BAD in Nigeria 1/7(Introduction)

in StemSocial2 months ago (edited)

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Depression vector created by pch.vector - and

In the last few posts, talked to talk a lot about anxiety, the definition, the cause of this condition, types of anxiety, the complication, and the demographics, we discussed a study and summarised the topic.

Depression vector created by pch.vector - and

Welcome to Medic Vibes, a place where we together about mental health disorders and make sense of things, my name is Dr Ebingo Kigigha, and I am a medical doctor (aspiring psychiatrist) and creative (illustration and music). We have been at this for 2 months consecutively. I would like to thank the @stemsocial community for all the support. I know we haven't been perfect so far but we are working towards that. This month it is going to be about Bipolar Affective Disorder or BAD as it is abbreviated. The first month was about Depression and the month after we talked about anxiety. We are starting the same way we started 2 months ago by discussing a study.

In this post, we will be introducing this study and reading it together over the next 7 days. I was a study that was done in Enugu Nigeria. Enugu is a state in Easter Nigeria with a population of about 820 thousand people

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Bipolar disorders
Bipolar disorders along with Depression are classed together as mood disorders. There are pathological states in the mood. So the question is what is a mood? A mod is the prevalent feeling or emotion that can affect thought patterns and actions. The mood disorders are also called affective disorders

The adjectives used to describe moods such as happy, sad, joyful angry are used by both the patients and the clinicians.

Mood also has the characteristics of fluctuating, mood swings as the younger generations would call them, and can go from the positive to the negative.

In mood disorders, there are signs and symptoms that are used to characterise them. Clinicians will observe cognition, talking patterns and state of consciousness.

It is hard to imagine a disorder in this basic human function in a way that won't affect relationships at work, at home and among friends. Given that emotions were our first means of crying and laughing.

The general thought about mood disorders is that they are just an extension of normal emotions. But this could be the furthest from the truth because these conditions do not have the same features as normal emotions.

Classes of mood disorder
2 months ago, we talked about depression, among the types of depression is Major Depressive Disorder it is otherwise known as unipolar depression.

Patients who are bipolar have these major depressive episodes and manic episodes. People are said to have unipolar mania or pure mania if they are yet to have a depressive episode or simply do not have a depressive episode.

Hypomania is a mood disorder characterised by an episode of mania that does not meet the mania criteria.

Cyclothymia is like dysthymia they are lesser forms of Bipolar affective disorder.

Less than 30 years ago it was thought that Bipolar Affective Disorder and Depression were the same conditions, in fact, we are only really starting to take Bipolar Affective Disorder as an equally serious condition.

Many patients have been wrongly diagnosed with Major Depressive Disorder simply because their manic phases have gone recognised.

Some authorities rope the two disorders together. explaining that recurrent depression is in a spectrum with classic bipolar disorder, bipolar II.

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Fig 1 to 4.png
Top Left King Saul, Top Right Hippocrates Bottom Left Robert Burton Bottom Right Anatomy of Melancholy

King Saul's features in the bible, were typical of mood disorders when he would have David play for him in his palace. Homer's Iliad, an old greek poem, describes the events of Ajax's death by suicide.

Hippocrates made efforts to explain mania and depression since 400BCE he believed that depression was a result of black bile and he referred to a depressive state as Melancholic (meaning Black Bile).

The first person to describe depression in English text was done by Robert Burton. His book Anatomy of Melancholy dates back as far back as 1621.

A Bipolar case was described by Jules Falret in 1854 that included alternating between depression and manic mood. It was called folie circularie.

The German psychiatrist Karl Kahlbaum in the early 1880s first used the term cyclothymia to explain how mania and depression were the same conditions. At the end of that century, Emil Kraepelin built on the previous knowledge accessible to make the criteria that is still used for manic-depressive psychosis.

Kraepelin explained that if there was no reduction in the manic-depressive then it was clearly schizophrenia which at that time was called dementia precox. Kraepelin also talked about involutional melancholia mood disorders affecting older adults.

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Since the time of Kraepelin, there have been major developments in the characteristics, epidemiology and signs and symptoms of mental issues.

These studies have made clear the general and specific outlook of Bipolar I and II.

Bipolar disorder is a severe mental illness characterized by chronicity, multiple recurrent episodes, heterogeneity and significant impairment in family, social and
occupational functioning (Dunner & Fieve 1974, Fawcet et al. 1987, Keller et al.1986, Coryell et al. 1995,
Maj et al. 1989).

According to Murray and Lopez in 1996, it was rated as the 8th cause of disability. It is currently ranked as the 6th leading cause of disability.

In the Year 2000, it was found that there was an appreciable risk of substance abuse. This was the work of Thase and Salloun. While two independent studies also found the risk of suicide, these were by Koukoupulos et al 1980 and Baldesserani et al 2001.

When a patient presents with mania, they are more likely to be diagnosed properly when compared to other presentations for example if they present with depression.

In studies done in the US and UK, it was also found to be confused with schizophrenia.

Before 1994 many people were receiving the wrong treatment for their conditions.

Some studies done at the end of the 20th century in Nigeria showed mania in western and Nigeria and showed a high proportion among Yorubas.

This paper attempts to show the features of BAD in developing countries, using Enugu as a case study.

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Gerald Klerman (1928 to 1992) explained that the most important things in treatment are concentrated on there a few of the patient's interrelational problems. The first part of his theory is that the problems of the patient emanate from dysfunction in an initial relationship, the very early ones. The next is that these relationships may bring up current features of depression.

Interpersonal therapy has been having success in dealing with interpersonal relationships.

This form of therapy has been successful if used as the main psychotherapy.

The therapy comprises about 12 to 16 weeks of therapy in which active participation is required.

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Hive Stories

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People illustrations by Storyset

This is story of treatment and dealing with BAD and hw the treatment goes. @inber talks about therapy and illustration. I hope you enjoy this post.


  • What did you learn about mood disorders?
  • What did you learn about Bipolar disorder?
  • What's the most interesting aspect of this study?


This study was a very significant study that helped to bing light to the features of BAD in developing countries. History has show that BAD is a disabling condition. Hisotry has also shown the importance of these types of discussions.

I hope that you learned a lot from this post.

To book me for illustration gigs click Here



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I know this is a series. I noticed you had an image and a few paragraphs borrowed from your previous post and slightly reworded. How come? In them you talk about mythical and real characters who seemingly suffered from mood disorders, which is interesting.


Actually, it's the other way around as this is the older post.

It was an interesting piece I felt people should know about. I'll try to put more effort into editing it, remove the image, and refer people to the formal post for more information.