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Bipolar Disoder in US n Canada

Running head: BIPOLAR DISORDER USA VS. CANADA 1
BIPOLAR DISORDER IN THE UNITED STATES AND CANADA
Kelley Callanan
University of South Dakota
October 15, 2017
Author Note
Kelley Callanan, Department of Health Sciences, University of South Dakota
Kelley Callanan is now a senior at the University of South Dakota.
This paper fulfills the critical writing graduate component of the course HSC 440,
Major Issues in Health and Human Services.
Correspondence concerning this paper should be addressed to Kelley Callanan,
[email protected].
Contact information: phn 605-431-8500
Availability: Monday – Sunday 7 am – 7 pm
BIPOLAR DISORDER USA VS. CANADA 2
Introduction
Bipolar disorder, formerly referred to as manic depression, is a condition that impacts
an individual’s mental health leading to extreme mood changes. These changes are characterized
by moods of lows and highs, that is, respectively, depression and mania (Taylor, 2016).
Individuals who are depressed may feel hopeless or sad and may have no interests in activities
that were once enjoyable (Bota, 2013). The effects of mood swings are possibilities of
interference with one’s sleep patterns, energy, behavior, judgment, and ability to think clearly.
Episodes characterized by mood changes may occur multiple times, or rarely, while others may
have emotional symptoms that endure between acute episodes (Taylor, 2016). Comparisons and
contrasts of bipolar disorder findings and intervention mechanisms between the USA and
Canada are described in detail throughout.
United States of America and Canada are both first world countries with similar quality
of life. Studying the nature of bipolar disorder between these two countries is likely to reveal
similarities and contrast in the trend of bipolar in the them. The comparison of bipolar in the two
countries will take into several considerations such as the effects and causes of the disease in
children, adults, women, and men. The study will also look at special populations. Another
aspect that will be focused on is the treatment processes and the interventions used at various
levels. A survey of bipolar disorder will reveal procedures that experts may consider in providing
treatment and at the same time suggesting new areas that may need further research.
Both countries have spent vast amounts of resources in medical studies. Unlike
developing countries, the US and Canada boast of some of the world’s best medical
infrastructure, experts, research centers, and effective treatment processes (Taylor, 2016). There
is a probability that bipolar disorder in the two countries have several similarities when it comes
BIPOLAR DISORDER USA VS. CANADA 3
to treatment and even prevalence rates. The wo countries may also have related strategies of
solving the problem. The field of medicine is often characterized with cross border borrowing
and sharing of ideas. Evidence based practices tends to be applicable in environments with
similar settings.
Nature and Magnitude
The condition is present in more than 5 million American adults who are approximately
2.6% of the country’s adult population. In Canada, the prevalence is much lower affecting
around 1% of adults. Other characteristics such as the age of onset are similar between the two
countries. The average age for the start of the condition is twenty-five years. There are several
other noted cases where bipolar disorder begins at an early age or even as late as the forties
(Andrade, 2017). People can develop the illness regardless of their races, ages, social classes, or
gender.
Two-thirds of individuals with bipolar disorder have at least one close relative suffering
from the same condition. It leads to a suggestion that bipolar disorder has heritable
components. The prevalence rate in the United States is much higher than in Canada. However,
the age of onset and the age at which it peaks is also similar between the two countries. Other
parts of the world share the same characteristics that mid-20s are the time that most people are
likely to have their first experience thus revealing the uniform nature of bipolar disorder.
However, there are other cases of bipolar in children in both the countries. Such cases are rare.
The two countries also share the fact that bipolar may have genetical components.
Examining the history of people with bipolar reveals incidences of bipolar within a family
(Taylor, 2016). However, such conditions may be challenging to solve simply because they are
BIPOLAR DISORDER USA VS. CANADA 4
genetically controlled. Managing or controlling the environmental factors that increase an
individual’s chances of developing the disease may slow it down.
The intensity of the disorder may differ between individuals. People have different ways
of reacting to both physical and mental illnesses (Andrade, 2017). One’s personality,
temperament, attitude, age, previous experiences with the condition are likely to predict the way
an individual will behave when the disorder has attacked. However, individuals who are aware of
the state are likely to understand their situation and will thereby strive not to indulge in any
dangerous activities (Taylor, 2016). Self-awareness is very critical towards early interventions,
and better self-care strategies. Therefore, people at risk of bipolar disorder should be identified,
and then helped to monitor his or her body. Some of their actions may be of potential harm nor
only to themselves but family members.
Most Affected by Bipolar Disorder
Even though both women and men seem to be equally impacted by bipolar disorder, in the
two countries, evidence showed that rapid cycling bipolar disorder is more common in women than
men. Women also tend to experience more mixed state and depressive episodes when compared to
men (Andrade, 2017). A man’s initial experience with the illness is likely to be expressed by a
manic state while women's initial condition is often that of a depressive state (Andrade, 2017). The
sex difference when it comes to the conditions is also shared across the two countries. Men and
women experience the symptoms differently, a factor that can be blamed on the biological and
mental differences between men and women. Other countries have the same features and
characteristics of bipolar between different sex.
BIPOLAR DISORDER USA VS. CANADA 5
Key Risk Factors for Bipolar Disorder
More studies have been conducted in the USA than Canada concerning bipolar disorder.
However, there is evidence that comportment of bipolar and its characteristics are similar in the
two countries. The triggers of the condition vary among individuals, and the main pattern of the
disorder is not known. However, there is a belief that genetic influence accounts for 70% of the
cases, implying that it has a hereditary component (Andrade, 2017). Individuals with a family
history of bipolar disorder have higher chances of developing the condition. The condition
runs in families. Individuals who come from families with bipolar sufferers have higher chances
of developing the mental illness when compared to those who are not (Taylor, 2016). It is
advisable that these trends are noticed, and individuals at risk are considered for individual
intervention. Ironically, identical twins do not have same chances of having the condition thus
implying that environment and genes do not work together in causing the condition.
Behavioral investigations have proven that candidate genes and chromosomal regions
have links with susceptibility to the illness (Andrade, 2017). First degree relatives have ten
times higher chances of developing bipolar disorder compared the rest of the population that
does not have this factor. It further suggests there is an active hereditary component responsible
for the condition. Such kind of studies my cut across the United States of America and Canada
and even other parts of the world.
Apart from hereditary factors, environmental influence can also increase one’s chances of
developing the disorder. The environment also has a significant impact on the possibility of
triggering episodes. Genetic and environmental factors may integrate to increase an individual’s
chances of developing bipolar disorder (Taylor, 2016). Interpersonal relations and recent life
BIPOLAR DISORDER USA VS. CANADA 6
events also have shown to be contributing factors to onset and recurrence of the bipolar
disorder. Significant life changes or stressful events may trigger bipolar in an individual. loss of
a loved one, or the onset of a medical problem are the main environmental reason that may cause
the problem. Drug abuse plays a significant role in facilitating the onset or progress of the
condition (Andrade, 2017). Drug users are highly at risk of developing the disease. Anxiety
disorders may also escalate to bipolar disorder, and such individuals should be monitored and
interventions made before they increase to worse levels.
Thirty to fifty percent of individuals diagnosed with the condition experienced abusive or
traumatic experiences during their childhood (Taylor, 2016). Such people also have an increased
risk of suicidal ideation and attempts of suicide. Events associated with a harsh environment,
such as homelessness, when a child is growing up has associated links with the development of
bipolar disorder (Andrade, 2017). It implies that parents have a role to play in shaping their
children and saving them from this condition. Treating children well and respecting their views
at the time of conflict will boost their self-esteem thus enabling them to grow up with reduced
risks of mental, physical, and social problems.
Neurological conditions may trigger bipolar disorder (Andrade, 2017). However,
documented evidence is lacking to the degree of verification. Physical injury may lead to
bipolar disorder though this has been determined not to be common. Position emission
technology and Functional magnetic resonance imaging are two scans that are allied in the
imaging of the human brain (Shattell, 2010). Certain identifications on the brain scan may have
associations with bipolar disorder thus putting the life of an individual at risk of the condition.
Studies are currently underway to establish the relationship between brain changes and bipolar
BIPOLAR DISORDER USA VS. CANADA 7
disorder. Traumatic brain injury, stroke, porphyria, multiple sclerosis, temporal epilepsy, and
HIV infection may also cause bipolar disease; however, the primary causes are hereditary.
Similarities of Bipolar Disorder
Signs and symptoms of bipolar disorder are consistent in the USA and Canada. The
defining feature related to a diagnosis of bipolar disorder is mania. Mania is characterized by
at least one week of irritable or elevated mood ranging from delirium to euphoria. Individuals
undergoing a manic episode may display features such as speaking rapidly, short attention span,
increase in goal-driven activities, racing thoughts, and agitation (Andrade, 2017). Other possible
symptoms include excessive spending and hypersexuality.
Irritability or anger characterizes depressive episodes, persistent feelings of sadness,
loss of interest in usually enjoyable activities, persistent feelings of depression, hopelessness,
inappropriate guilt, poor sleeping habits, changes in appetite, fatigue, lack of concentration,
feelings of worthlessness and suicidal thoughts (Andrade, 2017). In several cases, both in the
USA and Canada, patients may have symptoms of psychosis, which is considered a severe
bipolar disorder. A depressive condition may lead to suicide if not adequately treated.
Hypomanic episodes are also frequent in sufferers of bipolar disorder. A hypomania is
a mild form of mania. However, this type of mania does not lead to a drop in one’s ability to
work or socialize; it does not have psychotic features of hallucinations or delusions (Andrade,
2017). An individual’s overall functioning is likely to increase during times of hypomanic
episodes. This type of condition does not usually escalate to mania. Individuals with
hypomania may show increased creativity while others show poor judgment or irritability.
BIPOLAR DISORDER USA VS. CANADA 8
In the USA and Canada, mixed episodes refer to a situation in which symptoms of
depression and mania take place simultaneously. Individuals in this state are likely to have
manic symptoms, like grandiose thoughts, and at the same time have depressive symptoms such
as feelings of guilt or suicidal ideation (Shattell, 2010). These individuals have an elevated risk
of suicidal behaviors attributed to the pairing of mood episodes.
Associated features in bipolar disorder refer to clinical phenomena that accompany the
condition but do not fall into the category of diagnostic criteria. Adults with bipolar disorder
experience changes in their cognitive abilities such as reduced attention and impaired memory
(Shattell, 2010). The phase of the disorder determines the way the individual observes and
reacts to different environments and situations. Some studies link bipolar disorder and
creativity. People with the condition, commonly, have trouble maintaining relationships.
Comorbid psychiatric conditions can complicate the diagnosis of bipolar disorders.
Some of these comorbid conditions are substance abuse, obsessive-compulsive disorders, eating
disorders, attention disorders, panic disorders, premenstrual cycles, and social phobias
(Shattell, 2010). The above symptoms should be used to identify the disorder and then
recommend treatment.
The mechanisms for determination of the disorder is similar to the USA and Canada.
The diagnosis process of the disorder takes into consideration several factors including self-
reported experiences of symptoms by the victim, abnormal behaviors as reported by friends, and
bizarre behaviors reported by family members (Shattell, 2010). Observable signs of the mental
illness by the clinician are additionally considered in diagnosis. Numerous rating scales for
evaluation and screening of the condition exist (Shattell, 2010). They include mood spectrum,
bipolar spectrum scale, general behavior inventory, and hypomania checklists.
BIPOLAR DISORDER USA VS. CANADA 9
Differential diagnosis involves imaging and blood tests aimed at excluding other medical
illnesses with clinical features that sometimes present comparable symptoms such as
hyperthyroidism, chronic diseases, and infections including syphilis and HIV (Shattell, 2010).
Reviewing of recent and current medications may rule out the above causes. Certain antibiotics
and other drugs may cause symptoms associated with bipolar disorder (Shattell, 2010). More
testing is performed when the time of the initial onset is mid or late life. Thorough screening
should be done to ensure that the condition is identified and effective treatment strategies are
described.
Bipolar spectrum disorders termed as bipolar I and II, bipolar NOS (not other
specified), and cyclothymic disorder. These disorders involve severe depressive episodes
alternating with hypomanic or manic episodes (Conus & McGorry, 2013). An individual may
also experience mixed episodes in which symptoms of both mood states can be noted. Unipolar
hypomania that does not ever display depression can also be seen in medical literature.
The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition)
classifies bipolar disorder into three subtypes. The first is bipolar I disorder which is
characterized by at least one manic episode. Bipolar II features episodes with either one or
numerous episodes of hypomania (Shattell, 2010). As described, hypomania does not have
much impact on the individual and may not disturb functional or social impairment. There is not
a symptom of psychosis within hypomania. The third type of diagnosis for bipolar is
cyclothymia which is characterized by hypomanic episodes with elements of depression that do
not qualify to be classified under major depressive episodes.
BIPOLAR DISORDER USA VS. CANADA 10
Recommendations for Improvement
Both countries consider medical and psychotherapy treatments in managing bipolar
disorder to help improve symptoms of the condition. Several psychotherapeutic and
pharmacological techniques can be applied in treatments. Individuals may also use self-help
strategies. Manic episodes present in bipolar I may require hospitalization. Psychotherapy is
performed with the intention of alleviating the significant symptoms, reducing negative
emotions, identifying events of the trigger, and spotting prodromal symptoms before exhibiting
acute episodes. Psychoeducation, family-focused therapy, and cognitive behavioral therapy
have vast evidence for efficacy when it comes to residual depressive symptoms. Treatment may
not be a natural process, and it is advisable to engage the bipolar sufferers in a talk therapy
(Severus et al., 2007).
Clinicians have used several medications to treat the condition. There is evidence that
supports lithium as the best medication for bipolar disorder. Lithium is one of the most
effective mechanisms for treating acute manic episodes (Severus et al., 2007). Other advantages
associated with lithium include prevention of relapse. Lithium also lowers the risks of suicide,
death, and self-harm for patients with bipolar disorder. The use of lithium in the treatment is
also a cheaper alternative that should be considered. Researchers have recommended lithium.
Both Canada and the United States of America use lithium for treating the issue (Conus &
McGorry, 2013). The treatment proceeds in other parts of the world have not been elaborated,
but Lithium remains the most effective strategy.
Anticonvulsants are applied for treating bipolar due to mood stabilizing properties.
Carbamazepine can efficiently manage manic episodes, and more evidence suggests that the drug
BIPOLAR DISORDER USA VS. CANADA 11
has advantages in improving a rapid cycling disorder, and for individuals who experience
psychotic symptoms. However, it is not as effective as lithium in treating relapse (Severus et al.,
2007). Lithium remains to be the best alternative that exists. More research should investigate
other therapies to provide much better options.
Recent studies on the use of lithium in treating bipolar disorder continue to show strong
results supporting lithium as the predominant medicinal therapy (Pisanu et al., 2011). Scholars
have also compared divalproex with maintenance therapy, lithium alone, and a combination of
several strategies with both drugs (Nierenberg et al., 2012). The outcomes of these studies were
not favorable. Half of the cases displayed a relapse. Another study has compared lamotrigine
maintenance and lithium after stabilization with any medication. Findings from the survey
showed that only a few patients could sustain stabilization (Nierenberg et al., 2012). The group
that stabilized had undergone consequential clinical circumstances in the early six months of
treatment.
Apart from medication or psychosocial mechanisms, several researchers have discovered
that omega 3 fatty acids can have appealing impacts on depressive symptoms. However, omega
3 fatty acids do not improve manic symptoms (Nierenberg et al., 2012). More studies need to be
conducted to establish efficacy concerning the possible role of omega 3 fatty acids. Studies
relating the brain and bipolar condition should also be launched to help in identifying certain
patterns (Severus et al., 2007). Perhaps this could be the final solution to the problem since it may
provide the exact parts of the brain affected and how to intervene.
Measures aimed at preventing the disorder have often focused on managing or
preventing stress. Traumatic childhood experiences have higher chances of causing future
bipolar disorders compared to children that did not experience traumatic events. Abusive
BIPOLAR DISORDER USA VS. CANADA 12
families and childhood adversities are common in having negative impacts on the child (Conus
& McGorry, 2013). Parents should take notice of their surroundings to ensure that children grow
in positive environments.
Nurses and other medical professionals may identify people at risk of adverse conditions
in their usual hospital routine (Conus & McGorry, 2013). Though not conclusive, there is
research pointing towards traumatic circumstances such as accidents or injuries increasing an
individual’s chances of developing bipolar disorder. Therefore, proper identification followed
by recommendations, such as talk therapy, may be advised.
Social and Economic Consequences
Bipolar disorder is ranked among significant universal health problems because it is
related to premature mortality and increased morbidity (Conus & McGorry, 2013). There are
high rates of misdiagnosis leading to a delay to slow and late interventions thus causing poor
prognoses. Difficulty attaining complete remission of existing symptoms decreases as the
severity of symptoms increase over time.
Individuals suffering from bipolar disorder have a decline in their cognitive capabilities
before their 1
st
episode. Cognitive dysfunction then becomes permanent with time. The acute
phases have more severe elements of cognitive problems (Bota, 2013). Remission has moderate
symptoms of impairment. Even when symptoms are in full remission, two-thirds of bipolar
disorder sufferers continue to have impaired psychosocial functioning impacting their ability to
work and function within society (Conus & McGorry, 2013). There is less adverse economic
impact due to disability for those suffering from bipolar disorder II.
BIPOLAR DISORDER USA VS. CANADA 13
A study conducted on bipolar disorder patients’ first admission in the US for both
mixed episode and mania discovered that half of the cases attained syndromic recovery after 6
weeks while 98% of them experienced the same within 2 years ("Statistics from the World
Health Organization and the Centers for Disease Control. World Health Organization Global
Statistics", 2011). Within the two-year period, 72% had no symptoms at all, while 40% attained
functional recovery leading to the ability to perform within a workplace environment (Conus &
McGorry, 2013). Within two years of recovery, another 40% experienced new episodes of
depression or mania. Canada has few studies concerning the intensive nature of the social
impact.
Episodes of bipolar disorder can cause suicidal ideation that may lead to attempts of
suicide (Conus & McGorry, 2013). Though not thoroughly calculated this leads to economic
consequences related to hospital admissions. People whose bipolar disorder condition starts
with a mixed affective episode or depressive episode have reduced chances of recovery and are
at risk of attempting suicide (Bota, 2013). One in every two persons with bipolar disorder is
likely to try to commit suicide at least once in their life. Those who try numerous times often
succeed. The above adverse effects of bipolar disorder imply that stakeholders involved should
be willing to act quickly in preventing and treating the condition to ensure that the lives of these
vulnerable people are saved.
There are costly actions that are related to the mental issue. One of these negative
behaviors is that excess spending is common among bipolar disorder sufferers, in several cases
most of these people do not realize until they overspend. The disorder pushes an individual to get
into a spending spree thus increasing the chances of misuse of money (Conus & McGorry,
2013). Most spending occurs during manic episodes. Some may resort to blind gambling that
BIPOLAR DISORDER USA VS. CANADA 14
may make them lose a lot of money. Dealing with a family member who has the condition may
also be costly (Bota, 2013). Patients with the disorder tend to cause financial strain on their
family members’. When such conditions persist for long, a lot of finance may be spent to treat
the patient. The cost of healthcare between the United States Canada is also similar, the amounts
charge in these treatment facilities vary from one hospital to another with private institutions
requiring huge sums of money.
Bipolar disorder is ranked as the 6
th
reason behind disabilities universally. The
prevalence of the condition is approximately 3% of the entire population. In the US, 0.8 %
experience a manic episode while 0.5 % may experience a hypomanic episode. These statistics
are provided according to the National Epidemiological Catchment Area survey (Bota, 2013).
The data also suggested that additional 5% of the American population had a bipolar spectrum
disorder. More revelations are that 1 % of the population had lifetime prevalence for the
condition meeting criteria for bipolar I and another 2.4% for bipolar II. In Canada, the
incidence is 2 % of the entire population. More studies should be conducted to investigate the
validity of prevalence among these populations.
There are methodological and conceptual variations and shortcomings in the above
findings. One of these limitations is that prevalence studies concerning bipolar disorder are
carried out in lay interviews which abide by fixed or structured questionnaires (Bota, 2013). In
such cases, the respondent may be limited from accurately describing their condition, yet
bipolar disorder exists in various forms and manifests differently thus affecting the validity of
such reports. Additionally, diagnoses vary depending on if a spectrum or categorical approach is
used. These considerations have raised concerns about the possibility of overdiagnosis or
underdiagnoses.
BIPOLAR DISORDER USA VS. CANADA 15
The incidence of bipolar disorder is similar for both women and men. Bipolar
disorder has similar frequencies across all cultures and ethnic groups. A WHO study conducted
in the year 2000 revealed that bipolar disorder also has similar prevalence across the world.
Despite the similarity regarding prevalence rates, there is variation in severity across the globe
(Conus & McGorry, 2013). In the developed world, disability-adjusted life year (DALY)
measurements were more positive than 3
rd
world countries which can be attributed to medication
availability and medical coverage.
There is no significant variation between American and Canadian culture. There are
similar perceptions of the disorder across individual groups within the two nations. Bipolar
disorder is among the least understood, known mental illnesses (Flaskerud, 2017). The brain
remains largely to be a mystery; technology may be invented in the future to help in better
understanding the condition. The current explanation can be easily downplayed since the
disorder is not completely understood (Flaskerud, 2017). Social stigma is also a factor that may
be lowered due to a complete understanding and dissemination of information concerning the
condition.
Bipolar disorder in children was not recognized until the last century when studies were
conducted, and there was enough evidence collected to determine children also experience
bipolar disorder (Flaskerud, 2017). In adults, bipolar disorder progression has features of
discrete episodes of mania and depression with no precise elements between them. In children
and adolescents, chronic symptoms or rapid mood changes are widespread. Anger and outburst
usually characterize the pediatric bipolar disorder. Children’s early symptoms of bipolar
disorder will most likely appear as depression (Conus & McGorry, 2013).
BIPOLAR DISORDER USA VS. CANADA 16
There is not substantial evidence concerning the development of bipolar disorder in late
adulthood (Conus & McGorry, 2013). In late life, treatment and recognition of bipolar disorder
may not be easy to accomplish in consideration of the presence of other complications such as
dementia. Medications being taken to treat other illnesses may also present obstacles in
recognition of the illness in the elderly.
Children and older people have the least risk of developing bipolar disorder. There is
currently not a clear explanation as to this pattern. However, the discussed causes of bipolar
disorder, such as environmental and genetical factors, may mean that is a factor. There is a
possibility that the periods between 20 to 40 years of age are characterized by other
environmental issues including pressure at work and relationship problems (Bota, 2013). These
are matters that older and younger individuals do not experience to the same degree.
Individuals suffering from repetitive disorders are aware of some of the trigger of manic
episodes, and one of the major problems identified is the lack of money (Bota, 2013).
Continuous worries about money is likely to elevate one’s chances of developing manic
depression and thus leading to the frustration of an individual thus affecting his normal mental
operations. Despite the fact that money is a problem across specific populations including the
wealthy groups, worries about money among bipolar patients may increase once one develops
the disease.
Self-awareness is necessary for the potential sufferers so that they can be able to monitor
and understand their behaviors when under mania or hypomanic state (Bota, 2013). It is also
possible that people who had been diagnosed with the condition might be able to note changes in
their behavior patterns and relate it with bipolar disorder thereby pushing the individual to seek
medical intervention (Conus & McGorry, 2013). There is a lot of benefits when dealing with a
BIPOLAR DISORDER USA VS. CANADA 17
patient who knows about the issue and helping the patient in such a case may not be a difficult
task.
Monitoring One’s Risk for Bipolar Disorder
Limited research exists concerning bipolar disorder in Canada. Research in the US also
reveals several loopholes on the causes, treatment, and interventions for the disorder. Monitoring
one's risks towards the condition may not be easy. However, being mindful of one’s risk factors
such as environmental determinants, family history, and certain life changes should be a reason
to seek check-up, especially when things begin to take a negative path (Conus & McGorry,
2013). An individual should be willing to discuss behavioral or mental symptoms that he or she
experiences with his or her healthcare. Early detection may be a critical step towards saving
individuals from the tormenting nature of the disease (Conus & McGorry, 2013). Doctors should
also be able to help individuals at risk by considering them for regular screening.
Family members also have the responsibility of monitoring their own. Behaviors that are
indicative of maniac or depressive conditions requires attention and family members should be
able to come out. Family members should also be concerned with individuals who have frequent
occurrences of the disorder to rescue the problem before it can escalate to extreme levels. There
are possibilities that bipolar disorder sufferers may not be able to able to detect such changes in
their moods and may just take it as a normal mood change. It is, therefore, the responsibility of
family members to detect such changes.
Conclusion
Bipolar Disorder continues to threaten the lives of many people around the world. The
United States of America and Canada are two neighboring countries with similar standards of
living. They have also made huge investments in healthcare compared to other parts of the
BIPOLAR DISORDER USA VS. CANADA 18
world. The investigation on the mental illness shows similar patterns between the United States
of America and Canada. Some of the shared trends between the two are that they have similar
age for onset of the disorder which is 25. It however, does not rule out child cases. Similar
characteristics such as the fact that bipolar prevalence is the same across all socioeconomic
classes is also shared not only between the two but the entire world. It thus reveals bipolar
disorder as a unique condition that does not favor class or one’s income since its features are
similar across the world.
Increasing awareness of the causes may help in correcting the environmental factors that
impact an individual’s life. Bipolar disorder is different from other illnesses due to prevalence
regardless of ethnicity or socioeconomic classes. Another difference is the condition is unlikely
to exhibit in elderly populations. Most mental problems such as dementia are known to affect the
elderly much more than the young population. Bipolar disorder is different is likely to be
associated with 30 or 40year old’s. Intervention strategies have proven that the state can be
managed so as to provide comfort to the sufferers. Most of these sufferers may not be able to
identify their conditions and depends on their care givers and family members for such help.
Family members should therefore be able to notice trends of mania or hypomania and then take
necessary action of informing experts. Physicians should also be able to take notice of people
who are likely to develop such conditions during their physical examination exercises.
People with history of the condition or have a family history of frequent bipolar attacks
are at the highest risks of becoming sufferers. The environment also plays a significant role in
facilitating the condition. However, proper steps such as good upbringing are related to reduced
cases of bipolar disorder. Medical therapy and psychotherapy are some of the effective ways of
managing bipolar disorder. Lithium has been used, both in the USA and Canada, as the
BIPOLAR DISORDER USA VS. CANADA 19
predominant medication for treatment which both effectively treats bipolar disorder and is cost-
effective. The two countries have similar trends when it comes to the mental illness. One notable
difference is that the prevalence rate in the US is two times more than in Canada.
BIPOLAR DISORDER USA VS. CANADA 20
References
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http://dx.doi.org/10.1111/bdi.12518
Bader, C., & Dunner, D. (2012). Bipolar disorder not otherwise specified in relation to the bipolar
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Bota, R. (2013). Cognition and closed systems. Mental Illness, 5(1), 9.
http://dx.doi.org/10.4081/mi.2013.e9
Conus, P., Macneil, C., & McGorry, P. (2013). Public health significance of bipolar disorder:
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Comparative Effectiveness Trial of Optimized Personalized Treatment With and Without Lithium
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