Description and Symptoms
Bipolar (manic-depressive) disorder is a brain illness that causes sudden changes in an individual’s mood, levels of activity, energy, as well as the ability to perform mundane tasks. It can affect both women and men to an equal extent and usually begins between ages 15 and 25, according to Merrill from the New York Times. While the exact causes of the bipolar disorder remain unknown to researchers, some life events such as recreational drug use, insomnia, or sometimes even childbirth have been identified as possible causes. According to the report written by the National Institute for Mental Health, the symptoms of bipolar disorder are divided into the states of manic and depressive episodes (3). The symptoms of manic episodes include insomnia, becoming more active, agitation, irritability, feeling “jumpy,” risky activities; on the other end of the spectrum, depressive episodes include symptoms such as sadness, lack of concentration, weariness, tiredness, thoughts about suicide, and feelings of emptiness (National Institute for Mental Health 3).
Bipolar disorder is classified into the following three categories: Bipolar 1, Bipolar 2 disorders, and Cyclothymia. An individual is diagnosed with Bipolar 1 when he or she experiences manic mood swings that affect daily activities, for example, aggressive behavior, agitation, abuse of substances, delusion, etc. In Bipolar 2, a patient may experience symptoms such as manic emotions as anger, irritability, happiness, and suicidal thoughts. Cyclothymia is the least severe type of bipolar and can appear from time to time.
Diagnosis and Treatment
Successful assessment, diagnosis, and treatment require healthcare professionals to possess knowledge about the episodic nature of bipolar. In some cases, patients may need immediate referrals to specialized care due to the risk of harm (McCormick et al. 532). To make an accurate diagnosis, healthcare professionals use the Mood Disorder Questionnaire and the Composite International Diagnostic Interview (McCormick et al. 532). Moreover, there has been a recent development in the electronic and Web-based screening tools targeted at achieving better assessment and screening efficiency.
Pharmacological treatment of bipolar disorder includes the administration of medications such as mood stabilizers (lithium, sodium valproate, lamotrigine, etc.), conventional antidepressants, and atypical antipsychotics (quetiapine, lurasidone, a combination of olanzapine and fluoxetine) (Geddes and Miklowitz 1674). Psychosocial treatments have also become integral components of bipolar disorder treatment with a focus on self-care and adherence to treatment. Cognitive-behavioral psychotherapy has shown to be effective in elevating the burden of bipolar, as found by Jones et al. (204).
Challenges in Treatment
With regard to the issues in bipolar management, nonadherence, comorbid medical and psychiatric disorders, and suicide attempts were classified as the most challenging. Among them, nonadherence is the most significant component that contributes to the poor treatment outcomes, leading to the increase in the emergency room visits rates and subsequent hospitalization of patients (McCormick et al. 534). It is also important to mention that suicide rates among patients with bipolar at the highest compared to individuals suffering from other psychiatric disorders. Therefore, the healthcare team is responsible for monitoring patients with bipolar for suicidality, especially among those individuals who experience persistent and reoccurring depressive symptoms.
Despite the fact that bipolar disorder has been surrounded by stigma for not being a “real” illness, it remains a persistent issue that deters patients’ well-being and requires further research with regards to diagnosis methods, treatment, and the overcoming of current challenges such as nonadherence or suicides.
Works Cited
Geddes, John, and David Miklowitz. “Treatment of Bipolar Disorder.” Lancet, vol. 381, no. 9878, 2013, pp. 1672-1682.
Jones, Steven, et al. “A Randomized Controlled Trial of Recovery Focused CBT for Individuals with Early Bipolar Disorder.” BMC Psychiatry, vol. 12, no. 1, 2012, p. 204.
McCormick, Ursula, et al. “Diagnosis and Treatment of Patients with Bipolar Disorder: A Review for Advanced Practice Nurses.” Journal of the American Association of Nurse Practitioners, vol. 27, no. 9, 2015, pp. 530-542.
Merrill, David. “Bipolar Disorder.” New York Times, 2013. Web.
National Institute for Mental Health. “Bipolar Disorder.” NIMH, 2015. Web.