Category: Bipolar Disorder

Introduction

This essay is about the bipolar disorder and its impact on humans. This paper will discuss a number of issues that surround the prevalence of the disease. The main aim of this paper is to identify the effects of bipolar on humans. It also seeks to explain and outline the different ways through which bipolar disorder inhibits a person’s ability to maintain relationships. The essay seeks to answer a number of questions that covers a broad scope of the bipolar disorder. This includes its prevalence, effects on people’s daily activities, it emotional implications as well as its treatment. This paper will discuss bipolar and its effects on human rational ability and social conduct.

Defining the bipolar disorder

Bipolar is a mental illness that affects an individual’s mood causing fluctuations in energy and activity levels (Chengappa & Gershon, 2013). Bipolar is also known as manic-depressive illness and its effects can abhorrently affect personal relationship with others. Patients suffering from the bipolar disorder exhibit exaggerated mood changes and this is known as mania or hypomania (Chengappa & Gershon, 2013). Defining the disease as either mania or hypomania depends on the severity of the changes in moods.

How does the disease negatively affect a person’s attention?

A person with bipolar disorder does not think normally as an average person. People suffering from the bipolar illness have a different mindset that alters their ability to concentrate and be attentive. Bipolar patients are extremely thoughtful and very anxious. Their minds perceive everything in the extremes and this gives them a fluctuation in moods very often. Such people do not get upset when wronged, they become very depressed and they always see like everybody hates them. This affects their ability to concentrate because something worth neglecting can depress them.

What age is the disease likely to be diagnosed?

Bipolar is a disease that affects almost 2 million people in the United States every year (MayoClinic, 2014). The likelihood of having this disorder is greatly influenced by genetic makeup and family background. People who have relatives that suffer from the disease are more likely to be diagnosed with the same compared to those who do not. The disease however has not been identified to have any form of prevalence with regard to races. It seems all races are affected equally. In terms of age, the disease is normally detected at 15-25 years of age and it also affects both men and women (Christian, 2014).

How does bipolar affect a person’s everyday functioning

Parts of life that are most affected

Bipolar makes relationships very difficult. A person suffering from bipolar has extreme mood swings that can leave their loved ones confused. It is actually very difficult to distinguish between the disease and the person. Therefore, when the disease is activated, the person behaves in a manner that changes the perception of the people living around him or her (Tracy, 2013). One minute a bipolar patient could be smiling and laughing with you and in the next they get very offended and suddenly they are not in the mood to talk anymore. This shift is so arbitrary that one may take offense and forget that the individual is suffering from a disease (Tracy, 2013).

Bipolar patients have a very unstable mood pattern. This makes them very unpredictable and one cannot tell their response when they are angry or exited. This affects their rationale when making decisions even at places of work or even in the family. Bipolar patients, when offended, they perceive it in the extreme way (Tracy, 2013). This may greatly interfere with their relationship with other people like children and spouses. When a person suffering from bipolar is offended by his or her spouse, they may see it as an expression of hate. When a person feels like they are being undermined or hated in a relationship, they may get very broken and this may cause trouble in that relationship (Tracy, 2013).

In working environment, bipolar patients also can have great problems in performing their mandates. For instance, when a customer in the workplace gets rude, a bipolar patient does not see it as a working challenge. On the contrary, they assume that the customer had targeted them and they take it very personal. This will definitely affect their working morale for the rest of the day (Tracy, 2013). They become so angry that they can go for days in a bad mood, hence affecting their performance. Students in schools and collages will also suffer the same fate. Feeling like everybody hates you can easily distract one from their rational mind set.

Ability to form friendships and relationships

People suffering from bipolar disorder find it very difficult to maintain friendly and lasting relationships with people. This has negative impacts on their social life and may have many disadvantages that can be detrimental to other aspect of their lives (MayoClinic, 2014). Bipolar patients are known to overreact to a simple situation. Friends will always have problems and sometimes even quarrel. In any healthy friendship, the parties involved must quarrel sometimes but that does not mean that they are not good friends (MayoClinic, 2014). Bipolar patients do not understand that people are meant to make mistakes and that even a close friend can disappoint them.

With their overacting tendencies, such people will have very few friends around them because people will feel very uncomfortable. Not only will people shun them, but they too will tend to shun people because they think they will be disappointed. Bipolar patients have a trust problem. They do not easily trust people because they are always paranoic. Friendship, on the other hand, is based on trust and understanding (MayoClinic, 2014).

intimate relationships are also greatly dependent on trust. Since bipolar patients find it difficult trusting people, it becomes difficult for them to get into serious relationships. Anxiety also makes them be very cautious hence locking out prospective friends.

How it affects their ability to work and play

As mentioned earlier, working and playing for bipolar patients is greatly compromised. This disease causes a person to become paranoid. Interacting with other people is also a problem hence creating a barrier for their ability to work in teams. Bipolar patients are never interested in joining a group of people because they need to protect themselves from being disappointed. A simple comment about their dressing or haircut can cause them mental stress for the rest of the day. Such reactions in a team of people with different temperaments can be very stressful. To avoid that, bipolar patients prefer to avoid people.

Treatment used to manage bipolar

Bipolar is classified as one of the long-term chronic conditions. However, the disease has a number of ways in which it can be treated and controlled. Nonetheless, the treatment of bipolar is specific and unique from one patient to the other. Part of the recommended treatment includes medication. In fact, some people treat their conditions without their knowledge. For instant, many drunkards and drug abusers use their drugs to suppress their symptoms. There are however two main types of medicines that are globally used to treat bipolar. They include Modd Mobilizer and Atypical antipsychotics (Bressert, 2014). Other treatments include psychotherapy and self-help strategies (Bressert, 2014).

How effective are these treatments

Lithium is one of the mood mobilizers that have been used for some time now and its effectiveness has been approved by major psychotherapists. On the other hand, atypical antipsychotic is thought to have great side effects even although it works very well in suppressing the impacts of the bipolar disease. Psychotherapy is one of the best strategies in treating and managing bipolar disorder, it is the greatest and the most successful method (Bressert, 2014). Psychotherapy basically helps the patients to deal with the challenges they face as a result o their illness. This is the best way to deal with a personality challenge.

Study

Roy Chengappa and Samuel Gershon, Bipolar Disorders, 2013, ISI Journal Citation Reports.

This journal has defined the disease and has given a wide range of its prevalence among the American pollution (Chengappa & Gershon, 2013). The journal gives real statistics to show the exact number of people suffering from the disease and their treatment records. Extensively, this journal has discussed the causes of the disease and also the most effective measures that have been proven to treat and manage the disease (Chengappa & Gershon, 2013). The journal also points out that the disease can cause great alteration to the normal human rationale ability. The study primarily focuses on the disease and its effects on its victims as well as methods of treating it.

Methods used in data collection and the major findings

The methods used by the authors to collect their data were mainly through questionnaires, interviews, and reporting. The major finding of the study includes the high number of people suffering from bipolar without their knowledge. Also the study has majorly identified the different ways of treating the disease. This research work has also included the different levels of severity of the diseases and the causes of such exaggerated high levels.

Conclusion

This paper has been set to discuss the bipolar disorder in detail. The paper clearly outlines how the disease affects a person’s ability to concentrate on their daily activities. It also has described the impacts and effects of the disease and how it affects person’s ability to make friends and establish lasting relationships. The paper has also outlined the age limit that professionals consider to be the most common age when most patients are diagnosed with the disease.

In this essay, a number of treatment methods have been discussed and ways to manage the disease have also been outlined. In the end of the paper, a study on one academic journal has been undertaken. The paper has summarized the findings of the journal and identified the methods used by the authors to collect the information thereof. This paper is a comprehensive study that has clearly and extensively discussed the bipolar disorder and its impacts on human’s ability to live social life.

References

Bressert, S. (2014). Treatment of Bipolar Disorder, Manic Depression. Psych Central. Web.

Christian N. (2014). What is bipolar disorder? What causes bipolar disorder?Web.

Chengappa, R., & Gershon, S. (2013). Bipolar Disorders.ISI Journal Citation Reports, 16 (6), 1399-5618. Web.

MayoClinic: Tests and diagnosis. (2014). Web.

Tracy, N. (2013).How a Person with Bipolar Thinks. Web.

Introduction

Bipolar disorder is a psychiatric mental disease that tends to make the patient have severe mood swings. The mood swings tend to be extreme of each other and can range from manic behavior to severe depression. This gives the characteristic name of the condition as a ‘bipolar’ disorder. In this paper, we have outlined the condition of a selected patient having bipolar disorder. The physical and mental condition as well s the symptoms of the patient are observed and recorded. Moreover, a teaching and nursing plan has been provided which will aid and contribute towards the treatment of the patient.

Initially, this disorder was only apparent in adults; however, in recent years, it has also been observed in children. The main reason is due to the changing family life and environment as well as the change increase in the pollutants which are unknowingly consumed by the young mothers and pregnant women in the region. This results in a chemical imbalance in the brain of the resultant child, making them highly susceptible to disorders akin to bipolar disorder. “Bipolar disorder is a chronic psychiatric disorder with a variable course and significant impact on patient’s social, occupational, and general functioning and wellbeing. Although there are effective pharmaceutical and psychosocial interventions for patients with bipolar disorder, many patients receive poor-quality care” (Revicki et. al.., 2005)

Description of the client/patient

The patient in question is Samantha Houghton (the names are changed for confidential purposes). She is a child of 13 years old who has been living with her family of two brothers and a single mother. The mother of the patient is a widow, so the child does not have a father in his family. The patient himself seemed jovial and almost hysterically happy on the first visit, however, continued observations of the patient have shown large mood swings going into a mode of depression where the client tends to get highly reserved and quiet. The client has been communicating with us in English only. However, oral communication has been limited due to the nature of his condition as well as the limited attention span depicted by the patient. Samantha’s school records provide that she has been fluctuating in her studies, showing exceptional skills on certain occasionally while flunking the assessments on others. The barriers to learning that exist for the client pertaining to the fact that the client has a very limited span of attention. As mentioned above, the client is able to perform well in her papers and tests; however, the mood swings tend to take over and make her performance a fluctuating one over a period of time,. Aside from this, the almost nonexistent groups of friends that are associated with the patient are not too close to the patient. The client herself has been isolating herself lately, making the condition of the disorder more severe by limiting her social interactions.

The cultural background of the person is white, and she has been born and raised in New York. Her grandparents come from England. There exist no history of mental illness in the family. However, the mother was able to provide that she was under high levels of stress and depression during her pregnancy due to her husband’s death.

The mental status of the client is highly volatile in nature right now. This is mostly because of the bipolar disorder that is being faced by the client. She has been able to depict extreme hysterias and manic happiness on occasion when she was able to win a computer game; however, otherwise, she has been under severe depression. Of late, her spells of volatile behavior and more prolonged, and the mood swings have started to come about more often. The main reasons that are aggravating the bipolar disorder for the patient include her family atmosphere and the fact that she is going through puberty at her age. With almost no friends, she is very alone and isolated, which is making the disorder take over her mental state. At this stage, without any treatment, the consequences of bipolar disorder mean that the patient might even suffer from an early death in the form of suicide. In order to monitor her behavior and treatment, she will have to be kept in close contact with the social welfare and the legal systems department for the rest of her life.

Teachin plan

In order to the patient, we will have to support the patient in terms of her development and growth as well as support her through her disorder. For this, first and foremost, the teaching plan has to be made, which will be focused on attaining the short-term goals of stabilizing her condition by increasing her attention span and enabling her to focus on her studies. Specialized tutoring would be provided, which will focus on maintaining the equilibrium of her mental state while providing for the education of the patient. Moreover, in the long term, the goal of the teaching plan would be to encourage the patient to become more communicative and more gregarious in nature. This will increase her confidence level and aid in stabilizing her mood swings. Moreover, the presence of family and friends would help her be more normal like others around her, making her less likely to be suicidal.

The timing in the teaching plan would be such that she will be catered to after her school hours. The duration of the sessions will be kept 1hour long in the begging which will be gradually increased to 3 hours in order to not burden the patient in a sudden manner. The treatment for the patient and her teaching would start alongside her stay in the hospital. This will make it possible for us to closely monitor her and test her in her real-world environment as she gets discharged. Her treatment, however, will continue even after her discharge and can span most of her life.

Intervention

The client will be initially taught her school course alongside basic decorum and behavioral techniques. She will be informed of the environment around her from a broader perspective, and a two-way session of discussion and arguments will be encouraged. Aside from this, she will be provided with medication to control her severe mood swings and erratic behavior, which has been characteristic of late. Aside from this, lifestyle changes would be made for her. This would include fixed waking up and sleeping timings, caffeine-free food, and education pertaining to drugs and alcohol. Aside from this, her day would be managed according to a strict schedule. The family would also be advised to keep crises and arguments at a low level in order to not trigger a disorder. The sibling communication and relationship will be encouraged in this case as this will aid the patient in becoming gregarious and less erratic over time. The alternate method of treatment would be hospitalization and medical treatment in order to make way for immediate control of her symptoms. A longer psychological treatment would follow the medical treatment.

Evaluation

The treatment of the patient will be evaluated according to her progress in the treatment and the way she is able to correspond with those around her. The timings of the mood swings and the communicative behavior will also contribute towards the evaluation of the patient.

References

Bipolar Disorder, Patient Health International – AstraZenec, (2003).

Goodwin, G.M., (2003), Evidence-based guidelines for treating bipolar disorder – recommendations from the British Association for Psychopharmacology, Journal of Psychopharmacology, Vol 17(2) (2003) 149–173. Web.

Kleinman, L.S., Lowin, A., Flood, E., Gandhi, G., Edgell, E., Revicki, D.A., (2003), Costs of Bipolar Disorder, Pharmaco Economics, Vol. 21 Issue 9, pp. 601-622,

Revicki, D.A., Matza, L.S., Flood, E., Lloyd, A., (2005), Bipolar Disorder and Health-Related Quality of Life: Review of Burden of Disease and Clinical Trials, Pharmaco Economics, Vol. 23 Issue 6, pp. 583-594.

Videbeck, S.L., (2005), Psychiatric Mental Health Nursing, Lippincott Williams & Wilkins, ISBN 078176033X

Definition of Bipolar Disorder According to the UK Psychiatry

In order to maintain academic objectivity, it is necessary to define the terms of mental health problems and bipolar disorder in UK psychiatry. Mind (2020) argues that mental health problems are a generic term for “depression and anxiety” and “schizophrenia and bipolar disorder” (para. 3). Bipolar UK charity organisation (n.d.) states that bipolar disorder is “a severe mental health condition characterised by significant mood swings including manic highs and depressive lows” (para. 1) In addition, Bipolar UK organisation provides population statistics on the number of people with this mental disorder. It is possible to note that there is also comparative statistics of the incidence of bipolar disorder to other severe and chronic illnesses. The authors of both web pages also describe the processes of diagnosis for bipolar disorder, the possible outcomes for the patients, and how it affects people’s everyday life.

Symptoms of Bipolar Disorder According to the UK Psychiatry

An important point is also to mention what UK psychiatry considers the primary symptoms of bipolar disorder. The Mind (2020) organisation believes that the main conventional signs of this condition are manic and depressive episodes, hypomanic episodes, and following their psychotic symptoms. The authors of the webpage also describe how people with this mental disorder live and advise how their loved ones can help them.

Leading Causes of Bipolar Disorder in the UK Psychiatry Terminology

It is also important to mention the leading causes of the development of bipolar disorder according to official data of the National Health Service (NHS). The organisation denies that there is a single trigger for this condition (NHS, 2019). Instead, they suggest that the cause of bipolar disorder is a combination of physical, social, and environmental factors. According to the NHS (2019), these factors are features of genetic heredity, changes in the chemical balance and processes in the brain, and a frequent stressful state (NHS, 2019). A stress state is usually caused by physical illnesses, sleep disturbances, and daily problems.

The Increased Rates of Bipolar Disorder in Black People Compared to White People in the UK

Several studies indicate increased bipolar disorder in Black people compared to white people in the UK. One such academic research is the work of Iwagami et al. The authors’ objective was to find a correlation between chronic kidney disease and severe mental illness, therefore, during the study, they also performed a population analysis. According to the results approved by the researchers, the proportions of Black ethnicity among the category of patients with severe mental illness exceed white ethnicity (Iwagami et al., 2018). The authors used comparative methodology and logistic regression in their work, and UK Clinical Practice Research Datalink as a key source (Iwagami et al., 2018). Researchers conclude that patients with severe mental disorders are more likely to have chronic kidney disease, which may be due to frequent medical testing procedures.

Baker’s briefing paper also confirms the statement about the increased incidence of bipolar disorder in Black people. The author of this work analyses data and statistics on mental health in the UK, covering the period over the past few years (Baker, 2020). The researcher also compares the current report with the results of similar papers from 2014 and 2017 (Baker, 2020). The study covers many different population indicators such as age, gender, ethnicity and other characteristics (Baker, 2020). Baker notes that Black people are “20% more likely than average to have accessed services in 2018/19” (Baker, 2020, p. 13). Moreover, the researcher concludes that the number of people with bipolar disorder has increased on average, especially among young women.

Majors, Carberry, and Ransaw also agrees in their book that the incidence of bipolar disorder among Black people is higher than among white citizens of the UK. To be more precise, the researcher claims that the comparative risk of the appearance of the condition is 1.4 over the past 20 years (Majors et al., 2020). The author notes wrote this work to help future and novice Black medical professionals (Ransaw et al., 2020). The researcher begins his research from the fifties of the last century in his book (Ransaw et al., 2020). According to the author, one of the critical features of this phenomenon is institutional racism.

Reasons for the Increased Rates of Bipolar Disorder in Black People in the UK

In the course of a review of academic work, the question arises as to why the rates of Black people with bipolar disorder are proportionally becoming higher compared to the white population. Bignall, Jeraj, Helsby and Butt (2019) believe that social and environmental factors serve as an additional trigger. These terms imply difficulties during migration, a cultural barrier in mental health institutions, cultural naivety and the criminal environment in ghettos (Bignall et al., 2019). Researchers also examine in detail the differences in the approach to the treatment of the mental health disorders of Black Migrants and Black British compared to other ethnic groups.

Another important cause of ethnic imbalance in bipolar disorder is systematic racism in mental health institutions. Palmer (2018) claims this in the thesis regarding this topic. According to the author, systematic racism is expressed in the form of lower access, treatment received and the outcome of mental health services (Palmer, 2018). The researcher, guided by a questionnaire, descriptive statistics, thematic analysis and interviews, found that only two of the respondents adhere to professional ethics of equality. The researcher also notes such secondary factors as workforce race inequality and unstandardised processes.

Mercer et al. conducted a similar study on ethnic equality in British mental health facilities. They argue that Black people have less access to mental health facilities than white people, even though Black people are proportionally more likely to suffer from mental disorders (Mercer et al., 2019). It is also important to note that the authors of this work were guided by Trust data (Mercer et al., 2019). The authors do not put forward the idea that the cause is systematic racism, but they state that a study of causal relationships is necessary.

Conclusion

The primary objective of this review was to review the academic and government sources related to the increased rates of bipolar disorder in Black people compared to white people in the UK. The author of this literary review has reviewed how UK psychiatry and the healthcare system define the terms of mental health problems, bipolar disorders, and symptoms of this condition. The specialists’ community opinions on the causes of this illness were also analysed. Based on academic sources, the author found out that the phenomenon under study exists in British society. Several researchers claim that the reason for this is systematic racism.

Reference List

Baker, C. (2020) Mental health statistics for England: prevalence, services and funding. London: House of Commons Library.

Bipolar UK. (n.d.) bipolar – the facts. 2020. Web.

Bignall, T., Jeraj, S., Helsby, E., & Butt, J. (2019) Racial disparities in mental health: literature and evidence review. London: Race Equality Foundation.

Iwagami, M., Mansfield, K. E., Hayes, J. F., Walters, K., Osborn, D. P., Smeeth, L., Nitsch D., & Tomlinson, L. A. (2018) ‘Severe mental illness and chronic kidney disease: a cross-sectional study in the United Kingdom’, Clinical Epidemiology, 10, pp. 421–429.

Mercer, L., Evans, L. J., Turton, R., & Beck, A. (2019) ‘Psychological therapy in secondary mental health care: Access and outcomes by ethnic group’, Journal of Racial and Ethnic Health Disparities, 6(2), pp. 419-426.

Mind. (2020) Bipolar disorder. Web.

Mind. (2020) Mental health problems – an introduction. Web.

NHS. (2019) Causes. Web.

Majors, R., Carberry, K., & Ransaw, T. (eds.). (2020) The international handbook of black community mental health. Bingley: Emerald Group Publishing.

Palmer, P. (2018) What are adult mental health services doing to improve the outcomes for Black service users? A mixed method analysis of Black Psychologists’ perspectives and UK mental health Trust data. DClinPsy Thesis. University of East London. Web.

The National Mental Health Association defines a mental disability disorder as an ailment, which leads to harsh instability in thinking or conduct of an individual leading to an incapability to deal with life’s everyday demands and customs (Miklowitz, 2011). According to the American Psychiatric Association, individuals with bipolar disorder exhibit incidents of severe obsession and despair (Miklowitz, 2011). The disease is believed to be hereditary. A person with bipolar disorder might portray increased energy, impatience, ecstatic feelings, great bad temper, sleeplessness, poor judgment, and aggressive behavior (Miklowitz, 2011). In the case study, Barry is depicted having depression issues, aggressive behavior, and agitated voice. Based on the above symptoms, it is apparent that he is suffering from a bipolar disorder. Concerning the symptoms discussed above, it should be noted that not all patients develop all the symptoms.

In the case study, Barry’s performance in the workplace has been affected by his ailment. As such, some clients have complained that he talks loudly in a restless voice. Therefore, it is not astonishing to note that individuals suffering from bipolar disorder face special challenges in their day-to-day activities. As illustrated by Barry, the pressure and random challenges in the place of work can have negative effects on the persons with the disease. Owing to this, employers, employees, and persons affected by the diseases should work together in ensuring that the best accommodation solutions are implemented in the place of work (Filsinger & Jeffries, 2005).

Currently, numerous accommodation solutions for workers suffering with bipolar disorder have been developed (Miklowitz, 2011). Some of these accommodations solutions are maintaining stamina, maintaining concentration, staying organized and meeting deadlines, managing memory deficits, working effectively with supervisors, interacting with coworkers, handling stress and emotions, maintaining attendance, and dealing with change. When administering the above accommodation solutions, it should be noted that not all individuals suffering from the disease require interventions for them to undertake their duties. Similarly, it should be noted that other individuals might require a few interventions. Therefore, before the accommodations are administered the limitations experienced by the employee suffering from the disease should be assessed. In the assessment, the extent of how the limitations affect performance, the available accommodation to tackle the issue, previous management measures, and the effectiveness of the selected accommodations should be highlighted (Miklowitz, 2011).

With respect to maintaining stamina in the workplace, the employer should ensure that employees with bipolar disorder such as Barry are given supple scheduling, allowed more frequent work breaks, allowed to work from home, and provided with part time work schedules. To maintain their concentration, employers and other employees should ensure that workers with bipolar disorder have reduced distractions in the work area, appropriate space enclosures or private offices, right to use white noise, access to environmental sound machines, increased natural lighting in their workplaces, uninterrupted work time, and frequent breaks.

To stay prepared and meet deadlines, employers should ensure that employees with bipolar disorder have daily to do lists, have access to calendars to note meetings and deadlines, electronic organizers, divide their large duties into smaller duties, and are regularly reminded about meeting important deadlines. To deal with memory deficit, employers should enable the affected employees to tape record meetings, offer type written minutes of each meeting, offer written instructions, enable additional training time, and offer written checklists.

With respect to working efficiently with superintendents, the supervisors should ensure that the affected employees are offered with positive praise and reinforcement, written job instructions. Similarly, the employers should come up with written work agreements, which comprise of accommodations adopted, understandable prospects of responsibilities, and the penalties of not meeting work standards. In addition, the employers should permit open communication between the affected employees, managers, and administrators. Similarly, they should come up with written long-standing and temporary goals, come up with plans to dress troubles before they arise, and come up with a process of assessing the efficacy of the accommodation adopted.

Concerning interaction with coworkers as an accommodation measure, the employers should inform all workers of their right to accommodations, and offer sensitivity education to employees and supervisors (Rosner, 2003). Likewise, the employers should not command workers to attend work-related social functions. To handle stress and emotions, employers should offer the affected employees with congratulations and constructive reinforcement whenever appropriate, access to counseling and employee assistance programs.

In respect to maintaining attendance, employers should ensure that employees with bipolar disorder are offered with supple leave for health concerns, offered with self-paced workload and supple hours (Rosner, 2003). Lastly, dealing with change can be adopted as an accommodation for workers with bipolar disorder. To address the negative impacts of change among the affected employees, the employer should acknowledge that change in the workplace poses immense challenges to employees with mental difficulties. Therefore, the employer should ensure that open communication among the employees, supervisors and the managers is enhanced to allow effective transition. Similarly, issues related to change can be tackled by conducting regular meetings to highlight workplace problems and productivity levels.

References

Filsinger, K. J., & Jeffries, D. M. (2005). Employment law for business and human resources professionals. Toronto: Emond Montgomery Publications.

Miklowitz, D. J. (2011). The bipolar disorder survival guide (2nd ed.). New York: Guilford Press.

Rosner, R. (2003). Principles and practice of forensic psychiatry (2nd ed.). London: Arnold.

Central Nervous System (CNS) disorders pose a major threat to the quality of life. They are complex in their mode of causing disturbances to mental stability, behavior and overall psychological well being. The chemistry of these disorders is interlinked with a spectrum of pathways. Treatment approaches targeted at the management of these disorders are important to consider and need thorough understanding with regard to their safety, efficacy and many other aspects. The present description is concerned with highlighting the treatment strategies of Lithium and Lamotrigine drugs for bipolar affective disorders. A bipolar disorder is a disease where individuals often switch between depression and bad or good moods. These swings in mood between depression and mania are very rapid. Bioloar disorder is of two types Type 1 and type 2.Individuals with type I disorder, earlier known as manic depression, posses minimum one episode of mania and major depression periods. Individuals with type II disorder,II have do not possess complete mania. They have increased impulsiveness and levels in energy that are similar to hypomania in the degree of severity. The periods related to type II alternate with depression episodes.

Firstly, there is a need to know about the role of mood stabilizers in psychiatry.

Mood stabilizer is a substance used for curing depressive symptoms and acute manic symptoms. They are also used in prophylactic measure for managing bipolar disorder‘s depressive and manic symptoms.In detail, mood disorders are conventionally considered as neurochemical disorders. these are linked with alterations in cellular resilience and structural plasticity. So in CNS, the role of mood stabilizers is to enhance the cytoprotective protein bcl-2 expression in the human neuronal cells and in vivo.

Here, mood stabilizers stimulate a pathway of signaling used by mitogen activated protein (MAP) kinase and extracellular signal-regulated kinase (ERK) pathway which are used by growth factors of internal origin. In addition, they enable the trophic help required for improving and managing ordinary synaptic connections. They also facilitate the chemical signals to restabilize the maximum output of vital circuits needed for general significance. Earlier, the role of mood stabilizing agents was better implicated in lessening the mood disorder led morbidity and mortality. This was accomplished by studying the gene expressin patterns of important kinases like protein kinase C (PKC) alpha. Preventing the activity of PKC is essential in contributing to antimanic strategy through the administration of mood-stabilizing agents.

Treatment options vary for Bipolar disorders. They may be biological treatment, with the use of mood stabilizers like drugs which have long been employed or psychological and social treatment with cognitive behavior therapy. Among these options, there is a need to choose and consider more effective therapy which has become an issue for health care professionals. Practice guidelines and clinical consensus support the use of mood stabilizers such as lithium or anticonvulsants either as add-on therapy for monotherapy for bipolar depression.⁵ But lithium was described to be efficacious in the reduction of manic relapses, and is not efficacious in the reduction of relapses that lead to depression. Lamotrigine, an anticonvulsant does not possess antimanic properties and not as efficacious for major depressive disorder treatment even though for bipolar depression, it is a sufficient antidepressant.In the period of 80s, etiological theories have been propounded for mental disorders which focus on psychological components of risk and susceptibility. On these grounds, cognitive therapy has gained popularity as adjunct for treating individuals with depressive disorders of severe and chronic nature.Being the coherent model as the solid framework, cognitive therapy is considered as highly effective psychological treatment strategy. It gives the patient a clear picture on the reasons behind the strategy employed, contributes to patients utilization of learned skills, improves the patients’ self-and efficacy sense. So cognitive therapy is considered as efficacious approach in the bipolar disorder treatment.Very often bipolar disorder patients face resistance to depression treatment approaches which is known as Treatment Resistant Depression (TRD). These patients even though have social functioning alterations, psychosocial treatment was largely investigated to prove its efficacy.

To this end, drug therapy was combined with cognitive behavioral therapy (group-CBT) to determine if such approach could enhance both social interactions and symptoms of depression in patients with TRD presented in mild form. CBT approach corrected dysfunctional cognitions, dysfunctional cognitions and psychosocial functioning. This has indicated that medication when being added with CBT has led to a positive effect in treatment resistance patients.

Earlier, when discriminated with psychoeducational principle based cognitive-behavioural therapy (CBT), there was no proper assessment of bipolar disorder’s psychosocial investigations with regard to psychoeducation (PE).Patients who received optimized treatment of BD,CBT approach as an additional support or adjunct in the longer course might be beneficial rather than PE implemented in short course.

These studies indicate that psychological treatment appears to be more effective than the biological treatment provided when it is given as an adjunct compared to biological treatment approaches.However, the use of lithium and Lamotrigine do have some benefits if one precisely considers their safety and efficacy. Lithium also known as Lithobid or Eskalith is bipolar disorder prescription drug. It is regarded as “maintenance treatment to support avoiding depression or mania episodes. Its indications include Depression, agitation not related bipolar disorder, Migraine, chemotherapy induced Neutropenia, Graves’ disease etc. The CNS effects of lithium toxicity carry the highest morbidity. They begin when present in mild form from sedation irritation to delirium, seizures, and death in severe cases. In overdoses of 1.6mEq/L,ut, of serum lithium levels,severe neurotoxicity results. It also causes life threatening effects like thyroid and renal toxicity, teratogenic disturbances etc. Lithium interacts much with diurectics and moderately with Non-steroidal anti-inflammatory drugs (NSAIDs) that cause toxicity. Lithium compliance is based on once daily dosing which was rated the most at 79% compared to twice , thrice and four times. It s contraindications are pregnancy, drug hypersensitivity, elderly patyients, caution if the patient has febrile illness, renal impairment, and volume depletion. Lithium monitoring parameters include diuretic or ACE inhibitor usage, depleted Na, baseline analysis of urine, Cr, dehydration etc. Next, Lamotrigine is indicated for Lennox-Gastaut syndrome generalized seizures and partial seizures in epilepsy as an adjunct.It is recommended for depression and bipolar I disorder as maintenance drug. The toxicity of lamotrigine is linked with epilepsy patients who were found with high concentrations of serum lamotrigine when prescribed. But later this toxic effect was not proven to be much significant from clinical trials. Lamotrigine interacts mostly with other drug valproate/ valproic acid and leads to rash which may be life threatening due to high dosage levels. The compliance of lamotrigine is based on valproate’s absence for its instant release and is recommended once daily.Its contraindications are drug hypersensitivity, caution in pregnant women, those on risk of suicide, hepatic and renal alterations. The above information reflects more toxic risk of lithium compared to Lamotrigine.

From a study, it was reported that compared to compared to lithium in the bipolar depression treatment, Lamotrigine was reported to be more safe and efficacious. In older patients with Bipolar I depression, the tolerability and efficacy of mood stabilizers has been investigated. Both lithium and lamotrigine were found to execute good tolerance and effective in maintenance. Lamotrigine has leas t side effects like headache, backache and rash whereas Lithium has most severe side effects like fatigue, diarrhea, xerostomia, headache and dyspraxia. However, even though both are suited well for treating older patients, it is reasonable to mention that Lamotrigine has overall safety and efficacy with regard to the safety, low toxicity and minimum drug interaction. With the above information, it can be summarized that the 74 year old lady with 38 years history of BAD, low mood and suicide attempt as associated complications needs a precise monitoring. Especially, Lamotrigine when used with

Quetiapine Procyclidine may not contribute to any side effects. But blood indices need to monitored regularly.These may involve counts of red blood cell. White blood cell, monocuyte or lymphocyte. The intercellular levels of Lamotrigine when used with other drugs in the old patient may induce some sort of changes in the blood indices which are essential parameters to consider. A failure to assess the blood indices may lead to improper management of Bipolar disorder with regard to drug interactions.This could avoid any chances of recurrences in the episodes of maniac symptoms or depression that could become aggravated with the increasing age.

References

Berger Fred K,Jolla La, Zieve David.Bipolar disorder[homepage on the internet]. 2011. Web.

Bauer MS, Mitchner L. What is a “Mood Stabilizer”? An evidence-based response.Am J Psychiatry. 2004; 161(1): 3-18

Gray NA, Zhou R, Du J, Moore GJ, Manji HK. The use of mood stabilizers as plasticity enhancers in the treatment of neuropsychiatric disorders.

J Clin Psychiatry. 2003;64 Suppl 5:3-17.

Manji HK, Bebchuk JM, Moore GJ, Glitz D, Hasanat KA, Chen G. Modulation of CNS signal transduction pathways and gene expression by mood-stabilizing agents: therapeutic implications. J Clin Psychiatry. 1999; 60 Suppl 2:27-39; discussion 40-1, 113-6.

Young Trevor L. What is the best treatment for bipolar depression? J Psychiatry Neurosci. 2008; 33(6): 487–488.

Scott Jan. Cognitive therapy as an adjunct to medication in bipolar disorder. The British Journal of Psychiatry.2001; 178: s164-s168.

Matsunaga M, Okamoto Y, Suzuki S, Kinoshita A, Yoshimura S, Yoshino A, Kunisato Y, Yamawaki S. Psychosocial functioning in patients with Treatment-Resistant Depression after group cognitive behavioral therapy.BMC Psychiatry. 2010; 10:22.

Zaretsky A, Lancee W, Miller C, Harris A, Parikh SV. Is cognitive-behavioural therapy more effective than psychoeducation in bipolar disorder? Can J Psychiatry. 2008;53(7):441-8.

Lithium Indications [home page on the internet].[2012]. Web.

Primary Psychiatry: Optimal Dosing of Lithium, Valproic Acid, and Lamotrigine in the Treatment of Mood Disorders [homepage on the internet] [2012]. Web.

Lithium: Contraindications [home page on the internet] 2012.

Lamotrigine [home page on the internet] 2012. Web.

Lamotrigine [home page on the internet] 2012. Web.

van der Loos ML, Mulder PG, Hartong EG, Blom MB, Vergouwen AC, de Keyzer HJ, Notten PJ, Luteijn ML, Timmermans MA, Vieta E, Nolen WA, LamLit Study Group. Efficacy and safety of lamotrigine as add-on treatment to lithium in bipolar depression: a multicenter, double-blind, placebo-controlled trial. J Clin Psychiatry.70(2):223-31.

Sajatovic M, Gyulai L, Calabrese JR, Thompson TR, Wilson BG, White R, Evoniuk G.Maintenance treatment outcomes in older patients with bipolar I disorder.Am J Geriatr Psychiatry. 13(4):305-11.

This case study describes a 26-year-old woman of Korean descent who was diagnosed with bipolar I disorder. Generally, bipolar disorder is a rather severe medical condition that is characterized by unusual shifts in concentration, activity levels, energy, and mood, as well as reduced ability to carry out everyday tasks (Carvalho et al., 2020). Particularly bipolar I disorder is “defined by manic episodes that last at least seven days, or by manic symptoms that are so severe that the person needs immediate hospital care” (National Institute of Mental Health [NIMH], 2020, para. 3). Depressive episodes that may last more than two weeks can also be present (Carvalho et al., 2020).

This mental disorder is typically treated with medications that may help manage symptoms. For example, treatment plans can include mood stabilizers (such as Lithobid), antipsychotics (namely, Zyprexa), and antidepressants (NIMH, 2020). To prevent triggering a manic episode, antidepressants and mood stabilizers should be combined.

There was a twenty-one-day hospitalization for the onset of acute mania. The patient’s physician reported her to be in overall good health, and lab studies were all within normal limits. During her hospitalization, there was genetic testing that revealed the woman being positive for the CYP2D6*10 allele, which negatively affects the metabolism of a number of drugs, namely mood stabilizers, antipsychotics, and antidepressants.

According to Tirona and Kim (2017), in Asians, CYP2D6∗10 that is characterized by nonsynonymous polymorphism and decreased activity is found in up to 50%. The woman confessed that she stopped taking her lithium that was prescribed in the hospital. The patient denies having auditory or visual hallucinations, and there are no signs of delusional or paranoid thought processes. What is more, the woman denies suicidal or homicidal ideation as well, though her Young Mania Rating Scale (YMRS) score is 22, which is mild mania.

The first decision step was to begin Risperdal 1mg orally twice a day. Researchers note that it is “indicated for the treatment of acute manic or mixed episodes associated with bipolar I disorder” (“Risperdal,” 2020, para. 4). Even though it is metabolized by CYP2D6, it was decided to avoid prescribing other medications and monitor the effectiveness and side effects of this drug (“Risperdal,” 2020). What is more, since it was impossible to rely on the patient and trust her about taking medicine properly after the lithium incident, prescribing only one drug and explaining the necessity of taking it was important.

The second decision point came after the patient returned to the office after four weeks. She was accompanied by her mother, who had to help her enter the office. The client looked very sedated and lethargic, and it was reported by the mother that the patient had been in this state since approximately a week after the last office visit. It was decided to decrease Risperdal to 1mg at HS. This decision was based on the necessity to avoid toxicity because it was evident that there was a problem with this drug metabolism.

In four weeks, the client returns to the office with several improvements. It becomes evident that she was compliant with the prescription, and now she appears to be less sedated and lethargic, which is the result of lowering the levels of Risperdal in her blood. What is more, her Young Mania Rating Scale has decreased from 22 to 16, which is a bit more than a 25% decrease in symptoms. Therefore, the third decision step is to continue at the same dose of Risperdal (1mg at bedtime) and reassess in four weeks. During this period, the patient is expected to get used to taking drugs and show an improvement in her mental state. After that, it may become possible to prescribe other medications and be sure that the woman will not avoid taking them.

References

Carvalho, A. F., Firth, J., & Vieta, E. (2020). Bipolar disorder. New England Journal of Medicine, 383(1), 58-66.

National Institute of Mental Health [NIMH]. (2020). Bipolar disorder. NIMH. Web.

Risperdal. (2020). RxList. Web.

Tirona, R. G., & Kim, R. B. (2017). Introduction to clinical pharmacology. In D. Robertson & G. H. Williams (Eds.), Clinical and translational science (2^nd ed, pp. 365-388). Elsevier.

Introduction

Nowadays, bipolar disorder (BD) is one of the most misrepresented yet prevalent mental health issues. There are numerous cultural factors, which contribute to the variations in diagnosis and treatment among different socio-economic and racial groups. The purpose of this essay is to examine a variety of legal, ethical, and cultural implications in treating patients with bipolar disorder.

The Impact of Culture and Systemic Oppression on Diagnosis and Treatment

Culture can amount for differences in how mental health patients communicate their symptoms or which treatment options are selected for them. Unfortunately, due to a variety of socio-economic factors some ethnic groups in the United States have lower level of health literacy (Oedegaard et al., 2016). Thus, they rarely seek help in the first place, which explains the statistics that demonstrate how minorities are often underdiagnosed for bipolar disorder (Oedegaard et al., 2016). As for treatment, privilege based on race and class factors in a person’s ability to not only receive acute psychiatric help but also maintenance during follow-up visits. Residents of low-income communities, who are often people of color, do not have access to the full range of treatments needed for efficient management of BD.

Theoretical Orientations and Interventions I Would Use

I would use cognitive behavioral theory (CBT) and interpersonal and social rhythm therapy (IPSRT) for treatment of patients with bipolar disorder. CBT centers on the balanced relationship between a patient’s feelings, behaviors, and thoughts (Miklowitz, 2019). IPSRT helps people with BD to keep track of their routines and sleep-wake cycles in order to prevent extreme mood swings (Miklowitz, 2019). As for specific interventions, I would focus on early intervention strategies such as positive lifestyle changes instead of relying on pharmacotherapy.

The Need for Additional Resources: Their Accessibility

Treatment of patients with bipolar disorder often requires the incorporation of additional resources apart from the aforementioned interventions. First, a crucial part of the treatment is a reliable support system, which many people do not have. Thus, medical professionals have a responsibility to introduce patients to innovative support networks, including online groups and offline socializing events. Additionally, patients sometimes require expensive pharmacotherapy to manage BD symptoms. Unfortunately, there are many people suffering from bipolar disorder who do not have access to medications, which are usually not covered by standard health insurance.

Methods to Address Concerns Regarding Patients with Bipolar Disorder

There are numerous concerns regarding the treatment of patients with bipolar disorder. Some of them include the adverse effects of medications as well as the patients’ need for acceptance, validation, and support, particularly during hyper-manic episodes. In a psychiatric setting, healthcare professionals have to identify the needs of a person suffering from BD, ensure that there is a close support network, and take preventative measures to limit negative implications of pharmacotherapy.

The Impact of Media Representation

Mass media forms the public’s attitudes and perceptions, which can be exceptionally harmful to people struggling with mental health disorders. TV shows, films, commercials, and gossip web-sites often portray psychiatric disorders negatively. Those suffering from extreme mood swings, which are the primary symptoms of BD, are usually portrayed as violent and overly dramatic (Srivastava et al., 2018). Moreover, misrepresentation of persons with bipolar disorder in the media results in exaggerations that contribute to the social stigma surrounding mental health issues. Thus, people who may experience some symptoms of BD often refuse to seek help because they believe they “have themselves to blame for their condition” (Srivastava et al., 2018, p. 2). Therefore, there is an overall lack of access to therapeutic attention among persons with bipolar disorder because of misleading imagery presented by mass media.

Conclusion

It is evident that bipolar disorder is a serious mental health issue, which often gets overlooked and underdiagnosed, especially among people from low-income communities. Unfortunately, due to socio-economic factors, some people have a lack of health literacy and limited access to the appropriate care. Thus, medical professionals have a task of incorporating all of the applicable and available therapies and interventions to ensure that the patient’s needs are met.

References

Miklowitz, D. J. (2019). Different types of therapy for bipolar disorder. National Alliance on Mental Illness. Web.

Oedegaard, C. H., Berk, L., Berk, M., Youngstrom, E. A., Dilsaver, S. C., Belmaker, R. H., Oedegaard, K. J., Fasmer, O. B., & Engebretsen, I. M. (2016). Socio- cultural challenges in the management of bipolar disorder: A trans- cultural qualitative study by the International Society of Bipolar Disorders (ISBD). UIB. Web.

Srivastava, K., Chaudhury, S., Bhat, P. S., & Mujawar, S. (2018). Media and mental health. Industrial Psychiatry Journal, 27(1), 1–5. Web.

Theoretical Causes

Bipolar disorder is one of the more difficult and less understood mental disorders, as its symptoms manifest in a variety of ways and cause comorbidities that often leave the core issue undiagnosed. The condition causes severe mood shifts in a person, making the handling of life and normal existence difficult. People suffering from bipolar disorder constantly go between the states of depression and mania, which affect their decision-making skills, mood, emotion, and ability to communicate with others. The exact triggers and causes of this disease are unknown, as is the case with many other mental diseases, but it is believed that genetics and a person’s heritage have a large influence. Sometimes the causes are also physical, such as a difference in the composition of the brain.

Associated Factors

Factors that cause instances of bipolar disorder are varied and can include both internal and external factors. As a disease closely connected with one’s genetics, some of the risk factors are inherent to a person’s body and being. Having a close relative who also suffers from bipolar disorder can put one at a higher risk (Leahy, 2007). A first-degree relative has a high chance of transferring the genes responsible for the disorder to an individual. Furthermore, traumatic events and occurrences can also present a danger to a person suspected of bipolar disorder. The death of a loved one or an instance of abuse can serve as a trigger for the condition. Other types of harmful events and self-detrimental practices can also become a contributing factor to suffering from BD. Such actions as consuming alcohol, drug use, or other types of substance abuse.

Pathology

Many individual brain regions are connected to the pathology of this condition. Since many of the areas are used by people when experiencing emotions, they are also connected with the occurrences of the disorder. Elevated activity in the amygdala region has been connected with occurrences of BD, as this section of the brain identifies the importance of emotional stimuli (Miklowitz & Johnson, 2006). Hyperactivity of the amygdala was shown to be one of the reasons for the sudden mood swings for those suffering from BD. Areas of the prefrontal cortex and hippocampus, are, alternatively underutilized and display diminishing activity (Miklowitz & Johnson, 2006).

Treatment

Treatment for this condition can be varied, as the condition is lifelong and requires constant monitoring, control, and adjustment to balance high quality of life and effectiveness. Treatment options are consequently primarily focused on managing the symptoms. Medication is oftentimes utilized, in different capacities (Leahy, 2007). To properly control the mood swings and stabilize one’s condition, medication is used. It helps the patient to find a balance between the two extremes. Counseling and treatment programs are also utilized, as they can offer patients both professional help and advice (Leahy, 2007). Specific treatment options to address the co-morbidities of the condition also exist, to address such issues and relationship trouble or substance abuse.

Techniques Used in Diagnosis, Care and Research

Diagnosis is performed through a variety of procedures, including both mental and physical examinations. Physical check-ups can identify any of the issues causing a person’s particular symptoms. An assessment by a psychiatrist that will discuss a person’s thoughts, feelings, and behaviors may also be used. Another technique is mood charting, which is used to document and understand the changes in the mood a patient shows. All of the above results will be compared to established criteria for diagnosing BD and the final verdict will be made based on it.

References

Leahy, R. L. (2007). Bipolar disorder: Causes, contexts, and treatments. Journal of Clinical Psychology, 63(5), 417–424. Web.

Miklowitz, D. J., & Johnson, S. L. (2006). The Psychopathology and Treatment of Bipolar Disorder. Annual Review of Clinical Psychology, 2(1), 199–235. Web.

Manifestations of various emotions and changes in a person’s mood are typical and depend on many factors – from temperament and character to ongoing events. However, when these changes are excessive, often occurring unexpectedly and for no apparent reason, and emotions get out of control, bipolar disorder may be diagnosed. According to McIntyre et al. (2020), bipolar disorder is a mental health condition that causes extreme mood swings that include emotional highs (mania) and lows (depression). Thus, bipolar depression is characterized by a depressed mood, decreased ability to think and concentrate, fatigue, and energy loss. Conversely, bipolar mania is characterized by abnormally optimistic behavior, increased activity and energy, reduced need for sleep, unusual talkativeness, and restlessness. One of the screening tools related to bipolar disorder is the Bipolar Spectrum Diagnostic Scale. McIntyre et al. (2020) assert that its specificity was high, which makes it of undoubted value in diagnosing a wide range of bipolar disorders. Therefore, BSDS has demonstrated high sensitivity in the recognition of the bipolar disorder.

According to Grunze et al. (2018), in severe episodes of mania, it is advisable to prescribe oral forms of dopamine antagonists, among which haloperidol, olanzapine, risperidone, and quetiapine are especially effective. Furthermore, Malhi et al. (2021) affirm that valproic acid is an alternative drug with a lower risk of side effects (dyskinesia). Still, it should not be used in women of reproductive age since the risk of teratogenic effects and damage to the fetus’s central nervous system is very high. It is also possible to use aripiprazole, carbamazepine, and lithium preparations. A short course of GABA modulators may be used to improve sleep quality in agitated, hyperactive patients. Stahl et al. (2017) note that no psychotherapy is an effective alternative for an acute manic episode. If initial therapy has been effective, maintenance treatment should be considered. It is recommended to continue therapy with an effective mood stabilizer or a combination of drugs for 3-4 months, gradually reducing or canceling sedative antipsychotic treatment with first-generation antipsychotic drugs and benzodiazepines.

References

Grunze, H., Vieta, E., Goodwin, G.M., Bowden, C., Licht, R.W., Azorin, J.-M., Yatham, L., Mosolov, S., Möller, H.-J., & Kasper, S. (2018). The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: Acute and long-term treatment of mixed states in bipolar disorder. The World Journal of Biological Psychiatry, 19(1), 2–58. Web.

Malhi, G. S., Bell, E., Bassett, D., Boyce, P., Bryant, R., Hazell, P., Hopwood, M., Lyndon, B., Mulder, R., Porter, R., Singh, A. B., & Murray, G. (2021). The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Australian & New Zealand Journal of Psychiatry, 55(1), 7–117. Web.

McIntyre, R.S., Berk, M., Brietzke, E., Goldstein, B. I., López-Jaramillo, C., Vedel Kessing, L., Malhi, G. S., Nierenberg, A. A., Rosenblat, J. D., Majeed, A., Vieta, E., Vinberg, M., Young, A.H., & Mansur, R. B. (2020). Bipolar disorders. The Lancet, 396(10265), 1841-1856. Web.

Stahl, S.M., Morrissette, D.A., Faedda, G., Fava, M., Goldberg, J.F., Keck, P.E., Lee, Y., Malhi, G., Marangoni, C., & McElroy, S.L. (2017). Guidelines for the recognition and management of mixed depression. CNS Spectrums, 22(2), 203-219. Web.

Case Overview

Sarah, a 22-year-old female, reports being happy all the time for the past two weeks. During this period, she has made several arbitrary decisions, such as gambling, unprotected sex, and work termination, which might lead to significant negative consequences in the future. She has had less sleep, experienced delusional episodes, and demonstrated highly unusual behavior.

Main Diagnosis

Mood disorder: Bipolar I disorder – A manic episode lasting up to three weeks.

Two Differential Diagnoses

The primary diagnosis differs from bipolar II disorder due to the evidence of a manic episode instead of hypomanic episodes (Purse, 2021). The diagnosis also differs from cyclothymia due to the highly irregular patient’s behavior and lack of consistent mood swings (Perugia et al., 2017).

Target Symptoms

• Elated affect during a psychiatric interview;
• Rapid speech;
• Poor concentration;
• Easily distracted;
• Hypersexuality;
• Risky behavior;
• Arbitrary decision-making;
• Feeling elevated all the time during the past two weeks;
• Sleeping disorder;
• Delusional.

Diagnostic Test

The diagnostic test for bipolar disorder requires the person to be in a manic episode for at least a week and sustain at least three common symptoms of the mental health problem (Purse, 2020). During the examined period, Sarah demonstrated more than five symptoms, including poor concentration, risky behavior, little sleep, hypersexuality, rapid speech, and others, confirming a manic episode of bipolar I disorder.

Treatment Plan

In the case of bipolar I disorder, the complex treatment should include medication, therapy, and lifestyle changes. The former generally concerns antipsychotics and mood stabilizers to prevent further episodes (Purse, 2020). Therapy is necessary to identify the manic episode triggers and moderate their impact (Purse, 2020). Lastly, lifestyle change is a complementary measure to improve the quality of life, sleep efficiency, and overall health (Purse, 2020). Ultimately, the complex treatment might successfully mitigate future manic episodes.

References

Perugia, G., Hantouchec, E., & Vannucchia, G. (2017). Diagnosis and treatment of cyclothymia: The “primacy” of temperament. Current Neuropharmacology, 15(3), 372-379.

Purse, M. (2020). What is a manic episode? VeryWellMind. Web.

Purse, M. (2021). Symptoms and diagnosis of bipolar disorder. VeryWellMind. Web.