BIOLOGICAL APPROACH
This approach looks at the environment, individual choice, and genetics. An example of what the biological approach involves would be the case of the Pima Indians. Type II Diabetes has a high prevalence rate among the Pima Indians. In the past, the Pima Indians lived in severe poverty where they were malnourished. Their genes, as a result, began to mutate so as to store more fats and sugars. However this also caused them to be more susceptible to Type II Diabetes. This mutation kept being passed down which is why the Pima Indian population still have relatively high prevalence rates of Type II Diabetes (Karim, Lecture 2.2).
As stated in the Introduction, there are biological differences between those who have bipolar disorder and those who do not. Hormonal imbalances and abnormalities with neurotransmitters have been linked to causing and/or triggering bipolar disorder. It has also been found that bipolar disorder can be inherited, indicating that there may be a gene for it. Additionally, the environment one is in plays a pivotal role as well – a stressful life event could cause and/or trigger the disorder. The video above highlights those biological aspects of bipolar disorder.
Using the biological approach to understand bipolar disorder is necessary as bipolar disorder's etiology – although unclear – is largely explained by biological and environmental differences. Medical anthropologists should use this approach to ascertain what is bipolar disorder's etiology. By looking at individuals and their communities, they might be able to learn what are the patterns involved with its prevalence – especially with those who have inherited it. |
ECOLOGICAL APPROACHThis approach looks at how humans interact with their environment. It incorporates the political economy, the natural resources, plants and animals, the biophysical landscapes and factors those in when looking at illnesses. The ecological approach also places emphasis on maintaining homeostasis – or balance – between the environment and humans. Additionally, a big component of the ecological approach is adaptation, which is defined as "patterns of behavior which enables people to cope with its surroundings" (Karim, Lecture 2.1).
As adaptation is a large part of evolution, there have been some arguments being proposing that the genes that cause bipolar disorder may have some sort of evolutionary advantage. While having severe bipolar disorder would be a disadvantage, having mild bipolar disorder may result in being more social and productive, ergo increasing chances of reproductive success. This is kind of similar to sickle cell anemia where having one copy of the gene is more advantageous than having two. Having one copy of the gene would actually increase survival rates with malaria as sickle cell changes the shape of the red blood cells which malaria cannot get through. However, if you have two copies of sickle cell, it will result in debilitating and potentially fatal anemia (Karim, Lecture 2.1). The image above shows how bipolar disorder is distributed globally based on disability adjusted years (Wikipedia). Epidemiologists can use the ecological approach and maps like the one above to see if there is any significant with regards to bipolar disorder's prevalence rates based off of location. There was a study done by Health.com where it was found that the United States had the highest prevalence rate among the 11 nations looked at – it was 4.4% (Gardner). However, aside from that fact, the prevalence and incidence rates of bipolar disorder are very similar on a global scale (World Health Organization).
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A CASE STUDY
Zhang, Agius, and Zaman's case study of a patient with bipolar disorder ("Case Report Of A Patient With Bipolar Disorder - Migraines And Epilepsy") provides insight into the symptoms of bipolar disorder. Their specific case study focuses on an individual with bipolar disorder, migraines, and epilepsy – a combination that is quite rare to exist in one, single patient. Something interesting to note is that all three of these disorder's etiologies are unclear. The patient is a 41-year old male who has a long history with depression, mood instability, migraines, and seizures. As he was diagnosed with bipolar disorder, migraines, and epilepsy, he had a lot of difficulty managing his health – especially with all of the symptoms he would have. This case study highlights the measures that were taken to assist the patient in managing his illnesses, via the use of medication. As finding the right medication or combination of medications is difficult for those with bipolar disorder, one could expect it to be all the more difficult for someone suffering from bipolar disorder, migraines, and epilepsy. The case study also mentions how the presence of these disorders are exacerbating each other, which is causing additional problems. While this case is quite unique in that the patient is suffering from three disorders that very rarely are seen to exist together, I think this case study provides good insight into the difficulties involved with managing health.
CULTURAL INFLUENCE
As you may have already read above, there are biological and ecological components to bipolar disorder. Although, as aforementioned, its etiology is unclear. There is also a cultural component to this disorder. In the Health.com study where we learned that the United States had the highest bipolar rate among the 11 nations looked at, it is important to know that those numbers would be impacted by cultural factors. Sara Bodner, an assistant professor of psychiatry at the University of Miami Miller School of Science, said, "It could be genetics; it could be environment. It also could be the way individuals in different cultures are willing to respond to this kind of an inquiry. Cultural awareness plays a very big role in psychiatry. Some cultures have a huge reluctance to speak about psychiatric things" (Gardner). The weight bipolar disorder may or may not carry varies country to country. As bipolar disorder is recognized in the United States – though there still is a lot of stigma – it results in effective treatment and care. However, if bipolar disorder is not recognized, those individuals may not be getting the proper care that they require. Ergo depending on the culture one is from and its recognition of mental illnesses like that of bipolar disorder does have an impact on subsequent treatment and care.
Next is the Ethnomedical Approach! To learn more about it, click here.
Next is the Ethnomedical Approach! To learn more about it, click here.
REFERENCE(S)
Ayuso-Mateos, Jose Luis. Global Burden of Bipolar Disorder in the Year 2000. WHO. World Health Organization, 2000. Web. July 2014.
Bipolar Disorder World Map. Digital image. Wikipedia. Wikipedia, Web. July 2014."Bipolar Overview." YouTube. AnswersTV, 4 Mar. 2008. Web. July 2014.
Gardner, Amanda. "U.S. Has Highest Bipolar Rate in 11-nation Study." CNN. Cable News Network, 7 Mar. 2011. Web. July 2014.
Karim, Tazin. "Lecture 2.1 Ecology and Adaptation." ANP 204. Lecture Notes. July 2014.
Karim, Tazin. "Lecture 2.2 Race and Medicine." ANP 204. Lecture Notes. July 2014.
Zhang, Catherine, Mark Agius, and Rashid Zaman. "CASE REPORT OF A PATIENT WITH BIPOLAR DISORDER - MIGRAINES AND EPILEPSY." Psyhiatria Danubina 24 (2012): 109-11. 2012. Web. July 2014
Ayuso-Mateos, Jose Luis. Global Burden of Bipolar Disorder in the Year 2000. WHO. World Health Organization, 2000. Web. July 2014.
Bipolar Disorder World Map. Digital image. Wikipedia. Wikipedia, Web. July 2014."Bipolar Overview." YouTube. AnswersTV, 4 Mar. 2008. Web. July 2014.
Gardner, Amanda. "U.S. Has Highest Bipolar Rate in 11-nation Study." CNN. Cable News Network, 7 Mar. 2011. Web. July 2014.
Karim, Tazin. "Lecture 2.1 Ecology and Adaptation." ANP 204. Lecture Notes. July 2014.
Karim, Tazin. "Lecture 2.2 Race and Medicine." ANP 204. Lecture Notes. July 2014.
Zhang, Catherine, Mark Agius, and Rashid Zaman. "CASE REPORT OF A PATIENT WITH BIPOLAR DISORDER - MIGRAINES AND EPILEPSY." Psyhiatria Danubina 24 (2012): 109-11. 2012. Web. July 2014