Bipolar disorder

Bipolar disorder, also called manic-depressive illness, is a complicated medical condition that expresses severe mental illness, affecting person’s mood, energy and ability to function. People who have bipolar disorder experience rapid extreme shifts in their moral disposition as well as in the ability to perform basic activities. Unlike the regular changes in a person’s mood, the symptoms of bipolar disorder are severe.Bipolar disorder’s symptoms include sharp, radical mood shifts from “overly “high” and/or irritable to sad and hopeless,” and vice versa, usually displaying stable condition and normal mood in periods between extremes. Such shifts in temper are followed by changes in energy and behaviour. The periods of highs and lows are called “episodes of mania and depression” (Hyman). Most patients experiencing the symptoms of bipolar disorder are able to receive effective treatment, which will eventually significantly stabilize the moral condition of a person.

Usually, treatment and recovery processes involve both special medication schedule and psychological procedures contributing to improvement of the overall condition. Bipolar disorder is a brain disorder that stimulates unusual changes in an individual’s mood, energy, and ability to function. The symptoms experienced by people with bipolar disorder may worsen their communication and relationship with surrounding community, compromise their attitudes and relationships with other people, significantly lower performance ability in their social (work, etc.) and personal activity. Some situations, demonstrating extensive function of the symptoms may essentially worsen an individual’s condition, and in some case may even result in a suicide. Although the symptoms are very serious and expose a sick person to potential danger from his/her harmful activity caused by mania/depression, bipolar disorder can be treated, and patients can lead full and productive lives.

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Statistics shows that about one percent of American population within the age group of 18 and older experiences bipolar disorder of different severity (Hyman). Typically, the illness is most likely to emerge in late adolescence or early adulthood and is further progressive, although in some cases the illness may expose first symptoms in childhood further developing into disorder or disappear during a process of early psychological development.One the initial error usually incurred by people who have bipolar disorder is failure to perform the proper diagnosis, and consequently recognize certain psychological processes as symptoms of the illness. Therefore, people often suffer during a long period of time before the fact of the existence of the illness is recognized and appropriate treatment system is prescribed. “Manic-depression distorts moods and thoughts, incites dreadful behaviours, destroys the basis of rational thought, and too often erodes the desire and will to live.It is an illness that is biological in its origins, yet one that feels psychological in the experience of it; an illness that is unique in conferring advantage and pleasure, yet one that brings in its wake almost unendurable suffering and, not infrequently, suicide” (Heiby).

The symptoms, which are expressed by dramatic changes in person’s mood and ability to perform basic activity, are divided into two groups: high and/or irritable state and sad/hopeless, which are also referred to as episodes of mania or depression. These processes occur in turns with a period of stable and normal position of mood in between.The symptoms of “manic episode” include the following: increased energy, activity, and restlessness, excessively “high,” overly good, euphoric mood, extreme irritability, racing thoughts and talking very fast, jumping from one idea to another, distractibility, lack of concentration, sleeplessness, unrealistic beliefs in one’s abilities and powers, poor judgment, spending sprees, a lasting period of behaviour that is different from usual, increased sexual drive, abuse of drugs (particularly cocaine, alcohol, and sleeping medications), provocative, intrusive, or aggressive behaviour, denial that anything is wrong (Fox).The diagnosis for manic episode of bipolar disorder is performed under circumstances when high mood conditions combined with three other symptoms are observed for minimum one week period, with daily frequency of occurrence. In case of irritable mood, four additional symptoms are required for bipolar disorder diagnosis.The symptoms of “depressive episode” of bipolar disorder include the following: lasting sad, anxious, or empty mood, feelings of hopelessness or pessimism, feelings of guilt, worthlessness, or helplessness, loss of interest or pleasure in activities once enjoyed, including sex, decreased energy, a feeling of fatigue or of being “slowed down”, difficulty concentrating, remembering, making decisions, restlessness or irritability, sleeping too much, change in appetite and/or unintended weight loss or gain, chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury, thoughts of death or suicide, or suicide attempts (Fox). The diagnosis for depressive episode is performed under circumstances when five or more symptoms are observed for minimum two weeks with daily frequency. Bipolar disorder can be divided into different stages, which identify the severity of either elevated or depressed condition: severe mania, hypomania (mild to moderate), normal or balanced mood, depression (mild to moderate), and severe depression.

Hypomania, which represents mild to moderate state of manic episode, may be enjoyed by person, and even provide an illusion of increased productivity and better performance ability.In some cases, the symptoms of hypomania are recognized by other people, although they may be rejected by the person who is experiencing it, which is in fact another symptom of manic episode. In such cases proper treatment procedures have to be prescribed, or otherwise a mild condition of bipolar disorder may progress into severe mania, or sometimes into depression. Severe episodes of mania or depression are serious psychological conditions and may include elements of psychotic symptoms, like psychosis. Generally, these symptoms are represented by hallucinations or delusions (Keltner). Psychotic symptoms emphasize the state of bipolar disorder that a patient is experiencing.For example, under manic episode psychotic symptoms may include representing oneself as some powerful individual, who possesses extraordinary powers, wealth, influential abilities, etc.

; however such considerations do not correspond with reality. Similarly, under depressive episode psychosis may be experienced as a perceived threat of being powerless, bankrupt, worthless personality, or illusion of a feeling that one has committed terrible crime, or responsible for devastating events. In such cases, when extreme states of bipolar disorders are accompanied by psychotic symptoms, the illness may be often confused with schizophrenia, which represents a false diagnosis, and, consequently, improper treatment methods.Occasionally, some patients express the presence of both types of symptoms: mania and depression, which is referred to as mixed bipolar state. Symptoms under a mixed state include agitation, trouble sleeping, significant change in appetite, psychosis, and suicidal thinking (Keltner). Feelings of sadness and hopelessness are combined in this case with highly energetic condition.

In some cases, bipolar disorder influences not only mental well being of a person, but also can have severe physical effects. For example, symptoms which stimulate drug abuse or excessive consumption of alcohol. Mood disorders may cause other serious malfunctions of an organism both mental and physical. Many cases of bipolar disorder may become suicidal.The risk of committing a suicide appears on the early stages of the illness development.

Therefore, it is critical to complete a proper diagnosis of the disorder on the early stages of its development in order to decrease the risk of potential suicidal outcome. Patients experiencing bipolar disorder can receive effective treatment, which provide an essential improvement of the condition of the illness. However, due to the ability of the illness to reoccur, the treatment procedures must be developed for a long-term medication period. The most effective treatment method is a combination of medicals consumption and psychological procedures, which are effective over a long period of the illness progression.In order to achieve the best treatment results the procedures must be continuous and mutually compensation with an attempt to exclude any periods of leaving the illness without control.

Medications, which are usually used to improve the condition of the patient, are referred to as “mood stabilizers” (Sachs). Mostly bipolar disorder patient undergo treatment using mood stabilizers over a continuous period of time, although there are some medical substances which are complimented to the treatment procedure periodically when needed. The later are designed for consumption over shorter periods, targeted to attack episodes of mania or depression that may occur during the primary treatment process.There are several different mood stabilizers, which are designed to assess different needs of a patient, as well as differentiated on the basis of the patient’s age and some other physical specifications. The first mood stabilizing medication approved by the US Food and Drug Administration is lithium, which is primarily designed for treatment of mania. Lithium is fairly effective in treating manic and depressive episodes with qualities of prevention of their possible reoccurrence (Kivlahan). Another type of medications is anticonvulsant medications, including valproate and carbamazepine. These medications also serve as a mood stabilizing element and are effective even in severe states of either episode.

Valporate is specifically designed for mania treatment (Sachs). Both types of medications anticonvulsant and lithium may be used in specific combinations I order to yield the best possible result of treatment. In the current medical practice lithium is preferably used in most cases with bipolar disorder patients. Children and adolescents are cured with lithium based medications, although anticonvulsants are sometimes used also.

However, research is still in the process in order to receive the exact data of the effects of anticonvulsants use on young organism, and the exact effectiveness and safety of prescribing such medications are still under development.By far, evidence shows that “valproate may lead to adverse hormone changes in teenage girls and polycystic ovary syndrome in women who began taking the medication before age 20” (Sachs). Furthermore, pregnant women with bipolar disorder or those who wish to conceive, are not recommended to practice extensive mood stabilizing medications consumption, because of its “possible harmful effects of existing mood stabilizing medications on the developing fetes and the nursing infant” (Sachs). Evidence also suggests that extensive consumption of antidepressant medication may lead towards potential complications, when a potential risk emerges for patients to switch to mania or hypomania from their depressed condition of bipolar disorder (Sachs).

Because of that fact, mood stabilizing medications are usually required for intake for patients with bipolar disorder, and may be complimented with antidepressant treatment elements in order to prevent from te potential transformation of the depression episode into mania. In today’s medical practice, the most commonly used mood stabilizing substances are lithium and valproate. However, the research is conducted in order to determine the safety and effectiveness of several new mood stabilizing alternative substances. Mostly these are elements which are used to cure other mental disorder, such as antipsychotic medications. The latter include clozapine, quetiapine, olanzapine, ziprasidone, and risperidone and all are considered as possible alternatives for bipolar disorder treatment.Clozapine research is especially critical as it is proven to provide possible alternative for those patients who fail to respond to either lithium or anticonvulsant medications.

Olanzapine has shown positive results and has been FDA proven to be effective method of mania treatment with severe symptoms. However, it is also effective in accessing psychotic depression treatment (Sachs). Other types of medications that are commonly used are clonazepam and lorazepam, which are helpful with preventing such symptoms as insomnia due to their high-potency benzodiazepine nature. However, such medications are known to stimulate habitual influence, and are used in treatment pans only on a short-term basis. On long-term intervals they are compensated with sedative alternatives, such as zolpidem (Sachs).Patients who experience bipolar disorder often display a tendency to possess abnormal thyroid gland function.

Insufficient or overloaded proportions of thyroid hormone in blood may cause rapid and extreme mood and energy changes. Patients, experiencing rapid cycling are the most probable to have thyroid difficulties. Therefore, their treatment plans must include thyroid levelling medicine in addition to other mood stabilizers. Lithium consumption has shown to stimulate low thyroid levels in some cases, are usually prescribed with thyroid complements (Rauch). Obviously, medication consumption plans are limited by a list of complications and side effects that are monitored to occur in case of certain supplement intake.Depending on the medication, side effects may include weight gain, nausea, tremor, reduced sexual drive or performance, anxiety, hair loss, movement problems, or dry mouth.

Along with medication plans, several psychological treatments are implemented as effective tools of preventing the progression of bipolar disorder. Certain forms of psychotherapy lead to essential improvements, such as increased mood stability as well as improved performance in some areas. The most commonly used practices in accessing bipolar disorder are family therapy, cognitive behavioural therapy, psycho education, and interpersonal and social rhythm therapy (Huxley). Family therapy is targeted at reduction of a distress level within the family, which are possible initiators of the illness’ symptoms.Cognitive behavioural therapy is primarily targeted at changing attitudes and negative thought models concerning one’s behaviour and community feedback, stimulated by the disorder’s symptoms. Psycho education process involves providing basic necessary information about the disorder to patient as well as family members in order to promote familiarity with common symptoms and methods of overcoming them, and to fasten the recognition process in case of the illness’ presence. Interpersonal and social rhythm therapy offers assistance for patients in overcoming every day difficulties of the illness. It is targeted to improve interpersonal relationship of te patient as well as increase the ability to perform.

It is very useful in preventing manic episodes (Huxley).A proper combination of psychotherapy procedures along with medication plans have to be developed in order to satisfy the demand of every patient and consider his/her uniqueness as for certain psychological and physiological specifications. Bipolar disorder is a serious mental illness and should be altered while the early stages of development are in progress; therefore, a proper and timely diagnosis is critical for patient’s mental health and life. Bibliography Bardick, A. D. , Bernes K. B. “A closer examination of bipolar disorder in school-age children.

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