Chloride Iodide
126-435: A bromide ion is the negatively charged form ( Br ) of the element bromine , a member of the halogens group on the periodic table . Most bromides are colorless. Bromides have many practical roles, being found in anticonvulsants, flame-retardant materials, and cell stains. Although uncommon, chronic toxicity from bromide can result in bromism , a syndrome with multiple neurological symptoms. Bromide toxicity can also cause
252-444: A magnetic field . Electrons, due to their smaller mass and thus larger space-filling properties as matter waves , determine the size of atoms and molecules that possess any electrons at all. Thus, anions (negatively charged ions) are larger than the parent molecule or atom, as the excess electron(s) repel each other and add to the physical size of the ion, because its size is determined by its electron cloud . Cations are smaller than
378-770: A meta-analysis , but this association disappeared after correction for multiple testing . On the other hand, two polymorphisms in TPH2 were identified as being associated with bipolar disorder. Due to the inconsistent findings in a genome-wide association study , multiple studies have undertaken the approach of analyzing SNPs in biological pathways. Signaling pathways traditionally associated with bipolar disorder that have been supported by these studies include corticotropin-releasing hormone signaling, cardiac β-adrenergic signaling, phospholipase C signaling, glutamate receptor signaling, cardiac hypertrophy signaling, Wnt signaling , Notch signaling , and endothelin 1 signaling. Of
504-588: A proton , which is considered to be positive by convention. The net charge of an ion is not zero because its total number of electrons is unequal to its total number of protons. A cation is a positively charged ion with fewer electrons than protons (e.g. K (potassium ion)) while an anion is a negatively charged ion with more electrons than protons. (e.g. Cl (chloride ion) and OH (hydroxide ion)). Opposite electric charges are pulled towards one another by electrostatic force , so cations and anions attract each other and readily form ionic compounds . If only
630-421: A + or - is present, it indicates a +1 or -1 charge. To indicate a more severe charge, the number of additional or missing atoms is supplied, as seen in O 2 (negative charge, peroxide ) and He (positive charge, alpha particle ). Ions consisting of only a single atom are termed atomic or monatomic ions , while two or more atoms form molecular ions or polyatomic ions . In the case of physical ionization in
756-411: A byproduct of serotonin , are present in the cerebrospinal fluid of persons with bipolar disorder during both the depressed and manic phases. Increased dopaminergic activity has been hypothesized in manic states due to the ability of dopamine agonists to stimulate mania in people with bipolar disorder. Decreased sensitivity of regulatory α 2 adrenergic receptors as well as increased cell counts in
882-487: A combination of energy and entropy changes as the ions move away from each other to interact with the liquid. These stabilized species are more commonly found in the environment at low temperatures. A common example is the ions present in seawater, which are derived from dissolved salts. As charged objects, ions are attracted to opposite electric charges (positive to negative, and vice versa) and repelled by like charges. When they move, their trajectories can be deflected by
1008-462: A consequence of substance use. In November 2018, Cyberpsychology published a systematic review and meta-analysis of 5 studies that found evidence for a relationship between problematic smartphone use and impulsivity traits. In October 2020, the Journal of Behavioral Addictions published a systematic review and meta-analysis of 40 studies with 33,650 post-secondary student subjects that found that
1134-439: A definitive diagnosis. Neurologic diseases such as multiple sclerosis , complex partial seizures , strokes, brain tumors, Wilson's disease , traumatic brain injury , Huntington's disease , and complex migraines can mimic features of bipolar disorder. An EEG may be used to exclude neurological disorders such as epilepsy , and a CT scan or MRI of the head may be used to exclude brain lesions. Additionally, disorders of
1260-415: A depressive episode, or vice versa, remain poorly understood. Also known as a manic episode, mania is a distinct period of at least one week of elevated or irritable mood, which can range from euphoria to delirium . The core symptom of mania involves an increase in energy of psychomotor activity . Mania can also present with increased self-esteem or grandiosity , racing thoughts , pressured speech that
1386-524: A diagnosis— disruptive mood dysregulation disorder —that covers children with long-term, persistent irritability that had at times been misdiagnosed as having bipolar disorder, distinct from irritability in bipolar disorder that is restricted to discrete mood episodes. Bipolar on average, starts during adulthood. Bipolar 1, on average, starts at the age of 18 years old, and Bipolar 2 starts at age 22 years old on average. However, most delay seeking treatment for an average of 8 years after symptoms start. Bipolar
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#17327987225351512-481: A diagnostically specific causal agent for bipolar, does place genetically and biologically vulnerable individuals at risk for a more severe course of illness. Longitudinal studies have indicated that full-blown manic stages are often preceded by a variety of prodromal clinical features, providing support for the occurrence of an at-risk state of the disorder when an early intervention might prevent its further development and/or improve its outcome. The aim of management
1638-449: A few weeks to a few months. Symptoms of the depressive phase of bipolar disorder include persistent feelings of sadness, irritability or anger, loss of interest in previously enjoyed activities , excessive or inappropriate guilt , hopelessness , sleeping too much or not enough , changes in appetite and/or weight, fatigue , problems concentrating, self-loathing or feelings of worthlessness, and thoughts of death or suicide. Although
1764-398: A fluid (gas or liquid), "ion pairs" are created by spontaneous molecule collisions, where each generated pair consists of a free electron and a positive ion. Ions are also created by chemical interactions, such as the dissolution of a salt in liquids, or by other means, such as passing a direct current through a conducting solution, dissolving an anode via ionization . The word ion
1890-415: A gas is extensively used for the detection of radiation such as alpha , beta , gamma , and X-rays . The original ionization event in these instruments results in the formation of an "ion pair"; a positive ion and a free electron, by ion impact by the radiation on the gas molecules. The ionization chamber is the simplest of these detectors, and collects all the charges created by direct ionization within
2016-400: A gas with less net electric charge is called the ionization potential , or ionization energy . The n th ionization energy of an atom is the energy required to detach its n th electron after the first n − 1 electrons have already been detached. Each successive ionization energy is markedly greater than the last. Particularly great increases occur after any given block of atomic orbitals
2142-513: A highly electronegative nonmetal, the extra electrons from the metal atoms are transferred to the electron-deficient nonmetal atoms. This reaction produces metal cations and nonmetal anions, which are attracted to each other to form a salt . Bipolar disorder Bipolar disorder , previously known as manic depression or manic depressive disorder , is a mental disorder characterized by periods of depression and periods of abnormally elevated mood that each last from days to weeks. If
2268-442: A history of childhood abuse and long-term stress . The condition is classified as bipolar I disorder if there has been at least one manic episode, with or without depressive episodes, and as bipolar II disorder if there has been at least one hypomanic episode (but no full manic episodes) and one major depressive episode. It is classified as cyclothymia if there are hypomanic episodes with periods of depression that do not meet
2394-549: A hospital admission, support services available can include drop-in centers , visits from members of a community mental health team or an Assertive Community Treatment team, supported employment , patient-led support groups , and intensive outpatient programs . These are sometimes referred to as partial-inpatient programs. Compared to the general population, people with bipolar disorder are less likely to frequently engage in physical exercise. Exercise may have physical and mental benefits for people with bipolar disorder, but there
2520-455: A job, leading to trouble with healthcare access, leading to more decline in their mental health due to not receiving treatment such as medicine and therapy. Bipolar disorder is uncommon in older patients, with a measured lifetime prevalence of 1% in over 60s and a 12-month prevalence of 0.1–0.5% in people over 65. Despite this, it is overrepresented in psychiatric admissions, making up 4–8% of inpatient admission to aged care psychiatry units, and
2646-523: A manic episode usually lasts three to six months. In severe manic episodes, a person can experience psychotic symptoms, where thought content is affected along with mood. They may feel unstoppable, persecuted , or as if they have a special relationship with God, a great mission to accomplish, or other grandiose or delusional ideas. This may lead to violent behavior and, sometimes, hospitalization in an inpatient psychiatric hospital . The severity of manic symptoms can be measured by rating scales such as
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#17327987225352772-434: A medical work-up to rule out other causes. Caregiver-scored rating scales, specifically from the mother, have shown to be more accurate than teacher and youth-scored reports in identifying youths with bipolar disorder. Assessment is usually done on an outpatient basis; admission to an inpatient facility is considered if there is a risk to oneself or others. The most widely used criteria for diagnosing bipolar disorder are from
2898-718: A mild to moderate effect . The risk of bipolar disorder is nearly ten-fold higher in first-degree relatives of those with bipolar disorder than in the general population; similarly, the risk of major depressive disorder is three times higher in relatives of those with bipolar disorder than in the general population. Although the first genetic linkage finding for mania was in 1969, linkage studies have been inconsistent. Findings point strongly to heterogeneity, with different genes implicated in different families. Robust and replicable genome-wide significant associations showed several common single-nucleotide polymorphisms (SNPs) are associated with bipolar disorder, including variants within
3024-483: A minus indication "Anion (−)" indicates the negative charge. With a cation it is just the opposite: it has fewer electrons than protons, giving it a net positive charge, hence the indication "Cation (+)". Since the electric charge on a proton is equal in magnitude to the charge on an electron, the net electric charge on an ion is equal to the number of protons in the ion minus the number of electrons. An anion (−) ( / ˈ æ n ˌ aɪ . ən / ANN -eye-ən , from
3150-604: A mixed state may have manic symptoms such as grandiose thoughts while simultaneously experiencing depressive symptoms such as excessive guilt or feeling suicidal. They are considered to have a higher risk for suicidal behavior as depressive emotions such as hopelessness are often paired with mood swings or difficulties with impulse control . Anxiety disorders occur more frequently as a comorbidity in mixed bipolar episodes than in non-mixed bipolar depression or mania. Substance (including alcohol ) use also follows this trend, thereby appearing to depict bipolar symptoms as no more than
3276-440: A molecule/atom with multiple charges is by drawing out the signs multiple times, this is often seen with transition metals. Chemists sometimes circle the sign; this is merely ornamental and does not alter the chemical meaning. All three representations of Fe , Fe , and Fe shown in the figure, are thus equivalent. Monatomic ions are sometimes also denoted with Roman numerals , particularly in spectroscopy ; for example,
3402-399: A neurological condition or injury including stroke, traumatic brain injury , HIV infection , multiple sclerosis , porphyria , and rarely temporal lobe epilepsy . The precise mechanisms that cause bipolar disorder are not well understood. Bipolar disorder is thought to be associated with abnormalities in the structure and function of certain brain areas responsible for cognitive tasks and
3528-402: A neutral atom or molecule is called ionization . Atoms can be ionized by bombardment with radiation , but the more usual process of ionization encountered in chemistry is the transfer of electrons between atoms or molecules. This transfer is usually driven by the attaining of stable ("closed shell") electronic configurations . Atoms will gain or lose electrons depending on which action takes
3654-421: A one-year span. Rapid cycling is usually temporary but is common amongst people with bipolar disorder and affects 25.8–45.3% of them at some point in their life. These episodes are separated from each other by a remission (partial or full) for at least two months or a switch in mood polarity (i.e., from a depressive episode to a manic episode or vice versa). The definition of rapid cycling most frequently cited in
3780-592: A positive charge, forming the ion NH + 3 . However, this ion is unstable, because it has an incomplete valence shell around the nitrogen atom, making it a very reactive radical ion. Due to the instability of radical ions, polyatomic and molecular ions are usually formed by gaining or losing elemental ions such as H , rather than gaining or losing electrons. This allows the molecule to preserve its stable electronic configuration while acquiring an electrical charge. The energy required to detach an electron in its lowest energy state from an atom or molecule of
3906-411: A precise ionic gradient across membranes , the disruption of this gradient contributes to cell death. This is a common mechanism exploited by natural and artificial biocides , including the ion channels gramicidin and amphotericin (a fungicide ). Inorganic dissolved ions are a component of total dissolved solids , a widely known indicator of water quality . The ionizing effect of radiation on
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4032-556: A role in bipolar disorder are the mitochondria and a sodium ATPase pump . Circadian rhythms and regulation of the hormone melatonin also seem to be altered. Dopamine , a neurotransmitter responsible for mood cycling, has increased transmission during the manic phase. The dopamine hypothesis states that the increase in dopamine results in secondary homeostatic downregulation of key system elements and receptors such as lower sensitivity of dopaminergic receptors. This results in decreased dopamine transmission characteristic of
4158-646: A significant decrease in the individual's ability to socialize or work, lacks psychotic features such as delusions or hallucinations , and does not require psychiatric hospitalization. Overall functioning may actually increase during episodes of hypomania and is thought to serve as a defense mechanism against depression by some. Hypomanic episodes rarely progress to full-blown manic episodes. Some people who experience hypomania show increased creativity, while others are irritable or demonstrate poor judgment. Hypomania may feel good to some individuals who experience it, though most people who experience hypomania state that
4284-414: A stable configuration. This property is known as electropositivity . Non-metals, on the other hand, are characterized by having an electron configuration just a few electrons short of a stable configuration. As such, they have the tendency to gain more electrons in order to achieve a stable configuration. This tendency is known as electronegativity . When a highly electropositive metal is combined with
4410-431: A type of skin eruption, see potassium bromide . The bromide ion has an ionic radius of 196 pm. Bromide is present in typical seawater (35 PSU ) with a concentration of around 65 mg/L, which is about 0.2% of all dissolved salts . Seafood and deep sea plants generally have higher levels than land-derived foods. Bromargyrite —natural, crystalline silver bromide—is the most common bromide mineral known but
4536-405: A weak-to-moderate positive association between mobile phone addiction and impulsivity. People with bipolar disorder often have other co-existing psychiatric conditions such as anxiety (present in about 71% of people with bipolar disorder), substance abuse (56%), personality disorders (36%) and attention deficit hyperactivity disorder (10–20%) which can add to the burden of illness and worsen
4662-401: A −2 charge is known as a dianion and an ion with a +2 charge is known as a dication . A zwitterion is a neutral molecule with positive and negative charges at different locations within that molecule. Cations and anions are measured by their ionic radius and they differ in relative size: "Cations are small, most of them less than 10 m (10 cm) in radius. But most anions are large, as is
4788-404: Is 5.3 ± 1.4 mg/L and varies with age and gender. Much higher levels may indicate exposure to brominated chemicals. It is also found in seafood. Ion An ion ( / ˈ aɪ . ɒ n , - ən / ) is an atom or molecule with a net electrical charge . The charge of an electron is considered to be negative by convention and this charge is equal and opposite to the charge of
4914-478: Is antiepileptic and as bromide salt, is used in veterinary medicine in the US. The kidneys excrete bromide ions. The half-life of bromide in the human body (12 days) is long compared with many pharmaceuticals, making dosing challenging to adjust. (A new dose may require several months to reach equilibrium.) Bromide ion concentrations in the cerebrospinal fluid are about 30% of those in blood and are strongly influenced by
5040-530: Is a lack of research. Psychotherapy aims to assist a person with bipolar disorder in accepting and understanding their diagnosis, coping with various types of stress, improving their interpersonal relationships, and recognizing prodromal symptoms before full-blown recurrence. Cognitive behavioral therapy (CBT), family-focused therapy , and psychoeducation have the most evidence for efficacy in regard to relapse prevention, while interpersonal and social rhythm therapy and cognitive-behavioral therapy appear
5166-433: Is analogous to the production of bleach , where chlorine is dissolved in the presence of sodium hydroxide. One can test for a bromide ion by adding an oxidizer. One method uses dilute HNO 3 . Balard and Löwig's method can be used to extract bromine from seawater and certain brines. For samples testing for sufficient bromide concentration, addition of chlorine produces bromine (Br 2 ): Bromide's main commercial value
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5292-410: Is associated with "classic mania", to dysphoria and irritability . Psychotic symptoms such as delusions or hallucinations may occur in both manic and depressive episodes; their content and nature are consistent with the person's prevailing mood. In some people with bipolar disorder, depressive symptoms predominate, and the episodes of mania are always the more subdued hypomania type. According to
5418-539: Is characterized by intermittent episodes of mania , commonly (but not in every patient) alternating with bouts of depression, with an absence of symptoms in between. During these episodes, people with bipolar disorder exhibit disruptions in normal mood , psychomotor activity (the level of physical activity that is influenced by mood)—e.g. constant fidgeting during mania or slowed movements during depression— circadian rhythm and cognition. Mania can present with varying levels of mood disturbance, ranging from euphoria , which
5544-407: Is crucial to establishing a treatment plan where these comorbidities exist. Children of parents with bipolar disorder more frequently have other mental health problems. In the 1920s, Kraepelin noted that manic episodes are rare before puberty. In general, bipolar disorder in children was not recognized in the first half of the twentieth century. This issue diminished with an increased following of
5670-413: Is difficult to interrupt, decreased need for sleep, disinhibited social behavior, increased goal-oriented activities and impaired judgement, which can lead to exhibition of behaviors characterized as impulsive or high-risk, such as hypersexuality or excessive spending . To fit the definition of a manic episode, these behaviors must impair the individual's ability to socialize or work. If untreated,
5796-600: Is effective in acute manic and depressive episodes, especially with psychosis or catatonia . Admission to a psychiatric hospital may be required if a person is a risk to themselves or others; involuntary treatment is sometimes necessary if the affected person refuses treatment. Bipolar disorder occurs in approximately 2% of the global population. In the United States, about 3% are estimated to be affected at some point in their life; rates appear to be similar in females and males. Symptoms most commonly begin between
5922-416: Is estimated to be between 1-5% of the world's popluation. While the causes of this mood disorder are not clearly understood, both genetic and environmental factors are thought to play a role. Many genes, each with small effects, may contribute to the development of the disorder. Genetic factors account for about 70–90% of the risk of developing bipolar disorder. Environmental risk factors include
6048-429: Is exhausted of electrons. For this reason, ions tend to form in ways that leave them with full orbital blocks. For example, sodium has one valence electron in its outermost shell, so in ionized form it is commonly found with one lost electron, as Na . On the other side of the periodic table, chlorine has seven valence electrons, so in ionized form it is commonly found with one gained electron, as Cl . Caesium has
6174-402: Is higher in those with an adult diagnosis of bipolar spectrum disorder than in those without, particularly events stemming from a harsh environment rather than from the child's own behavior. Acutely, mania can be induced by sleep deprivation in around 30% of people with bipolar disorder. Less commonly, bipolar disorder or a bipolar-like disorder may occur as a result of or in association with
6300-615: Is in the breakdown of adenosine triphosphate ( ATP ), which provides the energy for many reactions in biological systems. Ions can be non-chemically prepared using various ion sources , usually involving high voltage or temperature. These are used in a multitude of devices such as mass spectrometers , optical emission spectrometers , particle accelerators , ion implanters , and ion engines . As reactive charged particles, they are also used in air purification by disrupting microbes, and in household items such as smoke detectors . As signalling and metabolism in organisms are controlled by
6426-510: Is its use in producing organobromine compounds , which themselves are rather specialized. Organobromine compounds are commonly used as brominated flame retardants . Some brominated flame retardants were identified as persistent, bioaccumulative, and toxic to both humans and the environment and were suspected of causing neurobehavioral effects and endocrine disruption . Many metal bromides are produced commercially, including LiBr , NaBr , NH 4 Br , CuBr , ZnBr 2 and AlBr 3 . AgBr
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#17327987225356552-453: Is made, while substance/medication-induced bipolar and related disorder is used if a medication is thought to have triggered the condition. Most people who meet criteria for bipolar disorder experience a number of episodes, on average 0.4 to 0.7 per year, lasting three to six months. Rapid cycling , however, is a course specifier that may be applied to any bipolar subtype. It is defined as having four or more mood disturbance episodes within
6678-577: Is not required for a diagnosis , though blood tests or medical imaging can rule out other problems. Mood stabilizers , particularly lithium , and certain anticonvulsants , such as lamotrigine , valproate , and carbamazepine , as well as atypical antipsychotics, including quetiapine , cariprazine , and aripiprazole , are the mainstay of long-term pharmacologic relapse prevention. Antipsychotics are additionally given during acute manic episodes as well as in cases where mood stabilizers are poorly tolerated or ineffective. In patients where compliance
6804-401: Is of concern, long-acting injectable formulations are available. There is some evidence that psychotherapy improves the course of this disorder. The use of antidepressants in depressive episodes is controversial: they can be effective but have been implicated in triggering manic episodes. The treatment of depressive episodes, therefore, is often difficult. Electroconvulsive therapy (ECT)
6930-399: Is often described simplistically as involving formation of the hydronium salt of bromide: Bromine readily reacts with water, i.e. it undergoes hydrolysis: This forms hypobromous acid (HOBr), and hydrobromic acid (HBr in water). The solution is called " bromine water ". The hydrolysis of bromine is more favorable in the presence of base, for example sodium hydroxide : This reaction
7056-443: Is often misdiagnosed with other psychiatric disorders. There is no definitive association between race, ethnicity, or Socioeconomic status (SES). Adults with Bipolar report having a lower quality of life, even outside of a manic or depressive episode. Bipolar can put strain on marriage and other relationships, having a job, and everyday functioning. Bipolar is associated with having higher rates of unemployment. Most have trouble keeping
7182-607: Is one short of the stable, filled shell with 8 electrons. Thus, a chlorine atom tends to gain an extra electron and attain a stable 8- electron configuration , becoming a chloride anion in the process: This driving force is what causes sodium and chlorine to undergo a chemical reaction, wherein the "extra" electron is transferred from sodium to chlorine, forming sodium cations and chloride anions. Being oppositely charged, these cations and anions form ionic bonds and combine to form sodium chloride , NaCl, more commonly known as table salt. Polyatomic and molecular ions are often formed by
7308-451: Is possible to mix the notations for the individual metal centre with a polyatomic complex, as shown by the uranyl ion example. If an ion contains unpaired electrons , it is called a radical ion. Just like uncharged radicals, radical ions are very reactive. Polyatomic ions containing oxygen, such as carbonate and sulfate, are called oxyanions . Molecular ions that contain at least one carbon to hydrogen bond are called organic ions . If
7434-618: Is produced by similar enzymatic reactions. In one specialized report, bromide is an essential cofactor in the peroxidising catalysis of sulfonimine crosslinks in collagen IV. This post-translational modification occurs in all animals and bromine is an essential trace element for humans. Eosinophils need bromide for fighting multicellular parasites. Hypobromite is produced via eosinophil peroxidase , an enzyme that can use chloride but preferentially uses bromide. The average concentration of bromide in human blood in Queensland, Australia,
7560-473: Is still used therapeutically in human epilepsy. Bromide is rarely mentioned in the biochemical context. Some enzymes use bromide as substrate or as a cofactor . Bromoperoxidase enzymes use bromide (typically in seawater) to generate electrophilic brominating agents. Hundreds of organobromine compounds are generated by this process. Notable examples are bromoform, thousands of tons of which are produced annually in this way. The historical dye Tyrian purple
7686-510: Is still very rare. In addition to silver, bromine is also in minerals combined with mercury and copper. Bromide salts of alkali metal , alkaline earth metals , and many other metals dissolve in water (and even some alcohols and a few ethers) to give bromide ions. The classic case is sodium bromide, which fully dissociates in water: Hydrogen bromide, which is a diatomic molecule , takes on salt-like properties upon contact with water to give an ionic solution called hydrobromic acid . The process
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#17327987225357812-518: Is the nature of the mood swings; in contrast to the sustained changes to mood over days to weeks or longer, those of the latter condition (more accurately called emotional dysregulation ) are sudden and often short-lived, and secondary to social stressors . Although there are no biological tests that are diagnostic of bipolar disorder, blood tests and/or imaging are carried out to investigate whether medical illnesses with clinical presentations similar to that of bipolar disorder are present before making
7938-527: Is to treat acute episodes safely with medication and work with the patient in long-term maintenance to prevent further episodes and optimise function using a combination of pharmacological and psychotherapeutic techniques. Hospitalization may be required especially with the manic episodes present in bipolar I. This can be voluntary or (local legislation permitting) involuntary . Long-term inpatient stays are now less common due to deinstitutionalization , although these can still occur. Following (or in lieu of)
8064-431: Is used for the largely obsolete photographic gelatin silver process . Lithium bromide was used as a sedative beginning in the early 1900s. However, it fell into disfavour in the 1940s due to the rising popularity of safer and more efficient sedatives (specifically, barbiturates ) and when some heart patients died after using a salt substitute (see lithium chloride ). Like lithium carbonate and lithium chloride , it
8190-432: Is written in superscript immediately after the chemical structure for the molecule/atom. The net charge is written with the magnitude before the sign; that is, a doubly charged cation is indicated as 2+ instead of +2 . However, the magnitude of the charge is omitted for singly charged molecules/atoms; for example, the sodium cation is indicated as Na and not Na . An alternative (and acceptable) way of showing
8316-556: The Fe (positively doubly charged) example seen above is referred to as Fe(III) , Fe or Fe III (Fe I for a neutral Fe atom, Fe II for a singly ionized Fe ion). The Roman numeral designates the formal oxidation state of an element, whereas the superscripted Indo-Arabic numerals denote the net charge. The two notations are, therefore, exchangeable for monatomic ions, but the Roman numerals cannot be applied to polyatomic ions. However, it
8442-614: The American Psychiatric Association 's (APA) Diagnostic and Statistical Manual of Mental Disorders , Fifth Edition (DSM-5) and the World Health Organization 's (WHO) International Statistical Classification of Diseases and Related Health Problems , 10th Edition (ICD-10). The ICD-10 criteria are used more often in clinical settings outside of the U.S. while the DSM criteria are used within
8568-606: The Bipolar spectrum diagnostic scale , Mood Disorder Questionnaire , the General Behavior Inventory and the Hypomania Checklist . The use of evaluation scales cannot substitute a full clinical interview but they serve to systematize the recollection of symptoms. On the other hand, instruments for screening bipolar disorder tend to have lower sensitivity . Bipolar disorder is classified by
8694-454: The DSM-5 criteria, mania is distinguished from hypomania by the duration: hypomania is present if elevated mood symptoms persist for at least four consecutive days, while mania is present if such symptoms persist for more than a week. Unlike mania, hypomania is not always associated with impaired functioning. The biological mechanisms responsible for switching from a manic or hypomanic episode to
8820-516: The International Classification of Diseases as a mental and behavioural disorder . Mental disorders that can have symptoms similar to those seen in bipolar disorder include schizophrenia , major depressive disorder, attention deficit hyperactivity disorder (ADHD), and certain personality disorders, such as borderline personality disorder . A key difference between bipolar disorder and borderline personality disorder
8946-514: The Young Mania Rating Scale , though questions remain about the reliability of these scales. The onset of a manic or depressive episode is often foreshadowed by sleep disturbance . Manic individuals often have a history of substance use disorder developed over years as a form of "self-medication". Hypomania is the milder form of mania, defined as at least four days of the same criteria as mania, but which does not cause
9072-839: The bipolar spectrum has been estimated at 0.71. Twin studies have been limited by relatively small sample sizes but have indicated a substantial genetic contribution, as well as environmental influence. For bipolar I disorder, the rate at which identical twins (same genes) will both have bipolar I disorder (concordance) is around 40%, compared to about 5% in fraternal twins . A combination of bipolar I, II, and cyclothymia similarly produced rates of 42% and 11% (identical and fraternal twins, respectively). The rates of bipolar II combinations without bipolar I are lower—bipolar II at 23 and 17%, and bipolar II combining with cyclothymia at 33 and 14%—which may reflect relatively higher genetic heterogeneity . The cause of bipolar disorders overlaps with major depressive disorder. When defining concordance as
9198-1140: The endocrine system such as hypothyroidism , hyperthyroidism , and Cushing's disease are in the differential as is the connective tissue disease systemic lupus erythematosus . Infectious causes of mania that may appear similar to bipolar mania include herpes encephalitis , HIV, influenza , or neurosyphilis . Certain vitamin deficiencies such as pellagra ( niacin deficiency), vitamin B 12 deficiency , folate deficiency , and Wernicke–Korsakoff syndrome ( thiamine deficiency ) can also lead to mania. Common medications that can cause manic symptoms include antidepressants, prednisone , Parkinson's disease medications, thyroid hormone , stimulants (including cocaine and methamphetamine), and certain antibiotics . Bipolar spectrum disorders include: bipolar I disorder, bipolar II disorder, cyclothymic disorder and cases where subthreshold symptoms are found to cause clinically significant impairment or distress. These disorders involve major depressive episodes that alternate with manic or hypomanic episodes, or with mixed episodes that feature symptoms of both mood states. The concept of
9324-513: The hippocampus , dorsal anterior cingulate cortex, and other parts of the prefrontal cortex. The model hypothesizes that bipolar disorder may occur when the ventral system is overactivated and the dorsal system is underactivated. Other models suggest the ability to regulate emotions is disrupted in people with bipolar disorder and that dysfunction of the ventricular prefrontal cortex is crucial to this disruption. Meta-analyses of structural MRI studies have shown that certain brain regions (e.g.,
9450-706: The lingual gyrus compared to people without bipolar disorder. In contrast, they demonstrate decreased activity in the inferior frontal cortex during manic episodes compared to people without the disorder. Similar studies examining the differences in brain activity between people with bipolar disorder and those without did not find a consistent area in the brain that was more or less active when comparing these two groups. People with bipolar have increased activation of left hemisphere ventral limbic areas—which mediate emotional experiences and generation of emotional responses—and decreased activation of right hemisphere cortical structures related to cognition—structures associated with
9576-469: The locus coeruleus indicated increased noradrenergic activity in manic people. Low plasma GABA levels on both sides of the mood spectrum have been found. One review found no difference in monoamine levels, but found abnormal norepinephrine turnover in people with bipolar disorder. Tyrosine depletion was found to reduce the effects of methamphetamine in people with bipolar disorder as well as symptoms of mania, implicating dopamine in mania. VMAT2 binding
9702-593: The 16 genes identified in these pathways, three were found to be dysregulated in the dorsolateral prefrontal cortex portion of the brain in post-mortem studies: CACNA1C , GNG2 , and ITPR2 . Bipolar disorder is associated with reduced expression of specific DNA repair enzymes and increased levels of oxidative DNA damages . Psychosocial factors play a significant role in the development and course of bipolar disorder, and individual psychosocial variables may interact with genetic dispositions. Recent life events and interpersonal relationships likely contribute to
9828-549: The 19th and early 20th centuries. Their use in over-the-counter sedatives and headache remedies (such as Bromo-Seltzer ) in the United States extended to 1975 when bromides were withdrawn as ingredients due to chronic toxicity . This use gave the word "bromide" its colloquial connotation of a comforting cliché . It has been said that during World War I , British soldiers were given bromide to curb their sexual urges. Bromide salts are used in hot tubs as mild germicidal agents to generate in situ hypobromite . The bromide ion
9954-568: The DSM criteria in the last part of the twentieth century. The diagnosis of childhood bipolar disorder, while formerly controversial, has gained greater acceptance among childhood and adolescent psychiatrists. American children and adolescents diagnosed with bipolar disorder in community hospitals increased 4-fold reaching rates of up to 40% in 10 years around the beginning of the 21st century, while in outpatient clinics it doubled reaching 6%. Studies using DSM criteria show that up to 1% of youth may have bipolar disorder. The DSM-5 has established
10080-461: The DSM-5 criteria for diagnosing unipolar and bipolar episodes are the same, some clinical features are more common in the latter, including increased sleep, sudden onset and resolution of symptoms, significant weight gain or loss, and severe episodes after childbirth. The earlier the age of onset, the more likely the first few episodes are to be depressive. For most people with bipolar types 1 and 2,
10206-541: The Greek word ἄνω ( ánō ), meaning "up" ) is an ion with more electrons than protons, giving it a net negative charge (since electrons are negatively charged and protons are positively charged). A cation (+) ( / ˈ k æ t ˌ aɪ . ən / KAT -eye-ən , from the Greek word κάτω ( kátō ), meaning "down" ) is an ion with fewer electrons than protons, giving it a positive charge. There are additional names used for ions with multiple charges. For example, an ion with
10332-598: The U.S. and are the prevailing criteria used internationally in research studies. The DSM-5, published in 2013, includes further and more accurate specifiers compared to its predecessor, the DSM-IV-TR . This work has influenced the eleventh revision of the ICD, which includes the various diagnoses within the bipolar spectrum of the DSM-V. Several rating scales for the screening and evaluation of bipolar disorder exist, including
10458-402: The ages of 20 and 25 years old; an earlier onset in life is associated with a worse prognosis. Interest in functioning in the assessment of patients with bipolar disorder is growing, with an emphasis on specific domains such as work, education, social life, family, and cognition. Around one-quarter to one-third of people with bipolar disorder have financial, social or work-related problems due to
10584-748: The bipolar spectrum is similar to that of Emil Kraepelin 's original concept of manic depressive illness. Bipolar II disorder was established as a diagnosis in 1994 within DSM IV; though debate continues over whether it is a distinct entity, part of a spectrum, or exists at all. The DSM and the ICD characterize bipolar disorder as a spectrum of disorders occurring on a continuum. The DSM-5 and ICD-11 lists three specific subtypes: When relevant, specifiers for peripartum onset and with rapid cycling should be used with any subtype. Individuals who have subthreshold symptoms that cause clinically significant distress or impairment, but do not meet full criteria for one of
10710-459: The body's chloride intake and metabolism. Since bromide is still used in veterinary medicine in the United States, veterinary diagnostic labs can routinely measure blood bromide levels. However, this is not a conventional test in human medicine in the US since there are no FDA-approved uses for the bromide. Therapeutic bromide levels are measured in European countries like Germany , where bromide
10836-519: The charge in an organic ion is formally centred on a carbon, it is termed a carbocation (if positively charged) or carbanion (if negatively charged). Monatomic ions are formed by the gain or loss of electrons to the valence shell (the outer-most electron shell) in an atom. The inner shells of an atom are filled with electrons that are tightly bound to the positively charged atomic nucleus , and so do not participate in this kind of chemical interaction. The process of gaining or losing electrons from
10962-538: The co-twins having either bipolar disorder or major depression, then the concordance rate rises to 67% in identical twins and 19% in fraternal twins. The relatively low concordance between fraternal twins brought up together suggests that shared family environmental effects are limited, although the ability to detect them has been limited by small sample sizes. Behavioral genetic studies have suggested that many chromosomal regions and candidate genes are related to bipolar disorder susceptibility with each gene exerting
11088-409: The corresponding parent atom or molecule due to the smaller size of the electron cloud. One particular cation (that of hydrogen) contains no electrons, and thus consists of a single proton – much smaller than the parent hydrogen atom. Anion (−) and cation (+) indicate the net electric charge on an ion. An ion that has more electrons than protons, giving it a net negative charge, is named an anion, and
11214-398: The criteria for major depressive episodes. If these symptoms are due to drugs or medical problems, they are not diagnosed as bipolar disorder. Other conditions that have overlapping symptoms with bipolar disorder include attention deficit hyperactivity disorder , personality disorders , schizophrenia , and substance use disorder as well as many other medical conditions. Medical testing
11340-449: The depressive episodes are much longer than the manic or hypomanic episodes. Since a diagnosis of bipolar disorder requires a manic or hypomanic episode, many affected individuals are initially misdiagnosed as having major depression and incorrectly treated with prescribed antidepressants. In bipolar disorder, a mixed state is an episode during which symptoms of both mania and depression occur simultaneously. Individuals experiencing
11466-520: The depressive phase. The depressive phase ends with homeostatic upregulation potentially restarting the cycle over again. Glutamate is significantly increased within the left dorsolateral prefrontal cortex during the manic phase of bipolar disorder, and returns to normal levels once the phase is over. Medications used to treat bipolar may exert their effect by modulating intracellular signaling, such as through depleting myo- inositol levels, inhibition of cAMP signaling , and through altering subunits of
11592-440: The dopamine-associated G-protein. Consistent with this, elevated levels of G αi , G αs , and G αq/11 have been reported in brain and blood samples, along with increased protein kinase A (PKA) expression and sensitivity; typically, PKA activates as part of the intracellular signalling cascade downstream from the detachment of G αs subunit from the G protein complex. Decreased levels of 5-hydroxyindoleacetic acid ,
11718-450: The elevated mood is severe or associated with psychosis , it is called mania ; if it is less severe and does not significantly affect functioning, it is called hypomania . During mania, an individual behaves or feels abnormally energetic, happy, or irritable, and they often make impulsive decisions with little regard for the consequences; there is usually also a reduced need for sleep during manic phases. During periods of depression,
11844-635: The former group present with milder manic episodes, more prominent cognitive changes and have a background of worse psychosocial functioning, while the latter present more commonly with mixed affective episodes, and have a stronger family history of illness. Older people with bipolar disorder experience cognitive changes, particularly in executive functions such as abstract thinking and switching cognitive sets, as well as concentrating for long periods and decision-making. Attempts at prevention of bipolar disorder have focused on stress (such as childhood adversity or highly conflictual families) which, although not
11970-454: The gaining or losing of elemental ions such as a proton, H , in neutral molecules. For example, when ammonia , NH 3 , accepts a proton, H —a process called protonation —it forms the ammonium ion, NH + 4 . Ammonia and ammonium have the same number of electrons in essentially the same electronic configuration , but ammonium has an extra proton that gives it a net positive charge. Ammonia can also lose an electron to gain
12096-435: The gas through the application of an electric field. The Geiger–Müller tube and the proportional counter both use a phenomenon known as a Townsend avalanche to multiply the effect of the original ionizing event by means of a cascade effect whereby the free electrons are given sufficient energy by the electric field to release further electrons by ion impact. When writing the chemical formula for an ion, its net charge
12222-434: The general population. Substance use disorder is a common comorbidity in bipolar disorder; the subject has been widely reviewed. The causes of bipolar disorder likely vary between individuals and the exact mechanism underlying the disorder remains unclear. Genetic influences are believed to account for 73–93% of the risk of developing the disorder indicating a strong hereditary component. The overall heritability of
12348-449: The genes CACNA1C , ODZ4 , and NCAN . The largest and most recent genome-wide association study failed to find any locus that exerts a large effect, reinforcing the idea that no single gene is responsible for bipolar disorder in most cases. Polymorphisms in BDNF , DRD4 , DAO , and TPH1 have been frequently associated with bipolar disorder and were initially associated in
12474-438: The illness. Bipolar disorder is among the top 20 causes of disability worldwide and leads to substantial costs for society. Due to lifestyle choices and the side effects of medications, the risk of death from natural causes such as coronary heart disease in people with bipolar disorder is twice that of the general population. Late adolescence and early adulthood are peak years for the onset of bipolar disorder. The condition
12600-428: The incidence of mood disorders is increasing overall with the aging population. Depressive episodes more commonly present with sleep disturbance, fatigue, hopelessness about the future, slowed thinking, and poor concentration and memory; the last three symptoms are seen in what is known as pseudodementia . Clinical features also differ between those with late-onset bipolar disorder and those who developed it early in life;
12726-441: The individual may experience crying, have a negative outlook on life, and demonstrate poor eye contact with others. The risk of suicide is high; over a period of 20 years, 6% of those with bipolar disorder died by suicide, while 30–40% engaged in self-harm . Other mental health issues, such as anxiety disorders and substance use disorders , are commonly associated with bipolar disorder. The global prevalence of bipolar disorder
12852-417: The least energy. For example, a sodium atom, Na, has a single electron in its valence shell, surrounding 2 stable, filled inner shells of 2 and 8 electrons. Since these filled shells are very stable, a sodium atom tends to lose its extra electron and attain this stable configuration, becoming a sodium cation in the process On the other hand, a chlorine atom, Cl, has 7 electrons in its valence shell, which
12978-465: The left rostral anterior cingulate cortex , fronto-insular cortex , ventral prefrontal cortex, and claustrum ) are smaller in people with bipolar disorder, whereas other regions are larger ( lateral ventricles , globus pallidus , subgenual anterior cingulate , and the amygdala). Additionally, these meta-analyses found that people with bipolar disorder have higher rates of deep white matter hyperintensities . Functional MRI findings suggest that
13104-467: The levels in non-manic people, suggesting that ventricular prefrontal cortex activity is an indicator of mood state. However, while pharmacological treatment of mania reduces amygdala hyperactivity, it remains more active than the amygdala of those without bipolar disorder, suggesting amygdala activity may be a marker of the disorder rather than the current mood state. Manic and depressive episodes tend to be characterized by dysfunction in different regions of
13230-447: The literature (including the DSM-V and ICD-11) is that of Dunner and Fieve: at least four major depressive, manic, hypomanic or mixed episodes during a 12-month period. The literature examining the pharmacological treatment of rapid cycling is sparse and there is no clear consensus with respect to its optimal pharmacological management. "Ultra rapid" and "ultradian" have been applied to faster-cycling types of bipolar disorder. People with
13356-409: The lowest measured ionization energy of all the elements and helium has the greatest. In general, the ionization energy of metals is much lower than the ionization energy of nonmetals , which is why, in general, metals will lose electrons to form positively charged ions and nonmetals will gain electrons to form negatively charged ions. Ionic bonding is a kind of chemical bonding that arises from
13482-510: The luminescence of the Sun to the existence of the Earth's ionosphere . Atoms in their ionic state may have a different color from neutral atoms, and thus light absorption by metal ions gives the color of gemstones . In both inorganic and organic chemistry (including biochemistry), the interaction of water and ions is often relevant for understanding properties of systems; an example of their importance
13608-479: The most common Earth anion, oxygen . From this fact it is apparent that most of the space of a crystal is occupied by the anion and that the cations fit into the spaces between them." The terms anion and cation (for ions that respectively travel to the anode and cathode during electrolysis) were introduced by Michael Faraday in 1834 following his consultation with William Whewell . Ions are ubiquitous in nature and are responsible for diverse phenomena from
13734-454: The mutual attraction of oppositely charged ions. Ions of like charge repel each other, and ions of opposite charge attract each other. Therefore, ions do not usually exist on their own, but will bind with ions of opposite charge to form a crystal lattice . The resulting compound is called an ionic compound , and is said to be held together by ionic bonding . In ionic compounds there arise characteristic distances between ion neighbours from which
13860-541: The onset and recurrence of bipolar mood episodes, just as they do for unipolar depression. In surveys, 30–50% of adults diagnosed with bipolar disorder report traumatic/abusive experiences in childhood, which is associated with earlier onset, a higher rate of suicide attempts, and more co-occurring disorders such as post-traumatic stress disorder . Subtypes of abuse, such as sexual and emotional abuse, also contribute to violent behaviors seen in patients with bipolar disorder. The number of reported stressful events in childhood
13986-502: The other. In correspondence with Faraday, Whewell also coined the words anode and cathode , as well as anion and cation as ions that are attracted to the respective electrodes. Svante Arrhenius put forth, in his 1884 dissertation, the explanation of the fact that solid crystalline salts dissociate into paired charged particles when dissolved, for which he would win the 1903 Nobel Prize in Chemistry. Arrhenius' explanation
14112-421: The processing of emotions. A neurologic model for bipolar disorder proposes that the emotional circuitry of the brain can be divided into two main parts. The ventral system (regulates emotional perception) includes brain structures such as the amygdala , insula , ventral striatum , ventral anterior cingulate cortex , and the prefrontal cortex . The dorsal system (responsible for emotional regulation) includes
14238-419: The prognosis. Certain medical conditions are also more common in people with bipolar disorder as compared to the general population. This includes increased rates of metabolic syndrome (present in 37% of people with bipolar disorder), migraine headaches (35%), obesity (21%) and type 2 diabetes (14%). This contributes to a risk of death that is two times higher in those with bipolar disorder as compared to
14364-655: The rapid cycling or faster-cycling subtypes of bipolar disorder tend to be more difficult to treat and less responsive to medications than other people with bipolar disorder. The diagnosis of bipolar disorder can be complicated by coexisting ( comorbid ) psychiatric conditions including obsessive–compulsive disorder , substance-use disorder , eating disorders , attention deficit hyperactivity disorder , social phobia , premenstrual syndrome (including premenstrual dysphoric disorder ), or panic disorder . A thorough longitudinal analysis of symptoms and episodes, assisted if possible by discussions with friends and family members,
14490-472: The regulation of emotions. Neuroscientists have proposed additional models to try to explain the cause of bipolar disorder. One proposed model for bipolar disorder suggests that hypersensitivity of reward circuits consisting of frontostriatal circuits causes mania, and decreased sensitivity of these circuits causes depression. According to the "kindling" hypothesis, when people who are genetically predisposed toward bipolar disorder experience stressful events,
14616-434: The spatial extension and the ionic radius of individual ions may be derived. The most common type of ionic bonding is seen in compounds of metals and nonmetals (except noble gases , which rarely form chemical compounds). Metals are characterized by having a small number of electrons in excess of a stable, closed-shell electronic configuration . As such, they have the tendency to lose these extra electrons in order to attain
14742-483: The stress of the experience is very painful. People with bipolar disorder who experience hypomania tend to forget the effects of their actions on those around them. Even when family and friends recognize mood swings , the individual will often deny that anything is wrong. If not accompanied by depressive episodes, hypomanic episodes are often not deemed problematic unless the mood changes are uncontrollable or volatile. Most commonly, symptoms continue for time periods from
14868-422: The stress threshold at which mood changes occur becomes progressively lower, until the episodes eventually start (and recur) spontaneously. There is evidence supporting an association between early-life stress and dysfunction of the hypothalamic-pituitary-adrenal axis leading to its overactivation, which may play a role in the pathogenesis of bipolar disorder. Other brain components that have been proposed to play
14994-410: The then-unknown species that goes from one electrode to the other through an aqueous medium. Faraday did not know the nature of these species, but he knew that since metals dissolved into and entered a solution at one electrode and new metal came forth from a solution at the other electrode; that some kind of substance has moved through the solution in a current. This conveys matter from one place to
15120-411: The three subtypes may be diagnosed with other specified or unspecified bipolar disorder. Other specified bipolar disorder is used when a clinician chooses to explain why the full criteria were not met (e.g., hypomania without a prior major depressive episode). If the condition is thought to have a non-psychiatric medical cause, the diagnosis of bipolar and related disorder due to another medical condition
15246-405: The ventricular prefrontal cortex regulates the limbic system , especially the amygdala. In people with bipolar disorder, decreased ventricular prefrontal cortex activity allows for the dysregulated activity of the amygdala, which likely contributes to labile mood and poor emotional regulation. Consistent with this, pharmacological treatment of mania returns ventricular prefrontal cortex activity to
15372-442: The ventricular prefrontal cortex. Manic episodes appear to be associated with decreased activation of the right ventricular prefrontal cortex whereas depressive episodes are associated with decreased activation of the left ventricular prefrontal cortex. These disruptions often occur during development linked with synaptic pruning dysfunction. People with bipolar disorder who are in a euthymic mood state show decreased activity in
15498-530: Was coined from neuter present participle of Greek ἰέναι ( ienai ), meaning "to go". A cation is something that moves down ( Greek : κάτω , kato , meaning "down") and an anion is something that moves up ( Greek : ἄνω , ano , meaning "up"). They are so called because ions move toward the electrode of opposite charge. This term was introduced (after a suggestion by the English polymath William Whewell ) by English physicist and chemist Michael Faraday in 1834 for
15624-400: Was found to be increased in one study of people with bipolar mania. Bipolar disorder is commonly diagnosed during adolescence or early adulthood, but onset can occur throughout life. Its diagnosis is based on the self-reported experiences of the individual, abnormal behavior reported by family members, friends or co-workers, observable signs of illness as assessed by a clinician, and ideally
15750-477: Was that in forming a solution, the salt dissociates into Faraday's ions, he proposed that ions formed even in the absence of an electric current. Ions in their gas-like state are highly reactive and will rapidly interact with ions of opposite charge to give neutral molecules or ionic salts. Ions are also produced in the liquid or solid state when salts interact with solvents (for example, water) to produce solvated ions , which are more stable, for reasons involving
15876-702: Was used as a treatment for bipolar disorder . From 1954 - 1977, the Australian biochemist Shirley Andrews was researching safe ways to use lithium for the treatment of manic depressive illnesses while working at the Royal Park Psychiatric Hospital in Victoria . While conducting this research she discovered that bromide caused symptoms of mental illness, leading to a major reduction in its usage. Bromide compounds, especially potassium bromide , were frequently used as sedatives in
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