Mental Health: Bipolar Disorder
Bipolar disorder is a mental illness that affects the abnormal functioning of the brain. This makes individuals to experience extreme shift in mood activity level, energy, and the capacity to carry out daily activities. Individuals may also experience psychosis in the maniac and depression phase. There are distinct types of bipolar disorder: bipolar 1 disorder, which is characterized by one or more mixed episodes, bipolar 2 disorder that is characterized by one or more major depressive episodes followed by not less than one hypomanic episode, and cyclothymic disorder that is characterized by at least two years of frequent hypomanic symptoms (Peacock, 2000, p. 4). Bipolar disorder runs in families and it is believed to be a genetic disease. Children with siblings or parents who have bipolar disorder may develop the illness four times their colleagues that do not have history of the disease. Bipolar disorder is enduring and recurrent illness. Individuals with the disorder need a long-term treatment in order to control symptoms of the disease. Effective maintenance treatment plan of bipolar disorder includes psychotherapy and medication. This prevents relapse and reduces symptoms severity (Peacock, 2000, p. 5).
Bipolar disorder is one of the oldest known mental illnesses. It was noticed as early as the second century. Aretaeus of Cappadocia came up with some symptoms of depression and mania and felt they could be linked to one another. The findings were substantiated in 1650 when Richard Burton wrote a book that focused on depression. In 1854, Jules Falret established the link between suicide and depression. His work led to the term bipolar disorder because he was able to differentiate between heightened moods and moments of depression (Meisel, 2011).
In 1875, Jules recorded findings that were termed as Manic-Depressive Psychosis. Francois Baillarger was able to characterize the depressive phase of bipolar disorder. His achievement permitted bipolar disorder to obtain its own classification from other mental disorder. In 1913, another scientist Emil Krapelin came up with the term manic-depressive, which highlights the effects of depression. This approach was accepted and it became the prevailing theory for bipolar disorder. Manic-depressive disorder was replaced by the term bipolar disorder in 1980. The 1980 research was able to make a clear distinction between childhood and adult disorder. The research is ongoing on how to treat the illness (Meisel, 2011).
Types of bipolar disorder
According to Sorento (2013), bipolar disorder can be classified into bipolar 1 disorder, bipolar 2 disorder, and cyclothymic disorder.
Bipolar 1 disorder. An individual suffering from this illness has at least one manic episode. A manic episode is a period of abnormally elevated mood that is usually accompanied by abnormal behavior that disrupts life. There is always a pattern of cycling between depression and mania.
Bipolar 2 disorder. Patients suffering from bipolar 2 disorder suffers from at least one hypomanic episode and episodes of depression. The moods cycles between high and low over time. The up moods do not reach full on mania.
Cyclothymic disorder. It causes emotional vicissitudes but they never reach the severity of mania. The mood swings from mild depression to hypomania.
The mania symptoms of bipolar disorder are delusions and hallucinations, increased mental and physical activity, and reckless behavior. In addition, the mania symptoms are aggressive behavior, excessive irritability, decreased need for sleep, grandiose delusions, poor judgment, and impulsiveness (Hukic et al. 2013).
Even though hypomania or mania are the defining characteristics of bipolar disorder, right through the course of the disease depressive symptoms are more pronounced than manic symptoms. Individuals suffering from bipolar disorder spend a good amount of their time suffering from syndromal depressive symptoms. Major depressive episodes in bipolar disorder are the same as those experienced in unipolar major depression. In most cases, patients suffer from depressed mood. They experience profound loss of interest in activities. This is usually coupled with symptoms such as weight loss or gain, fatigue, excessive guilt, suicidal thoughts, feelings of worthlessness, psychomotor slowing, and difficulty in sleeping (Hukic et al. 2013).
Treatments for Bipolar Disorder
The treatments for bipolar disorder are aimed at reducing the severity and frequency of the episodes of mania and depression in order to allow the patient to live a normal life. The most common treatments are medication and psychotherapy.
A number of people with bipolar disorder are in need of medication in order to keep their symptoms under control. Continuous medication reduces the severity and frequency of mood episode. In some cases, it can prevent mood episodes completely. A number of medications that can help to stabilize mood swings for individuals suffering from bipolar disorder exist. The most common ones are antipsychotic medicines, anticonvulsant medicines, and lithium carbonate. The episodes of depression in bipolar disorder are treated just like clinical depressions.
Lithium carbonate. It is the most common medication for treating bipolar disorder. Lithium is the long lasting technique for treating depression, mania, and hypomania. It is prescribed for a minimum period of six months. For this medication to be effective, the dosage has to be correct. Incorrect dosage has a numerous side effects.
Anticonvusalant medicines. They include lamotrigine, carbamazepine, and valproate. They are long-term mood stabilizers. Valproate is a genetic term that is used to describe different formulations of valproic acid. It is a mood stabilizer and helps to treat manic or mixed phases. Carmazepine is only prescribed after permission from the doctor. Patients start with low dose before it is gradually increased. Lamotrigine is administered to prevent recurrences of either depressions or manias.
Antipsychotic medicines. They are prescribed to treat episodes of mania or hypomania; they include olanzapine, risperidone, airipiprazole, and questiapine. Mania can develop very fast and give rise to risks that harmful to the patient and others around. When mania is in its severe form, Antipsychotic medicines are used because they are antimatic.
It is the most essential part of treatment for a number of people severing from bipolar disorder. When the depression is classified as mild to moderate, psychotherapy can work alone. A good therapist can help individuals with bipolar disorder to modify emotional or behavioral patterns that are contributing to the illness. The most common therapies that can be used to treat bipolar disorder are Prodrome Detection, Psychoeducation, Cognitive therapy, and Play therapy
Prodrome Detection. It was developed by Dr. Perry and can be used to avert and reduce the number of manic episodes. The therapy begins by asking patients to identify early warning signs in the previous episodes. Prodrome detection involves ruminating thoughts and sporadic sleep. After the prodromes are identified, they are written on laminated card. The patient is required to carry it all the time. A copy provided to the treatment team. A plan action is instituted and contractual agreement is made to implement the plan the emergence of prodrome symptoms. A journal is kept with increased writing assignments around the time that lead to the first signs. This form of treatment may not be effective because episodes occur with little or no warnings. What is more, patients abandon the therapy once they feel better.
Psychoeducation. Clinicians assert that patients with bipolar disorder need to be given accurate information regarding their diagnosis, prognosis, and treatment. Psychoeducational intrusions can be offered in various ways. This can be to individuals, families, or group of professionals. Media devices such as radio, television, and online delivery can be used to maximize the impact. This can also be done to increase the retention of material. In individual psychoedcuation therapy, participants are subjected to between 7 and 12 sessions that involve teaching them how to identify prodromal symptoms of manic relapse and depression. Family-focused psychoeducation involves putting patients on a 21 one-hour session that is delivered over nine months. The therapy comprises of three consecutive models.
The first step involves 7 sessions that focuses on signs and symptoms of the disease or illness, the aetiology of the disease, and the growth of strategies to prevent relapses. The second step is communication improvement training. There are between 7 and 10 sessions administered using role-play. Between sessions, patients are thought active listening skills. The last step is problem-solving training. It comprises of between 4 and 5 sessions. Participants are required to specify family problems that may be part of the relapse. They are encouraged to develop effective skills for that enable them come up with solutions to their problems.
Cognitive therapy. The goal of this therapy is to help patients with bipolar disorder to gain a new outlook on their condition by challenging fears and negative thoughts. A short-term therapy focuses on eliminating specific problems. Both the patient and the therapist contribute. Normally, thoughts influence feelings. Distorted thoughts lead to problematic moods, emotions, and behaviors. Patients are thought how to get rid of these thoughts. They are also offered with strategies that can promote effective problem solving. Cognitive therapy presents mindlessness technique, which allows patients to gain some distance from negative thinking.
In the cognitive therapy patients are taught how to re-enter some situations that they may been avoiding for a long time. Any activity that offers pleasure or mastery is planned. Patients are also trained on new skills such as assertiveness and social interaction. In order to contain they feelings, patients are thoughts how to tolerate or accept painful emotions. In addition, they are taught strategies for managing extreme emotional reactions (Sorrento, 2013).
Play therapy. This form of therapy is common for children suffering from bipolar disorder. Young patients are allowed to express their emotions, desires, and fears in play. Therapists help children to enhance their skills in perception, interpersonal relationships, mood, and attention. Many tools can be used in play therapy. The most common one is floor-time therapy. In this therapy, structure play sessions are created for parents to play with their children. It helps to overcome deficits in relatedness and attention (Sorento, 2013).
The most preferred treatment for treating bipolar disorder is psychotherapy.This is because it has few physiological side effects. This makes the treatment essential for older adults who are already taking other medications.In addition, Psychotherapy provides the prospect of effective treatment for patients that have responded slowly to medications. Psychotherapy enhances family and interpersonal relationships affected by illness. It also promotes higher functional achievement. Psychotherapy offers a more effective identification and management of adverse effects of medication that may tend to limit its acceptance. With psychotherapy, it is very easy to detect early signs of impending illness. Psychotherapy offers improved skills that are aimed at minimizing stressors that contribute to recurrence risk. In contrast, psychotherapy takes very long time to produce the intended benefits when compared to drug therapy. In addition, it is not effective for patients with severe depression.
is mental illness that is characterized by depressed mood most of the day. This
can be indicated by subjective report or observation made by others. it is also
characterized by markedly diminished interest or pleasure in all or almost all
activities of the day indicated by either subjective account or observation
made by others and significant weight loss even when not dieting or weight
gain. This is indicated by decrease in appetite nearly every day. The other
signs are insomnia or hypersomnia every day, psychomotor agitation or
retardation every day, fatigue or loss of energy nearly every day, feelings of
worthlessness or excessive guilt, diminished ability to think or concentrate,
and recurrent thoughts of death. The most preferred treatment of bipolar
disorder is psychotherapy. The most common therapies that can be used to treat
bipolar disorder are Prodrome Detection, Psychoeducation, Cognitive therapy,
and Play therapy. Psychotherapy has some few side effects.
Hukic, D., Frisén, L., Backlund, L., Lavebratt, C., Landén, M., Träskman-Bendz, L., & … Ösby, U. (2013). Cognitive Manic Symptoms in Bipolar Disorder Associated with Polymorphisms in the DAOA and COMT Genes. Plos ONE, 8(7), 1-7. doi:10.1371/journal.pone.0067450.
Meisel, A. (2011). Investigating depression and bipolar disorder: Real facts for real lives. Berkeley Heights, NJ: Enslow Publishers.
Peacock, J. (2000). Bipolar disorder. Minnetonka, MN: Life Matters.
Sorento, M. (2013). Bipolar Disorder: Everything You Need to Know about Bipolar Disorder. Bloomington, IN: Booktango.