Medicine by Jennifer Quach

Today, medicine is one of the most important sciences in the world. This text will deal with a subject that is not very well-known: psychology. Are medications given as reliable as scientists say? What are the social and moral issues that prevents the prescription of those?
To begin with, you should know what defines bipolar disorder and how it affects brain activities. Those who suffer from change of humour often go through two phases: mania or hypomania and depression. When someone is in the mania phase, he/she feels joy and can be hyperactive. The energy level of that person is at its highest level, sometimes, preventing him/her to sleep or articulate. However, many may feel the contrary, i.e. angry or irritated. Hypomania, an attenuated form of mania, with the same symptoms or almost, can take place at this very first period of bipolarity. The second phase, depression,  is the opposite of mania or hypomania. In other words, the person feels disoriented at the psychological level, is not interested in everyday life and may have suicidal thoughts.

Scientists believe that bipolar disorder is caused by the lack of balance of neurotransmitters in the brain. The three chemicals affecting the feelings of an individual are called dopamine, serotonin and norepinephrine. The lack of serotonin, a neurotransmitter that sends messages between the different parts of the brain, may cause depression since certain neurotransmitters depend on it, such as the one responsible for our mood, dopamine, which plays an extremely important role in the human body. Dopamine is responsible of motivation and feelings of pleasure. An insufficient or excessive quantity  can interfere with the dopaminergic pathways, causing excitement or depression. Finally, norepinephrine , directly related to the sympathetic nervous system and reacts based on perceived stress.
For these reasons, the mood stabilisers are prescribed to patients suffering of bipolarity. These medications prevent them from developing mania symptoms by stabilising the production of neurotransmitters responsible of mood swings. There are several types of mood stabilisers such as lithium, the first and the most used. Lithium was discovered in 1817 when doctors doubted that this element reacts naturally on people and calm them. It was in 1949 that the psychiatrist John Cade had published a book explaining the benefits of lithium, but the use of this drug was only legalised by the < U..S. Food and drug Administration >  in 1970. Its effectiveness has a link with a neurotransmitter called glutamate and neurons of the human brain. Two other drugs are also present in Psychology: olanzapine and aripiprazole. Olanzapine decreases dopamine production whereas aripiprazole increased it. Finally, the anticonvulsants broaden the amount of aminobutyric acid (GABA), a neurotransmitter that quiets neurons.
However, there are several side effects to the use of stabilisers. Since they are not present naturally in our body, they can create several problems such as addictions; they may give a feeling of drunkenness to the consumer . Other side effects depend on the type of prescription drugs, but the most common are: tremors in the hands, the weakening of muscles, loss of coordination, etc. Fortunately, doses can be controlled and other drugs, prescribed, to reduce side effects. According to Dr. Thomas Jensen of the International Foundation for bipolarity: ‘Their advantages include that they can be rapidly introduced, rapidly adjusted, and often can, at the cost of some annoying side effects, bring the acute mania or agitation of a mixed state under control in 24 to 72 hours. This rapid effect is not shared by the other mood stabilisers. Prior to the advent of antipsychotic mood stabilisers, an acutely manic patient was typically hospitalised for many weeks as the more traditional mood stabilisers slowly took hold.’
 To continue, many aspects can restrict the prescription of mood stabilisers. First, for moral reasons, physicians face  serious dilemmas in relation to pregnant mothers suffering from bipolarity. They have a duty not to harm the fetus and giving medications like lithium, could harm the developing baby. On the other hand, if they do nothing, the child will suffer the same psychological disorder as his mother, which will not help him to live a better life. Children and adolescents also create a dilemma: often, psychiatrists do not know whether they should increase the dose. Often, time given for the benefits to be seen is not enough and these young people do not grow in a prosperous environment for these improvements occur. Sometimes, their school does not evaluate their mental condition well, which distorts data.
Thank you in advance!

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