Bipolar Disorder Archives - Page 5 of 10

Thesis Statement for Bipolar Disorder

Posted on December 15, 2024 | by Laureen

Part 1. Literature Review and Ethical Considerations

Article One: Treatment outcomes of an acute bipolar depressive episode with psychosis (Marco Antonio Caldieraro MD, PhD1,2, et al., 2018)

The research by Caldieraro et al. was designed to study the impact of psychosis on patients with bipolar disorder (Caldieraro et al., 2018). The researchers conducting the interview also wanted to compare the use of lithium and quetiapine in the psychotic subgroup (Caldieraro et al., 2018). The methodology of finding the participants was designed to keep the inclusion and exclusion to a minimum as the participants had taken part in the Bipolar CHOICE study (Caldieraro et al., 2018). The independent variable in the study was the addition of the medication to the patient, the dependent variable was the observed positive or negative effect on the patient (Caldieraro et al., 2018). The hypothesis of the study was to see if there was a change in the symptoms of those patients with bipolar, and those with bipolar and exhibiting psychotic features at the present moment (Caldieraro et al., 2018). The researchers decided that the study would need to be replicated with a higher number of participants displaying current psychotic features (Caldieraro et al., 2018).

Article Two: Psychopharmacological treatment of psychotic mania and psychotic bipolar depression compared to non-psychotic mania and non-psychotic bipolar depression (Bjørklund et al., 2016. )

The research by Bjorklund et al., 2016 was designed to see if the psychopharmacological treatment of non-psychotic and psychotic episodes of bipolar depression and mania varies in clinical practice (Bjorklund et al., 2016). The researchers conducted a register-based survey that sought out people with their first diagnosis of mania or bipolar depression between the years 2010-2012 (Bjorklund et al., 2016). The independent variable was the psychopharmacological treatment given within the first three months of the diagnosis (Bjorklund et al., 2016). The dependent variable was the variance in treatment at the clinical practice the patient was seen (Bjorklund et al., 2016). The researchers concluded that more studies to see if antipsychotics would be the better choice for the treatment of bipolar depression and mania (Bjorklund et al., 2016).

Article 3: Anti-inflammatory agents in the treatments of bipolar depression: a systematic review and meta-analysis (Rosenblat JD et al., 2016).

The design of the study was which was qualitative and quantitative to see if anti-inflammatory agents play a role in the treatment of bipolar depression (Rosenblat JD et, al., 2016). The data was collected from a variety of online databases and clinical trials (Rosenblat JD et al., 2016). The independent variable was the information collected that used the anti-inflammatory agents and the dependent was the placebo group (Rosenblat JD et al., 2016). The conclusion of the research was that more needed to be done but there was an overall increase of depression in patients that used the anti-inflammatory markers compared with those that used standard therapy as the adjunct.

Article 4: A re-examination of antidepressant treatment-emergent mania in bipolar disorders: evidence of gender differences (Scott J. et al., 2017).

The design of the study was to explore the clinical and prevalent profiles of females and males who develop emergent mania through antidepressant treatment (Scott J. et al., 2017). The research had a random group and a control group that was taken from an original sample of 754 (Scott J. et al., 2017. The research found that 87% of the cases they worked with, which was whittled down to 75, have antidepressant treatment-mania emergent (Scott J.et al. 2017). The study also saw that the cases varied from male to female (Scott J. et al., 2017). There was also a need to examine the history of suicide attempts, alcohol/drug abuse, thyroid, and family history (Scott J. et al., 2017).

Part 2:

For the first study, the researchers had to take into consideration many factors. Particularly Principle B. Fidelity and Responsibility (Nestor and Schutt, p.61, 2015). Principle B. Fidelity and Responsibility states, “Psychologists uphold professional standards of conduct, clarify their professional roles and obligations, accept responsibility for their behavior, and seek to manage conflicts of interest that could lead to exploitation or harm” (Nestor and Schutt, p.61, 2015). They had to make sure that no subjects would be negatively affected by taking the medication they wanted to study, and if they were, they would need to be taken off the medication immediately.

I believe they did take consideration as the participants had been part of the bipolar CHOICE study. The bipolar CHOICE study was, “Bipolar disorder is among the 10 most disabling medical conditions worldwide. While lithium has been used extensively for bipolar disorder since the 1970s, second-generation antipsychotics (SGAs) have supplanted lithium since 1998. To date, no randomized comparative-effectiveness study has compared lithium and any SGA. Method: Within the duration of the study (September 2010-September 2013), participants with bipolar I or II disorder (DSM-IV-TR) were randomized for 6 months to receive lithium (n = 240) or quetiapine (n = 242) (Andrew A. Nierenberg et al., 2019). There is a significant need for more research on bipolar disorder, and I think this study took care to take ethical considerations.

The second study also had to follow similar ethical guidelines. I feel that they took into consideration the subjects, as it was a study to see if the treatment varied in clinical practices. It appears to me that the study would benefit patients, current or the future. On the American Psychological Association website, they made an amendment to Section 8: Research and Publication. The amendment states, “8.14 Sharing Research Data for Verification

(a) After research results are published, psychologists do not withhold the data on which their conclusions are based from other competent professionals who seek to verify the substantive claims through reanalysis and who intend to use such data only for that purpose, provided that the confidentiality of the participants can be protected and unless legal rights concerning proprietary data preclude their release” (www.apa.org, 2019). Psychologists are made to share information that is critical and relevant, and I believe this study did just that for the future advancement of the treatment of bipolar.

The third research article had to take into consideration the use of an anti-inflammatory agent, and the use of a placebo (Rosenblat JD et al., 2016). I believe that this falls under Principle C. Integrity which states, “Psychologists seek to promote accuracy, honesty, and truthfulness in the science, teaching, and practice of psychology. In these activities, psychologists do not steal, cheat, or engage in fraud, subterfuge, or intentional misrepresentation of fact (Nestor and Schutt, p. 61, 2015).

I could see how, as a researcher, it may be somewhat tempting to want to alter the outcome to be the desired effect of one’s hypothesis. The idea behind any research is to potentially increase the success rate of the people affected by the illness or disorder. It needs to be a very ethical team, that conducts studies, to protect the validity of the research and makes sure that all the results are shared truthfully and honestly.

The fourth research article, which I found the most fascinating, had to take serious ethical considerations. Nestor and Schutt share in chapter two that randomness is a process of chance or luck (Nestor and Schutt, p. 11, 2015). The research needs to, “ use a legal analogy, the burden of the researcher is to prove that the phenomenon under the study is unlikely due to chance” (Nestor and Schutt, p. 11, 2015). For Scott J et al the mission of the study was to determine if mania stemmed from the use of an antidepressant (Scott J. et al., 2017). I imagine that is a challenging experiment. The researchers have to monitor the subjects closely in an effort to make sure there are no additional unsettling repercussions.

This study really made me think as if I was a person that experienced a severe manic episode after a change in my medication. I was not part of a research study but the doctor I was seeing at McLean Hospital really seemed to push for this one medication. There was really no need to change the medication I was on, yet he seemed driven by it. When I wound up back in an inpatient unit, the doctors at the hospital got access to my medical records. The doctor had indicated that I was displaying signs of mania and disconnect from reality, but he made no changes in my medication. While reading chapter three something really stood out to me. “causality requires the elimination of alternative explanations. In other words, a researcher must show that nothing other than the identified causal variable could be responsible for the observed effect-that is, there is no other plausible explanation for the relationship” (Nestor and Schutt, p. 26, 2015). It has become clear to me that the need for ethical review in all cases is critical. I can see how necessary it was in the fourth study, and how I wish it had been taken for me.

Part 3:

For my research proposal, I would like to learn more about the treatments used in bipolar disorder, and the genetic factor of being a female. I have read a lot about bipolar disorder, and the birth of my child brought the disorder to the forefront of my being. Looking back at my life, when I first had my period things began to shift. It was the huge hormonal shift in my body that made things change for me.

In my head, the design of my study would be a random selection of females within the therapeutic practice I use. It is located in Newton MA, so the reach of the geographical location and the ages and ethnicities will be varied. In a perfect world, I would be able to reach a large population of women, to get the best possible outcome for my research.

I want to explore the use of drugs that are used for patients with bipolar, particularly the drugs Depakote and Lamotrigine. “Depakote (divalproex sodium) is also used to treat manic episodes associated with bipolar disorder, and migraine headaches” (www.rxlist.com, 2019). Lamotrigine “Lamictal (lamotrigine) is an anticonvulsant used alone or in combination with other antiseizure medications for treating certain types of seizures (www.rxlist.com, 2019). Both drugs are used in the treatment of bipolar and both have great success or create adverse reactions.

I want to take a survey of what medication is primarily used, and if the positive verse negative results were immediate or took weeks to appear. Asking these questions will require me to be very ethical in my study. I carry biased against one of the medications due to my personal experience with the drug. On the other hand, I am very curious if people had a good or bad experience in their treatment.

One of the main reasons I would want to conduct this study is to narrow down if there is a similar component in women that have an adverse reaction to Lamictal. Is there a similarity that all the women have that makes the drug work against their body chemistry, or is it a completely random case? To me, this seems fascinating.

Principle D. Justice states, “Psychologists exercise reasonable judgment and take precautions to ensure that their potential biases, the boundaries of their competence, and the limitations of their expertise do not lead to or condone unjust practices” (Nestor and Schutt, p. 61, 2015). I will really need to check my biases walking in, and just gain and study the information required for an informative response. The most important thing would be for me to see if there is a similar genetic trait, similar life stressors, or if it is a completely random effect of the medication.

It really is something I am very curious about and I would love to be part of a research study that gains more information. One of the things that I noticed in reading all the research studies was that there is a clear need for more research on bipolar. I would love to be part of a study that looked at hormonal shifts, childbirth, and any other huge mitigating factors that affect a person with bipolar disorder. I truly believe knowledge is power and I would like to be able to provide more knowledge to the people affected by this disorder.

Reference:

Bjørklund, L. B., Horsdal, H. T., Mors, O., Gasse, C., & Østergaard, S. D. (2017). Psychopharmacological treatment of psychotic mania and psychotic bipolar depression compared to non-psychotic mania and non-psychotic bipolar depression. Bipolar Disorders,19(6), 505-512. doi:10.1111/bdi.12504
Caldieraro, M. A., Dufour, S., Sylvia, L. G., Gao, K., Ketter, T. A., Bobo, W. V., . . . Nierenberg, A. A. (2018). Treatment outcomes of the acute bipolar depressive episode with psychosis. Depression and Anxiety,35(5), 402-410. doi:10.1002/da.22716
Ethical Principles of Psychologists and Code of Conduct. (n.d.). Retrieved June 6, 2019, from https://www.apa.org/ethics/code/
Friedly, J., Bauer, Z., Comstock, B., Dimango, E., Ferrara, A., Huang, S., . . . Smith-Bindman, R. (2014). Challenges conducting comparative effectiveness research: The Clinical and Health Outcomes Initiative in Comparative Effectiveness (CHOICE) experience. Comparative Effectiveness Research,1. doi:10.2147/cer.s59136
Lamictal vs. Depakote: Differences & Side Effects. (n.d.). Retrieved June 29, 2019, from https://www.rxlist.com/lamictal_vs_depakote/drugs-condition.htm#what_is_lamictal
Nestor, P., & Schutt, R. K. (2015). Research methods in psychology: Investigating human behavior. Thousand Oaks, CA: SAGE Publications.
Rosenblat, J. D., Kakar, R., Berk, M., Kessing, L. V., Vinberg, M., Baune, B. T., . . . Mcintyre, R. S. (2016). Anti-inflammatory agents in the treatment of bipolar depression: A systematic review and meta-analysis. Bipolar Disorders,18(2), 89-101. doi:10.1111/bdi.12373
Scott, J., Brichant-Petitjean, C., Etain, B., Henry, C., Kahn, J., Azorin, J., . . . Bellivier, F. (2017). A re-examination of antidepressant treatment-emergent mania in bipolar disorders: Evidence of gender differences. Acta Psychiatrica Scandinavica,135(5), 479-488. doi:10.1111/acps.12728

Narrative Essay on My Sister and Her Bipolar Disorder

Posted on December 15, 2024 | by Laureen

Bipolar disorder or manic-depressive disorder are terms that we hear in the media or possibly even from an acquaintance who is talking about knowing someone who has it. This disorder is characterized by extreme mood swings and changes in energy levels. This is a form of mental illness that affects not only the person who has it but also the people that live with the individual. I know this firsthand because my sister has bipolar disorder.

My sister has been seeing a psychiatrist regularly since the age of 12. She tended to always be somewhat emotional and impulsive as a young child. As she got older and started middle school, her outbursts increased and became very aggressive. I would dread the mornings. I would try to get up before everyone else and leave early for school to avoid the morning tantrums, as I would call them. My sister had great difficulty getting ready and functioning some days and would literally lay on the floor screaming while my parents would take turns trying to help her to be able to face the day. My mom is a therapist, so she was usually the one that my sister would respond to best. I could, however, see the toll it was having on my mother and how tired she often looked. I was powerless to help my sister or my parents, and the only thing I could do was pray that today would be one of the better days and she would be able to get on the bus without a scene. As she got into high school, we would often hear her up at all hours of the night arranging her room in different ways or vacuuming.

Thankfully, my sister sees a psychotherapist regularly, and her mood cycles have stabilized with medications and talk therapy. She has had significant improvements in her functioning level, but I would not consider her anywhere close to ‘cured’. She takes medicine to control the mood swings, but she still experiences manic episodes, or high swings as we call it in my household. This is when things become very tense with my parents and my sister. Because there is no rationalizing with her at all when she is manic. My sister becomes very defensive and anything I try to discuss with her she takes as a personal attack and becomes very aggressive. She usually doesn’t remember how bad she gets when she is in this ‘high’ state. I usually just spend a lot of time in my room to avoid conflict with her. Then there is the downswing period. This is when she has trouble getting out of bed and showering. These are the times that she often cries and tells us how much she loves us and will try to not do the things that she does to hurt us anymore. I began to realize that this illness that had such control over my sister also somewhat defined my life on a lesser scale.

I am looking forward to going away to college. I sometimes feel guilty about this. I want a life without mental illness, without the emotions of confusion and pain that my sister’s episodes brought to me. I realize I can be supportive from afar. At times I found myself feeling resentful of all the attention she required from my parents to help her to manage symptoms. I would also experience waves of anxiety. My family always gave 100 percent. One of my parents was always at my baseball games, and they never missed a parent-teacher conference. We had family vacations, and they did their best to instill morals and values in both of us. She just always required more.

I have witnessed my parents go through their own stages of grief, experiencing guilt, blame, and eventually acceptance of the illness. I was placed into therapy at a young age to help me to get through this process and make it out with minimal damage. I heard the statement ‘It’s a disease, it’s not her fault’ hundreds of times. Thankfully, my parents were smart enough to realize the impact on the ‘healthy child’, and that was me. I worked hard at understanding and processing my feelings in regard to witnessing my sister losing herself at times. My sister was supposed to be the one whom I played games with, socialized with, and who at times would be there for me while going through milestones together. Instead of this happening, I watched my sister’s mental functioning deteriorate.

I used to wonder if my experience should really matter since it was my sister that was the one going through the daily struggles to function. I have come to realize that I have gone through some devastating situations, no matter to what degree, and I have been changed by them. Over time, I have learned that I cannot judge or ignore my own feelings. I am learning self-acceptance and that means the scars too. My one hope I still have is that one day this illness will allow me to have the healthy, supportive brother and sister relationship that I still wish for.

Essay on Bipolar Disorder Case Study

Posted on December 15, 2024 | by Laureen

It is extremely common for patients with mental health conditions to present in acute settings rather than specialty mental health settings with acute or chronic general medical illnesses. With a collaborative multidisciplinary team approach and with proper screening and treatment, successful outcomes for those patients in an acute care setting are becoming an increasingly more standard practice. (Cerimele et al., 2014)

Patients with serious mental health illnesses often experience excessive morbidity and mortality rates compared to the general population. Bipolar sufferers are twice as likely to experience a stroke, 1.6 times more likely to develop ischaemic heart disease, and 1.3 times more likely to have hypertension. As a nurse working in an acute care setting, it is important to assess both the patient’s physical and mental health needs equally and promote healthy living activities. (Howard & Gamble, 2010)

Mr. Walter Reed is a 69-year-old man who presented to the emergency department confused. Mr. Reed’s medical history included bipolar disorder, type 2 diabetes, and hypertension. After a thorough investigation, Mr. Reed was found to have raised serum creatine clearance. Mr. Reed’s current medications on admission were:

Lithium Carbonate, extended-release, 600mg orally, BD
Metformin, extended-release, 1000mg, daily
Candesartan 16mg orally, daily

Mr. Reed was admitted to the medical ward and Lithium was ceased due to raised serum creatine clearance and for renal function to stabilize. Mr. Reed was commenced on quetiapine once daily starting at 50mg to be titrated over time to 300mg daily. 3 weeks post-admission, Mr. Reed’s mood has deteriorated, and he has developed poor sleep patterns, decreased appetite, low mood, and has been neglecting daily activities such as showering. Mr. Reed has been spending most of the day in bed and states to the nurse he has been having suicidal thoughts and has been hoarding his night-time medications with the intent to overdose. Mr. Reed is showing signs of depression symptoms which is also a symptom of bipolar disorder.

Bipolar sufferers experience repeated episodes of high, elevated moods (mania) and episodes of low mood (clinical depression). These episodes can last days or weeks and interfere with how the person acts, thinks, and feels both physically and emotionally. In turn, this can interfere with a person’s safety, daily living needs, work, or study commitments, and relationships. (Black Dog Institute, 2019) A person suffering a depressive episode may experience changes including:

Low mood – sadness, irritability, tearfulness
Loss of interest in activities previously enjoyed
Loss or gain of appetite – eating more or less than usual, losing or gaining weight without trying.
Sleep pattern changes – sleeping for more periods of time, especially during the day, or trouble falling asleep and insomnia.
Lack of motivation and energy.
Feeling hopeless and worthless.
Poor concentration and memory.
Self-harm or suicidal thoughts. (Hungerford, Hodgson, Clancy & Mon., 2016)

Mr. Reed is experiencing a depressive low, likely from medication changes, and he has not been taking his medication, length of stay in the hospital, relationship breakdown with his wife, and symptoms of bipolar disorder. Healthcare workers are required to respond to mental health deterioration. This can be done in many ways which may include:

Addressing patients’ needs – physically and mentally may include the well-being of family members as well.
Increased frequency and/or level of nursing observations.
Support and encouragement to the patient to manage their own mental state.
Completion of the MMSE. – a short questionnaire used to measure cognitive impairment. K10 – a tool used to measure psychological distress. DASS 21 – a tool used to measure signs of depression
Continuous monitoring by health staff
Further assessment by a mental health clinician
Use of additional PRN medications to treat symptoms. (Hungerford, Hodgson, Clancy & Mon., 2016)

Medication along with psychotherapy is an effective first-line treatment for bipolar disorder. Medications are used to treat episodes of depression, mania, or hypomania and can prevent these episodes from happening again. Mood-stabilizing medications can include lithium, sodium valproate, carbamazepine, or lamotrigine. If the person experiences psychotic symptoms such as hallucinations and delusions, they may require antipsychotic medications such as risperidone, quetiapine, or olanzapine. Antidepressant medication may also be prescribed to manage episodes of depression or suicidal thoughts. (Health Direct, 2019)

Mr. Reed was commenced on quetiapine due to lithium affecting the kidneys and contributing to reduced kidney function with long-term use. Excessive lithium use is contraindicated in patients with renal impairment and cardiovascular disease. As an alternative, quetiapine is the second-line maintenance drug after lithium for the long-term maintenance treatment of bipolar disorder. Quetiapine frequently causes drowsiness and can aid in Mr. Reed’s insomnia at night time, in turn assisting with proper sleep-wake cycles. (Post, 2017)

Psychotherapy has been proven to increase mood stability, improve functioning, and fewer hospitalizations. Therapeutic interventions commonly used for bipolar disorder include cognitive behavioral therapy, family-focused therapy, psychoeducational, and interpersonal and social rhythm therapy (IPSRT). IPSRT primarily focuses on three areas: psychoeducation, particularly the understanding of the illness and the medication roles, lifestyle rhythms that encourage regular sleep, activity, and exercise, and interpersonal therapy to encourage the person to be aware of the connection between interpersonal conflict and mood dysregulation. (Ruegg, Watson, DelBello, Adler & Rodrigo Patino Duran, 2018)

Mr. Reed may be involved in behavioral and cognitive therapies that include education, relaxation exercises, coping skills training, stress management, or assertiveness training. The patient would learn these skills within an individual or group setting and be encouraged to practice skills learned outside the therapy setting. (Ruegg, Watson, DelBello, Adler & Rodrigo Patino Duran, 2018)

Mr. Reed’s wife, other family members, or close friends may be invited to attend therapy sessions. This would provide support and encouragement to the patient and assist loved ones to learn coping skills which could assist them as well. Family therapy can assist those caring for Mr. Reed to understand his condition, solve problems and cope constructively with the patient’s illness. Family therapy may assist with communication and repair relationships. (Ruegg, Watson, DelBello, Adler & Rodrigo Patino Duran, 2018)

Culture has an important role in how a person talks about their mental ill-health. It contributes to how and where a person seeks help and from whom, family, friends, or professionals. When assisting someone outside your own culture and beliefs, it is crucial you consider the spiritual or cultural contexts of a person’s behaviours. Being culturally aware will assist the person how to understand mental ill-health. Patient commitment and informed decision making are crucial for health and mental health communication, regardless of ethnicity. Providing adequate information and support to patients increases patient participation and improves treatment outcomes. The staff involved in Mr. Reed’s care needs to be mindful of his culture, social and family context, his explanatory models, his perception of the health professional, and the stigma associated with mental illness. (Kiropoulos, Blashki & Klimidis, 2005)

Bipolar disorder can be an isolating and challenging illness. Caring for someone with bipolar disorder requires an understanding of the person’s triggers, providing the best treatment options and methods of preventing relapse, reducing probable negative consequences and providing tools and constructive strategies to enable the person, and their family to cope with the impact of the disease on their daily lives. (Health Direct, 2019)

The major factors for living with mental illness for Mr. Reed and his wife include distress from symptoms:

Fear/anxiety/worry – Mr. Reed may be experiencing these symptoms due to the changes in his healthcare routines. Eg. Medications, new general health issues and exacerbation of mental health issues.
Lack of energy or motivation – a common symptom of depression however Mr Redd is not taking his medication which could be causing these symptoms to become worse.
Loss of control – Mr. Reed could be feeling this way due to being in hospital. Patients often report feeling this way due to health professionals making decisions about their health care without consulting them.
Symptom control/management – Due to not taking his prescribed medications and lack of psychology input Mr. Reed has no coping strategies in place to deal with symptoms.
Medication changes, and the side effects that come from that – Mr. Reed’s medications were changed from Lithium to Quetiapine. Mr. Reed may not understand the reason why this has had to happen. Education regarding medications is very important to ensure patient compliance.
Relationship breakdown – Mrs Reed is visibly stressed, and Mr. Reed can see that. This would put a lot of strain on their relationship and breakdown trust and communication between them. Both Mr and Mrs Reed require some supportive services.
Prolonged hospital admission – being in hospital for long periods of time can affect a patient mentally and physically. Hospital admissions also affect the carer as their routines are disrupted to visiting their loved one each day.
Financial worries – perhaps Mr. Reed is unable to work, and Mrs Reed can only work part-time so his wife can be available to care for her husband and poor self-esteem and self-acceptance.

Health professionals are governed by codes of practice that specify they practice in a lawful way and within the rules of ethical conduct. These include the Australian Association of Social Workers, 2008; Australian Nursing and midwifery council, 2008a, 2008b; Australia Psychological Society, 2007. Health professionals should include in their practice style principles of truthfulness, equity and equality, respect and dignity, sanctity and quality of life and privacy and confidentiality. (Hungerford, Hodgson, Clancy & Mon., 2016)

The Mental Health Act provides people with mental illness the right to autonomy, freedom and self-determination, and how we provide the least restrictive health care. The Mental Health Act provides protection to individuals and the community ensuring their rights are observed, and they have access to the appropriate care. (NSW Legislation, 2008)

The Mental Health Act provides health care agency’s guidance concerning the treatment and care of their patients and involvement of carers. This includes assisting people with a mental illness to continue living, working and participating in the community. This happens by involving patients in their treatment plans and plans for ongoing care, using medication for therapeutic effect rather than punishment or restraint, ensuring the rights of carers by keeping them informed. (NSW Legislation, 2008)

The Mental Health Act also recognises the patient’s age, gender, religious, cultural and language needs and ensures health professionals respect cultural needs without bias or stigma. (Directory et al., 2019)

Mr. Reed and his wife will have a range of needs that may be social and psychological meaning they will require access to doctors, nurses, psychiatrists, psychologists, social workers, occupational therapists and other therapists and the carer. The multidisciplinary team can provide continuity of care, present various skills, education, and support whilst providing a holistic view of Mr. Reed’s care needs. (Hungerford, Hodgson, Clancy & Mon., 2016)

Mr. Reed’s doctor and psychiatrist would work together to ensure that medications are correct and effective for any mental health and general health issues. Some medications may interact poorly together, this may require the input of a pharmacist as well to ensure the correct dosages and medications are being prescribed safely. The psychologist has the expertise to assess psychological functioning and can deliver therapies to Mr. Reed and his wife to assist with coping skills and build a stronger relationship. (‘Multidisciplinary Team Care – HealthOne NSW’, 2019)

Nurses both in the acute setting and in the community can provide support to both Mr. Reed and his wife, advocate for the patient were required, administer medications and monitor their effectiveness or side effects, assist with daily living activities and educate Mr. Reed and his wife on his condition. (‘Multidisciplinary Team Care – HealthOne NSW’, 2019)

Social workers would assess Mr. Reed and his wife’s needs regarding services required and arrange for the appropriate assessments to take place e.g., ACAT assessment due to his age of 69 to access services such as ITACS or community nursing. Social workers can also provide information about financial assistance available and assist to complete applications. Occupational therapists would assist in the rehabilitation of Mr. Reed by assessing his functional abilities in areas such as social skills or the ability to perform everyday tasks. Occupational therapies can provide individualized programs to help. They may also assist in the procurement of any equipment required for discharge to assist with completing daily tasks. (Hungerford, Hodgson, Clancy & Mon., 2016)

To conclude, Bipolar Disorder exists and is an issue worth focusing on. It affects people from varying backgrounds, cultures, professions, and philosophies – and it affects various – if not all – aspects of their life, as well, almost always in a detrimental way. It can keep a person from sleeping well at night, from eating and interacting with people, from doing things they enjoy, and even things they have to do – like going to work and other responsibilities. What is most tragic about Bipolar Disorder is the fact that it can occur suddenly and without any warning – it just happens. Nothing, in particular, may trigger it. Bipolar Disorder doesn’t discriminate by wealth, ethnicity, and religious creed.

Treatment for Bipolar Disorder Essay

Posted on December 15, 2024 | by Laureen

Introduction

Adam dropped out of school at 19 years old to join the music. He traveled the country with his music band. In his twenties, he met his wife when h but the marriage did not last for long. Adam has been drinking excessively and suffers from long periods of depression, has been unemployed for three and a half years. Tom, who loves his father, Adam, is reluctant to visit because he feels nervous staying overnight, especially when his father has been drinking excessively, and is occasionally aggressive in his manner. Adam was referred by his GP for psychiatric assessment. He has been diagnosed as Bipolar. He now has a key worker called Patrick, who intends to refer him to a rehabilitation center. Adam feels he can talk to his key worker Patrick, whom he feels listens to him and wants to support him. However, he often feels he cannot talk about his mental health condition to other people, as he feels it is misunderstood. This impacts him socially and he avoids going out too often. In this essay, we shall discuss therapeutic communication, psychosocial and socio-political influences, health determinants, and service provision to Adam’s condition.

Effective therapeutic communication

According to Esmeralda, Eugjen, and Erinda (2013), the concept of ‘therapeutic communication’ refers to the process in which the nurse consciously influences a client or helps the client to a better understanding through verbal or nonverbal communication. Therapeutic communication involves creating avenues that allow patients to express themselves. Therapeutic communication uses verbal and nonverbal approaches (Esmeralda, Eugjen, and Erinda, 2013 ). Therapeutic communication is the interaction between the patient and the health worker which is meant to help the patient. (Esmeralda, Eugjen and Erinda 2013). To achieve effective therapeutic communication; nurses must exercise the component of privacy and confidentiality facilitating free expression by the patients. (Esmeralda, Eugjen and Erinda 2013). It is therefore important that in any healthcare setting, communications are effective to effectively advance care to patients. It is based on effective communication that the different issues that arise in inpatient care can be understood. Most patients need to be able to communicate with physicians and other caregivers to be well understood. The use of both verbal and non-verbal communication must at all times be applied in the healthcare setting to help patients communicate their health issues.

When analyzing therapeutic communication between nurses and patients it’s important to adhere to maintaining a standard procedure to treat patients adhering to a standard procedure facilitates information exchange, and creates bonding and respect between the patient and nurse. (Esmeralda, Eugjen and Erinda 2013). Taking the case study of Adam, I can conclude that Adam is facing barriers to effectively communicating his condition. Adam is experiencing stress. Adam has a failed marriage and has been unemployed for more than three years. The accumulating stress levels pushed Adam into excessive drinking such that his conduct has made him aggressive to his family members such as his son Tom and his parents. Because of this, his siblings and son are reluctant to visit him because of his aggressive nature. Therefore, being professional is one of the main issues that must at all times be put into consideration. In so doing, patients are assured that information shared with their caregivers will be held with utmost privacy and that it will be well synthesized and put to effective use. The above will help in proper care advancement since the basis of the patient’s communication will at all times be understood.

Moreover, Adam is suffering from depression which is a barrier to ineffective therapeutic communication. Depression is a symptom of bipolar disorder that Adam was diagnosed with. As a result, Adam is not willing to listen to people around him which also presents a huge communication barrier. He is withdrawn and this can be evidenced by the fact that he lives alone and also that he has only one confidant who goes by the name Patrick. Depression makes Adam reserved and unwilling to open up to the people around him. However, given the health condition that Adam shows, Patrick must be the only person that Adam confides provides psychosocial support to Adam. This will help Adam understand his condition better, as well as help, him learn how to maintain the stability of his condition.

Therapeutic communications help in providing good health care to patients. For quality health care, there must be a good relationship between patients to have improved well-being of the patients (Amoah, Anokye & Boakye, 2019). Therapeutic communication is also nonverbal by the use of cues. Therapeutic communication is recognized for improving adherence among patients, trust, giving comfort, making patients control their emotions, and providing patients with knowledge about their health. (Amoah, Anokye. & Boakye, 2019). According to Dejan and Zlatko (2017), therapeutic communication eliminates negativity amongst healthcare users in solving healthcare problems by providing channels that help improve health conditions. Nurses are mandated to protect patients who cannot make good health choices. Effective therapeutic communication acts as a form of treatment for patients. Effective communication is guided by the following principles; (1) Set clear ideas, having a clearly defined idea will make it easy to communicate (2) use appropriate language that simple and is easily understood. (3) Consistency and conformity to standard practices at the hospital. (4) Adequate and complete to avoid incomplete information affecting adherence and other outcomes. (5) communication should come at the right time when it is most needed. (6). Communication should go through the right channels to remove the element of doubt from the recipient.

Psychosocial and socio-political influences

Education is an important psychosocial variable. According to Cousin, Mast, Roter, and Hall, (2012) when tackling education, two questions are raised that is; how long did one stay in school, and the award attained from school? It is also evident that the quality of education is relevant to the health of a person such as mortality, morbidity, health behaviors, and functional limitations. People with lower levels of education are more susceptible to poor health throughout their entire lives. Taking the example of Adam, he dropped out of school at the age of 19 (Cousin, Mast, Roter, Hall, 2012). Due to the low levels of education he attained, he was not able to find a job for more than three years. As a result of being stressed, he resorted to heavy drinking.

According to the survey carried out by Popa-Velea & Purcărea (2014), infants born to Caucasian mothers with fewer than 12 years of schooling are 2.4 times more likely to die before their first birthday than infants born to mothers with 16 or more years of education. The above is true for other ethnic groups African American, Hispanic, American Indian, and Asian/Pacific Islander infants. Making education compulsory in the different states in the United States suggests that higher education standards will lead to better health thereby reducing the rate of mortality.

Adam was diagnosed as being bipolar. This is a lifelong mental illness that is characterized by mania and depression. Kornhaber, Walsh, Duff & Walker (2016) point out that issues such as lack of finances and unemployment will lead to low self-esteem, self-esteem, loss of identity, and lowered self-confidence making it hard for the patient to cope with society. Overall men that are employed will demonstrate better mental health compared to unemployed men. This can also be noted in the case of Adam who is unemployed, suffers from depression, and has been diagnosed as Bipolar. According to David and Sheri(2010), lack of social support will lead to increased levels of depression among people with bipolar disorder. BD patients are sensitive to reward and the more they pursue their goals and attain them, the more they are likely to suffer from mania. (David and Sheri 2010). When BD patients experience negative events, it increases the likelihood of developing depressive symptoms, as do levels of familial expressed emotion. Psychosocial interventions can speed recoveries from episodes and delay recurrences over 1–2-year intervals. (David and Sheri 2010)

Considering Adam’s economic status, it is evident that he was not financially stable. According to Kornhaber, Walsh, Duff & Walker (2016), there is a correlation between income and mortality. Unhealthy habits such as alcohol abuse and smoking are more pronounced among people with low incomes. This assumption holds for the case of Adam who has unhealthy practices of excessive drinking and it is evident that income inequality is inversely related to good health.

Social care services

Adam has developed a drinking problem, I would refer him for alcohol support services within his area of residence. Quitting or reducing alcohol consumption requires help or even coming up with a plan that will help Adam live an alcohol-free life. Similarly, Adam can be encouraged to join groups such as Alcoholics Anonymous (AA) that can be easily accessed within his area of residence and can help him manage his addiction. Adam can also be initiated into alcohol treatment. There are different types of treatment programs such as; (1) residential where a client is on treatment from 30 to 90 days and resides at the treatment facility. (2) Partial hospitalization, a person is monitored for 4-5 hours a week at the hospital. The above strategy would, in the end, help to address the extent of his current addiction tendencies. Moreover, more emphasis needs to be placed on understanding the main cause of his daily drinking behavior. It is from the above background that better methods of addressing his situation can be adopted. Also, the family plays a vital role in this kind of condition. It would, in the end, help him to overcome his habit given the above-suggested treatment programs.

Adam was diagnosed as being bipolar. I would immediately refer him to a health facility for the support given that his mental condition is a lifelong illness that needs immediate attention to mitigate severe effects. To address the issue of bipolar disorder, there are mainly three aspects that need to be taken into consideration. The main treatment strategy that he needs to adopt in this particular case is the use of antipsychotics, mood stabilizers, and the use of antidepressants. The whole treatment process often is associated with a combination of mood stabilizers and psychotherapy. Valproic acid and lithium are the most common treatment drugs for patients with bipolar disorder. In the same manner, I would encourage him to disclose his condition to the family as well as request his family members to offer psychosocial support in helping him manage this mental condition.

Conclusion

Therapeutic communication is intended to ease communication between patients and healthcare professionals by creating an atmosphere where patients can express their opinions. Health professionals should use therapeutic techniques to give the best medical treatment to the patients. Bipolar disorder is a lifelong mental illness that is characterized by symptoms of mania and depression. Bipolar patients find challenges in communicating with people around them because of their mental disorder. Patients with Bipolar disorder need support from trained health professionals and people around them. While analyzing Adams’s condition, he must be directed to the right places to receive social service. Given the above, he can be properly attended to help him recover from alcohol addiction and stress disorders. As discussed in the essay, the level of education attained, and the income status of a person have a strong correlation with the quality of health of a person. As elucidated in the above paragraphs, more research needs to be done to better understand the general parameters that can be adopted to address the issue of bipolar disorder among many people across the world.

References

Amoah, V.M.K., Anokye, R., Boakye, D.S., et al (2019). A qualitative assessment of perceived barriers to effective therapeutic communication among nurses and patients. BMC Nurs 18, 4[online] (updated 2019). Available at https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-019-0328-0#citeas [Accessed March 13, 2020]
Cousin G, Schmid Mast M, Roter DL, Hall JA.(2012). Concordance between physician communication style and patient attitudes predicts patient satisfaction. Patient EducCouns. 2012;87(2):193–197
David and Shari. L . J (2010). Social and Familial Factors in the Course of Bipolar Disorder: Basic Processes and Relevant Interventions: National Center for Biotechnological Information.[online], available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2727612/#R8 [ Accessed March 13, 2020]
Dejan, Zlatko .C , (2017). Therapeutic Communication in Health Care: Researchgate.[online] (updated 2017) available at https://www.researchgate.net/publication/320245946_Therapeutic_Communication_in_Health_Care[ Accessed March 13, 2020]
Esmeralda, Eugen. S, Erinda L, (2013). Therapeutic communication [online available at
file:///C:/Users/HAZZ/Downloads/27_Shreko_Sortiri_Lika%20(2).pdf [Accessed March 13, 2020]
Kornhaber, R., Walsh, K., Duff, J., & Walker, K. (2016). Enhancing adult therapeutic interpersonal relationships in the acute health care setting: an integrative review. Journal of multidisciplinary healthcare, 9, 537–546. https://doi.org/10.2147/JMDH.S116957
Popa-Velea, O., & Purcărea, V. L. (2014). Issues of therapeutic communication relevant to improving quality of care. Journal of medicine and life, 7 Spec No. 4(Spec Iss 4), 39–45.

Analysis of Bipolar Disorder in ‘Silver Linings Playbook’ Essay

Posted on December 15, 2024 | by Laureen

“But you, you’re not exactly the everyday man on the street, but you’re not nuts.” ~ Randle McMurphy

Madness throughout time and culture has been portrayed as a dissociation from the ordinary perception of the real world otherwise known as mental illness. Mental Illness is present worldwide resulting in severe marginalization which furthermore develops the broad interpretation that the mentally ill are merely ‘incorrect pieces within a jigsaw puzzle’ who are incapable of ‘fitting in’. These ideas are reflected within David Russell’s Silver Linings Playbook, which narrates the burdens the mentally ill face to fit into society. Alongside this such ideas are also evident within Ken Kesey’s One Flew Over the Cuckoo’s Nest which highlights the difficulty the mentally ill face to conform when faced with unconventional and unethical means of treatment. Both controversial texts represent madness as a hindering mental state that damages society as a result of inadequate support methods and treatment.

An overarching presence of inadequate authority and a widespread negative perception of mental illness burdened the 1950’s causing large-scale opposition towards authoritative figures and sparking a ‘writers revolution’ referred to as the beat generation. Ken Kesey reflects these counterculture views alongside his personal experience with psychiatric wards in One Flew Over the Cuckoo’s Nest using the intricately developed characters and setting to highlight the core beliefs of the Beat generation and expose society’s ill-informed view of mental illness. Kesey successfully demonstrates the mentality of the beat generation through the character of McMurphy who takes the role of a Christ-like figure who unveils the twisted desire of the ward and tries to lure his ‘followers’ away from the unconventional and inhumane ways of the institution and the corrupt authority, represented by the Nurse Ratched. Kesey narrates the story through Chief Bromden, a mentally ill Native American with a warped sense of reality, to encapsulate the historical issues of the time through symbolism and metaphors. A symbolic reference to society and its negative perception is seen when Bromden refers to society as “The Combine” to encapsulate the oppression society burdens upon the people within and depict the ward as a facility to repair the damaged members of society or merely to “just to keep them from walking around the streets giving the product a bad name.” (Chief Bromden, Part 1). This quote helps encapsulate the views of society and in particular highlights the perception that the mentally ill are damaging to society as a result of being different.

Showcasing the transfer of society’s negative perception of mental illness from the 1950s to the modern day, David Russell’s Silver Linings Playbook follows the everyday struggles faced by Patrick Solitano Jr. to reintegrate into society after being institutionalized to cure his long-term bipolar disorder. Patrick finds himself struggling to mold to society’s demands due to the broadscale negativity towards his illness alongside poor means of treatment. While struggling with the harsh treatment of society Patrick ultimately finds satisfaction and clarity through Tiffany Maxwell who suffers from extreme grief as a result of her husband’s death and faces the same marginalization from society being labeled as crazy and a “slut”. While Patrick and Tiffany occasionally behave irrationally, audiences are inclined to almost feel a sense of sorrow for the pair as a result of the marginalization he experiences. Patrick voices his struggle with society deeming “The world hard enough as it is. It’s hard enough as it is. Can’t somebody just be positive?” this statement truly highlights and identifies the crippling nature of modern-day arrogance towards mental illness and the effect its negativity has on those who are in recovery. Alongside this, it encapsulates his desire to feel accepted without the pressuring back-breaking demands of society. Ultimately David Russel encapsulates twenty-first-century views towards mental illness and allows audiences to contrast the film to the real world and how the perception of mental illness has been retained through generations.

Kesey utilizes his characters’ relationships to further demonstrate the dominant perception of madness. Within the novel McMurphy and Nurse Ratched together form one of the most impactful relationships due to being polar opposites of each other’s desires for the patients in the ward, where McMurphy represents rebellion and anti-conformism and Nurse Ratched represents society’s emasculation. This ultimately results in frequent headbutting of the two with the main goal of having the patients support them. Nurse Ratched’s crusade to control the patients is reflected in the music within the ward. Even though McMurphy makes a direct request for Ratched to turn down the music she ultimately defends the use of it stating that “Mr. McMurphy… I think you’re being very selfish. Haven’t you noticed that there are others in this hospital besides yourself? There are old men here who couldn’t hear the radio at all if it were lower… Old fellows like Matterson and Kittling, that music is all they have.” However, Harding explains to McMurphy that the patients do not require the music and tend to ignore it after being in the wards for so long. This is an implicit attempt of Nurse Ratched to maintain power as the music symbolizes her dominance within every meter of the ward. Alongside this, it highlights Nurse Ratched’s hold on the ward and the detrimental effect on the patients as a whole and hinders their recovery through torturous means of treatment and fear. Overall the relationship between McMurphy and Nurse Ratched is formed around the dominant perception of mental illness and helps highlight the negative effects of inadequate support.

Meanwhile, within Silver Linings Playbook the relationship between Patrick and his parents is explored and highlights the damaging effects of mental illness, as he returns to society, he is forced to integrate back into his parents’ house which burdens Patrick Solitano Sr. and Dolores. Both of Patrick’s parents become weary of him once he returns to society being officially diagnosed as suffering from bipolar. They struggle to find ways to aid him during his various episodes which is most prevalent during his outburst in which he knocks over his mother and gets into a physical altercation with his father. The two desire greatly for Patrick to reflect that of an ordinary individual and rid himself of his illness. Patrick’s relationship with his parents ultimately highlights the negative perception of mental illness and the ever-demanding ideals of returning to being a normal citizen.

Treatment for mental illness within the 1950s saw various methods implemented to restore a patient’s brain function and rid them of their condition so they could once again be ‘normal’. The most common means of treatment were the use of lobotomies and electroshock therapy. A lobotomy is the process of severing connections within the brain with the intention of damaging neurological connections to stop mental illness. Meanwhile, ECT involves electrically induced seizures to alter the brain’s chemistry to reverse the effects of mental illness.

These treatments were reflected in Kesey’s One Flew Over the Cuckoo’s Nest to demonstrate the dangers they withheld when used incorrectly and immorally as can be seen when Nurse Ratched uses the methods as punishment for patients who fail to conform to her desires and demands. The damages of such punishments are evident throughout many instances within the novel in which characters such as Ellis and Ruckly who are former acute turn chronic as a result of botched procedures. Alongside this, the unconventional use of ECT being repetitively used as a torture device is what ultimately leads to McMurphy’s Christ-like sacrifice on the cross-shaped bed which signifies his death to save the patients of the ward. This is most evident when Nurse Ratched states that she may stop the treatment if McMurphy admits his wrongdoings indicating the therapy is unorthodox and used alternatively to cure him. Overall One Flew Over the Cuckoo’s Nest entails the damaging effects of treatments being used unethically and as a means of punishment rather than a cure.

With Silver Linings Playbook being a modern-day insight into mental illness, the film features modern-day forms of treatment and therapy, ranging from prescription drugs to alternate forms of treatment such as dance therapy however it provides the argument of the effectiveness of treatment when it is used accordingly. Although both Patrick and Tiffany occasionally behave sporadically it can be determined that the treatment, they are receiving is positive and is used to ease the effects of mental illness. Possibly the most effective treatment, dance therapy makes a noticeable impact on both Tiffany and Patrick which can be identified when the film highlights the pair enjoying themselves while practicing to dance being evidently more exuberant and fulfilled compared to alternate scenes where they are seen struggling to get through the day. This successful treatment aids in unveiling the possibility it has on helping the mentally ill when it is used solely for curing mental illness rather than agonizing punishment for failing to conform. Overall Silver Linings Playbook features the positive nature of treatment in comparison to the destructive effects within One Flew Over the Cuckoo’s Nest, highlighting its ability to restore those who suffer from mental illness to a state of happiness and clarity bordering that of “normality”

Ultimately both the novel and film unveil the aligned perception that mental illness is hindering mental state as a result of unconventional and inadequate. Both texts expose the stigmatization of mental illness that is still apparent within the modern-day 58 years after Ken Kesey highlighted the flawed perception within One Flew Over the Cuckoos and allows audiences to re-examine the current treatment the mentally ill face alongside feeling sympathetic for the suffering they face as a result of such a negative perception as a whole. Furthermore, it helps audiences grasp the brighter side of mental illness and recognize that it’s not all bad. “Never before did I realize that mental illness could have the aspect of power, power. Think of it: perhaps the more insane a man is, the more powerful he could become.”

Essay on Bipolar Disorder Case Study

Posted on December 5, 2024 | by Laureen

Lithium Carbonate, extended-release, 600mg orally, BD
Metformin, extended-release, 1000mg, daily
Candesartan 16mg orally, daily

Low mood – sadness, irritability, tearfulness
Loss of interest in activities previously enjoyed
Loss or gain of appetite – eating more or less than usual, losing or gaining weight without trying.
Sleep pattern changes – sleeping for more periods of time, especially during the day, or trouble falling asleep and insomnia.
Lack of motivation and energy.
Feeling hopeless and worthless.
Poor concentration and memory.
Self-harm or suicidal thoughts. (Hungerford, Hodgson, Clancy & Mon., 2016)

Addressing patients’ needs – physically and mentally may include the well-being of family members as well.
Increased frequency and/or level of nursing observations.
Support and encouragement to the patient to manage their own mental state.
Completion of the MMSE. – a short questionnaire used to measure cognitive impairment. K10 – a tool used to measure psychological distress. DASS 21 – a tool used to measure signs of depression
Continuous monitoring by health staff
Further assessment by a mental health clinician
Use of additional PRN medications to treat symptoms. (Hungerford, Hodgson, Clancy & Mon., 2016)

The major factors for living with mental illness for Mr. Reed and his wife include distress from symptoms:

Fear/anxiety/worry – Mr. Reed may be experiencing these symptoms due to the changes in his healthcare routines. Eg. Medications, new general health issues and exacerbation of mental health issues.
Lack of energy or motivation – a common symptom of depression however Mr Redd is not taking his medication which could be causing these symptoms to become worse.
Loss of control – Mr. Reed could be feeling this way due to being in hospital. Patients often report feeling this way due to health professionals making decisions about their health care without consulting them.
Symptom control/management – Due to not taking his prescribed medications and lack of psychology input Mr. Reed has no coping strategies in place to deal with symptoms.
Medication changes, and the side effects that come from that – Mr. Reed’s medications were changed from Lithium to Quetiapine. Mr. Reed may not understand the reason why this has had to happen. Education regarding medications is very important to ensure patient compliance.
Relationship breakdown – Mrs Reed is visibly stressed, and Mr. Reed can see that. This would put a lot of strain on their relationship and breakdown trust and communication between them. Both Mr and Mrs Reed require some supportive services.
Prolonged hospital admission – being in hospital for long periods of time can affect a patient mentally and physically. Hospital admissions also affect the carer as their routines are disrupted to visiting their loved one each day.
Financial worries – perhaps Mr. Reed is unable to work, and Mrs Reed can only work part-time so his wife can be available to care for her husband and poor self-esteem and self-acceptance.

Treatment for Bipolar Disorder Essay

Posted on December 5, 2024 | by Laureen

Introduction

Effective therapeutic communication

Psychosocial and socio-political influences

Social care services

Conclusion

References

Amoah, V.M.K., Anokye, R., Boakye, D.S., et al (2019). A qualitative assessment of perceived barriers to effective therapeutic communication among nurses and patients. BMC Nurs 18, 4[online] (updated 2019). Available at https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-019-0328-0#citeas [Accessed March 13, 2020]
Cousin G, Schmid Mast M, Roter DL, Hall JA.(2012). Concordance between physician communication style and patient attitudes predicts patient satisfaction. Patient EducCouns. 2012;87(2):193–197
David and Shari. L . J (2010). Social and Familial Factors in the Course of Bipolar Disorder: Basic Processes and Relevant Interventions: National Center for Biotechnological Information.[online], available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2727612/#R8 [ Accessed March 13, 2020]
Dejan, Zlatko .C , (2017). Therapeutic Communication in Health Care: Researchgate.[online] (updated 2017) available at https://www.researchgate.net/publication/320245946_Therapeutic_Communication_in_Health_Care[ Accessed March 13, 2020]
Esmeralda, Eugen. S, Erinda L, (2013). Therapeutic communication [online available at
file:///C:/Users/HAZZ/Downloads/27_Shreko_Sortiri_Lika%20(2).pdf [Accessed March 13, 2020]
Kornhaber, R., Walsh, K., Duff, J., & Walker, K. (2016). Enhancing adult therapeutic interpersonal relationships in the acute health care setting: an integrative review. Journal of multidisciplinary healthcare, 9, 537–546. https://doi.org/10.2147/JMDH.S116957
Popa-Velea, O., & Purcărea, V. L. (2014). Issues of therapeutic communication relevant to improving quality of care. Journal of medicine and life, 7 Spec No. 4(Spec Iss 4), 39–45.

Analysis of Bipolar Disorder in ‘Silver Linings Playbook’ Essay

Posted on December 5, 2024 | by Laureen

“But you, you’re not exactly the everyday man on the street, but you’re not nuts.” ~ Randle McMurphy

Treatment of Bipolar Disorder

Posted on December 4, 2024 | by Laureen

It is normal to experience mood changes throughout the day. In high mood, one may feel happy and energized while in low mood one may feel sad and inactive. To a normal person, the mood changes do not get out of control; one is able to have a balance between the high and low moods.

Unlike normal people, people with Bipolar disorder experience extreme and sustaining mood changes that interfere with their lives (Smith, Segal and Segal par 3). The extreme mood swings experienced by Bipolar disorder patients lead to severe psychological distress that makes it impossible for the patients to lead normal lives. Also referred to as Manic Depression or Bipolar Affective Disorder, Bipolar disorder is categorized as one of the serious mood disorders.

The mood disorder is characterized by extremely high (manic or hypomanic) and unusual depression states that last for days or weeks. Bipolar disorder can lead to very severe effects if not treated. Mood swings resulting from the disorder can affect school or job performance, break relationships or even lead to suicide. Pharmacotherapy and psychological therapy are the treatment options that are found to be most effective with Bipolar disorder patients.

As aforementioned, Bipolar disorder has great effects on normal functioning of the patients. The sad thing about Bipolar disorder is that it tends to be a life time problem and getting an effective treatment is a challenge. However, early diagnosis and treatment of the disorder lead to positive results. Use of medication is the common option for treating Bipolar disorder (Smith, Segal and Segal par 14).

Medications referred to as ‘mood stabilizers’ are used to counter mood swings and reduce the symptoms of the disorder. Use of mood stabilizers for on a long-term basis is known to have positive results on Bipolar disorder patients. However, since patients respond differently to mood stabilizers, different medication should be tried in order to come up with the best combination for a particular patient (Sachs, et al. 9).

For effective treatment, mood stabilizers are used with combination of antidepressants and anticonvulsants. The mood stabilizer that is found to be most effective with most Bipolar disorder patients is Lithium (Sachs, et al. 9). The mood stabilizer is used together with anticonvulsants such as Carbamazepine, Valproic acid and Lamotrigine. The effective combination of medications has to be used for a long time in order to prevent reoccurrence of the mood changes.

Many Bipolar disorder patients however tend to default medication. It is therefore advisable for Bipolar disorder patients to continue with their medications even when they feel as if they are cured. Although medications provide the most immediate intervention to Bipolar disorder, they do not completely cure the disorder but manage it. In addition to medications, a Bipolar disorder patient has to adopt a lifestyle that supports wellness.

Though medications are the most obvious treatment option for Bipolar disorder, better results are attained when the patients receive psychotherapy alongside medications. Therapy helps Bipolar disorder patients to manage various issues resulting from the disorder, including affected self-esteem, work and relationship. Psychotherapy can also be of great help if a Bipolar disorder patient is struggling with other issues such as substance abuse.

Considering that treatment for Bipolar disorder can continue for a long time, psychotherapy helps to keep the patient in medications and therefore increase chance for success. Cognitive-behavioral therapy, Family-focused therapy and Interpersonal and social rhythm therapy are the common psychotherapies with Bipolar disorder (Smith, Segal and Segal par 16). Cognitive-behavioral therapy is particularly helpful in helping a Bipolar disorder patient to manage symptoms.

This type of therapy targets the thinking patterns of a patient and can help Bipolar disorder patients to avoid triggering the symptoms through their thinking patterns. Interpersonal therapy is very important to a Bipolar disorder patient. The psychological therapy helps Bipolar disorder patients to manage their relationships, which could be highly affected by the mood disorder. Interpersonal therapy also helps the patients to manage stress and therefore reduce occurrence of the symptoms.

Considering that Bipolar disorder affect biological rhythms, social rhythm therapy can be of great help to Bipolar disorder patients. In addition to the above mentioned therapies, family focused therapy can be incorporated in treatment of Bipolar disorder. Bipolar disorder affects not only the patient but also other family members living with the patient. Family focused therapy helps in addressing the effects of the disorder to the family and therefore helps to create a strong support system for the patient.

Bipolar disorder is among the severe mood disorders. Apart from affecting the normal functioning of the patients, Bipolar disorder can have severe effects on a patient’s relationships or even lead to suicide. For better results, a Bipolar disorder patient should seek early treatment.

Medications and psychological therapy are the main treatment options for Bipolar disorder. Mood stabilizers such as lithium are effective in treating the disorder. The mood stabilizers are used together with anticonvulsants and antidepressants in order to achieve the better result. In addition to medications, psychotherapy is used to achieve the best result. Therapies such cognitive therapy, family-focused therapy and interpersonal therapy help in managing symptoms and helping the patients to live well in spite of their suffering.

Works Cited

Sachs, Gary, David Printz, David Kahn, Daniel Carpenter and John Docherty. The Expert Consensus Guideline Series Medication Treatment of Bipolar Disorder. 2000. Web.

Smith, Melinda, Jeanne Segal and Robert Segal. Treatment for Bipolar Disorder: Getting Help and Choosing Treatments. 2010. Web.

The Psychosocial Context of Bipolar Disorder

Posted on December 4, 2024 | by Laureen

When people begin to notice frequent symptoms of apathy, melancholy, depression in their moods and behavior they often consider these episodes as the results of stressful situations and tensions in their everyday life. When people pay attention to their abnormally energy and happiness they can consider these moods as the results of definite positive emotions.

These people will be right in the most cases, if such episodes are not severely intensive and interchange each other. Otherwise, these reactions can be the symptoms of bipolar disorder. Bipolar disorder is the psychological state when people can often experience high moods or mania and depressions which are observed during different periods of time or at the same time.

People with bipolar disorder can be characterized as both highly emotional and greatly depressed because these two opposite states constantly interchange each other in their lives. Thus, the peculiarities of bipolar disorder base on the affective and cognitive components of the personality.

Moreover, physicians determine several stages for the analysis of bipolar disorder. They accentuate two categories of the factors which can cause such a mood disorder as bipolar disorder. These factors are of the biological and psychosocial character (Plotnik and Kouyoumdjian).

Biological factors are connected with the genetics and neurology. Thus, people’s severe variations in the mood are the results of definite processes which can be observed in their brains and are conditioned with the genetic components (Plotnik and Kouyoumdjian).

Psychosocial factors include the ability to cope with stresses, to perceive the reality and overcome the difficulties, to express definite emotions and interact with other people (Mansell and Pedley). In their study, Lauren Alloy and the group of the researchers focus on the psychosocial context for the development of bipolar disorder as one of the most influential factors.

Thus, “bipolar individuals experience increased stressful events prior to first onset and recurrences of mood episodes”, and “negative life events precede the manic/hypomanic as well as the depressive episodes of bipolar individuals” (Alloy et al. 1047). If the social aspects can influence the development of the symptoms of the illness negatively, there are also social factors which can contribute to the effective treatment of bipolar disorder.

That is why definite support from the patient’s family and his friends can decrease “the deleterious effects of stress or directly enhance functioning among bipolar individuals, whereas high criticism and emotional over involvement (high expressed emotion or EEQ) from family members can provide additional stress and worsen the course of bipolar disorder” (Alloy et al. 1050).

Nevertheless, it is rather difficult to differentiate between the positive results of pleasant events which can influence the effectiveness of the treatment or those which can have the impact on the progress of manic episodes. The causes for the development of manic symptoms are thoroughly studied today.

In their article, Warren Mansell and Rebecca Pedley pay attention to the fact that the development of manic moods is closely associated with the definite level of the psychomotor activation, and it is also caused by the increased processing of the perception of positive or negative information (Mansell and Pedley).

It is rather difficult to diagnose bipolar disorder at the first stages when people are characterized by the high level of productivity, creativity, and sleep disorders. However, in a definite period of time these people can experience the decline of their energy and concentration, negative moods and anxiety (Mansell and Pedley). The states of euphoria and hyperactivity are changed by the depressive moods and even suicidal thoughts.

Nevertheless, there is the discussion about the effects which can have the states of activity, euphoria, and creativity for these people and for the society. There are many facts that some prominent artists and talented personalities suffered from bipolar disorder. Is there the connection between creativity and bipolar disorder?

The researchers accentuate strong “associations between mood disorders, especially bipolar disorder (BD), and creativity, which raises questions regarding possible mechanisms underlying such associations and as to why a potentially life-threatening and debilitating illness such as BD may confer advantages for creative accomplishment” (Srivastava and Ketter 522).

The fact that many famous creative personalities have achieved the great results in their activities can significantly influence the individual opinion on their works and make the public pay more attention to their details. The possibility of such an interesting connection between bipolar disorder and creativity is also widely discussed in literature and movies.

The main character of the popular movie of 1993 Mr. Jones, starring Richard Gere, suffers from bipolar disorder. The symptoms of this illness are vividly depicted in the picture. Bipolar disorder is characterized by manic-depressive episodes which influence the person’s behavior, moods, and cognition. It is important that this illness affects also the personal self-esteem and his self-perception.

The character performed by Richard Gere is a really charismatic person who attracts the public’s attention and impresses by the provocative behavior. When Mr. Jones experiences the manic episodes he feels the great energy and euphoria, he is powerful and extravagant. In spite of the fact such attitudes to the reality can be characterized for many people who have the highest level of their self-esteem, Mr. Jones is too expressive in his actions and even in his desire to fly. This is the behavior of the ill person, but not an extravagant one.

The evidences of Mr. Jones’s illness become obvious when he experiences depressive episodes which almost destroy his ability to be aware of the reality and its aspects. The audience can observe the peculiarities of the symptoms which are typical for those persons who suffer from bipolar disorder in the depictions of the severe symptoms experienced by Mr. Jones.

His concentration and memory decrease, he is apathetic and loses the interest to his life, nothing can enjoy him. The range of the states from the highest level of happiness and creativity to sadness and confusion is one of the main characteristic features for bipolar disorder.

The manic-depressive disorder is the interesting and important issue for the discussions and analysis because it is connected with such controversial problems as the role of mood disorders and particularly bipolar disorder in the development of people’s creativity and talents, and its association with delusions and hallucinations which can result in the great artistic works (Srivastava and Ketter).

Plotnik and Kouyoumdjian describe the causes and the peculiarities of the bipolar disorder’s treatment in the part of their work about mood disorders and schizophrenia (Plotnik and Kouyoumdjian).

They concentrate on the results of the illness for the person, but they do not pay much attention to the effects which these disorders can have for the society. That is why it is rather interesting to examine the controversial problem from the point of creativity and other positive impacts which this disorder can have.

Bipolar disorder is one of the most discussed mood disorders because its symptoms are characterized by a great range of expressions and effects for the personality who suffers from the disorder and for the society. It is possible to treat the disorder only in connection with the person’s social life and family because this illness is often the result of his or her different psychosocial problems.

Works Cited

Alloy, Lauren B., Abramson, Lyn, Y., Urosevic, Snezana, Walshaw, Patricia D. Nusslock, Robin, and Amy M. Neeren. “The Psychosocial Context of Bipolar Disorder: Environmental, Cognitive, and Developmental Risk Factors”. Clinical Psychology Review 25.8 (2005): 1043-1075. Print.

Mansell, Warren, and Rebecca Pedley. “The Ascent into Mania: A Review of Psychological Processes Associated with the Development of Manic Symptoms”. Clinical Psychology Review 28.3 (2007): 494-520. Print.

Plotnik, Rod, and Haig Kouyoumdjian. Introduction to Psychology. USA: Wadsworth Publishing, 2010. Print.

Srivastava, Shefali, and Terence A. Ketter. “The Link between Bipolar Disorders and Creativity: Evidence from Personality and Temperament Studies”. Current Psychiatry Reports 12.6 (2010): 522-530. Print.