modified sleep patterns such as insomnia, excessive sleep, and early morning awakenings.
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A change in the eating habits and appetite can be seen. Rapid weight loss and excessive weight gain may be observed.
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Persons often suffer from increased sweating and twitching.
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Features like nail biting, increased thirst, and the feeling of a lump in the throat can be observed.
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An increased heart rate may cause palpitation and may be associated with an increased rate of breathing. Sometimes, the patients can feel shortness of breath with increased muscle tension.
What Is the Connection Between Bipolar Disorder and Anxiety Disorder?
It is observed that in some cases, persons suffering from anxiety disorders may suffer from bipolar disorder.
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One of the main connections is the functioning of the hypothalamus-pituitary-adrenal system (HPA system). As already discussed, during anxiety, the activation of this axis is seen. In patients with bipolar disorders, impairment in the function of the HPA axis is observed.
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Another important connection seen in both conditions is the presence of inflammatory mediators. These factors are associated with increased stress. The high level of tumor necrosis factor-alpha and interferons decreases the amount of serotonin and dopamine. The inflammatory cytokines are associated with a decrease in the activity of tryptophan (a factor needed for the production of neurotransmitters) and increased serotonin reuptake by various mechanisms. These phenomena are related to increased mental stress. Thus, stress caused by inflammatory substances may cause anxiety. However, the presence of such inflammatory mediators is also observed in patients with bipolar disorders.
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The activity of the neurotransmitters is also an important connection between the two conditions. In patients with anxiety disorders, decreased inhibitory signaling by gamma-amino-butyric acid (GABA) or increased excitatory activity by glutamate is observed. In bipolar disorder patients, the low-level and dysfunctioning activity of gamma-amino-butyric acid (GABA) is observed.
Conclusion:
Bipolar disorder and anxiety disorder are both responsible for psychological instability. The abnormality of the hypothalamus-pituitary-adrenal system (HPA system) is seen in both of these conditions. Also, increased activity of inflammatory mediators is seen in both of these conditions. Apart from this, low levels of neurotransmitters like GABA are seen in both cases.
