Bipolar Disorder as Part of a Larger Group of Disorders within the DSM-IV Diagnostic Manual - Essay Example

? MOOD DISORDER Mood Disorder Word Count 500 (6 pages) Write an essay which attempts to make an initial diagnosis of the individual’s problems, outlining the diagnostic criteria from DSM-IV on which your initial diagnosis is made. Is the disorder part of a larger group of disorders within the DSM-IV? Is the disorder heritable? Is it treatable? Does B’s discussion of his behaviour meet any of the criteria of defining abnormal behaviour? ?? I. Introduction (50 words) There are three elements which will be discussed here: that bipolar disorder is part of a larger group of disorders within the DSM-IV diagnostic manual; the disorder is heritable yet treatable; and the fact that B’s discussion of his behaviour does meet some of the criteria which defines abnormal behavior. II. Part of a Larger Group of Disorders (300 words) Bipolar disorder is a disorder that’s in the category of mood disorders. According to Schou (2004), “Mood disorders are recognized as episodes when the patients experience alternating periods with symptoms and intervals without symptoms. In bipolar disorder there may be episodes of mania, periods with abnormal elation and increased activity, and depression, periods with abnormal sadness and melancholy” (pp. 7). B may have other problems in addition to bipolar disorder. His admission that he sometimes became paranoid is evocative of this fact. According to Griez (2005), “A comorbid anxiety disorder in 40% to 90% of subjects with bipolar disorder in community samples” (pp. 16). One of the only reasons that adequately explains bipolar problems might be an abnormality that occurs in the brain. According to Bogousslavsky & Cummings (2000), “The initial studies of emotional disorders following brain injuries included patients with various lesions…studies suggest[ed the left hemisphere is critical as a sphere in depression]” (pp. 65). Since B’s sleep cycles were affected depending upon the place he found himself in his cycling phases, this may have had an affect on his mood. According to Amsterdam, Hornig, & Nierenberg (2007), it is thought that “…sleep-wake cycle alterations are central to these disorders…” (pp. 96). It is not uncommon for bipolar disorder to be given as a diagnosis. However, it should be mentioned that many other disorders or illnesses can be misdiagnosed; there may be other underlying causes for having mood swings. According to Shives (2007), “[S]everal medical illnesses are highly correlated with mood disorders” (pp. 326). Bipolar disorder is a condition that must be dealt with promptly, so that B’s destructive behaviors—indicative of a manic phase—won’t have a disastrous toll on familial relations. This should be avoided at all costs by seeking appropriate medical treatment as soon as possible. III. Heritable Yet Treatable (600 words) B’s mother, with whom he has a very close relationship, has suffered from depression for a number of years. His maternal uncle is a recluse who has always been described by the family as ‘a highly creative eccentric who is too sensitive for the real world.’ B’s problems may stem from certain inherited genes which may have influenced his behaviours. According to Dubovsky and Dubovsky (2002), “Careful studies have repeatedly demonstrated that mood disorders are familial” (pp. 78). B’s symptoms seem typical of what bipolar disorder entails. “Somatic symptoms characterizing mood disorders are nearly equivalent across cultures” (Barlow & Durand, 2008, pp. 228). B’s milder episodes of mania were amazingly intoxicating, and they gave him much pleasure and lots of energy and ideas which translated into major work ideas and inventions; this was a golden time for B. He was not actually diagnosed until he was almost 28, by then his behaviour had become more excessive and was affecting his work and personal relationships and everything around him. He got away with things for so long because his family was so well-known and wealthy and he was so successful in his work, that people accepted that B was a genius. As such, he was almost expected to be somewhat unusual. B might have had mixed episodes if his emotions indeed ran together. According to Ghaemi (2007), “Every depressed patient should be assessed carefully for current manic symptoms to rule out a mixed episode” (31). As such, B is part of a small percentage of the population that might be affected by this illness, according to the seriousness of his symptoms. According to Schatzberg (2005), “[A]t least 5% of the population have disabling bipolar disorder…” (45). It is, however, more common to suffer from depression. According to Levin (2008), “Overall, anywhere from 5 to 15 percent of the…adult population will suffer from depression at some time” (pp. 8). One way B can cope is to be able to manage his emotions. According to Daley (2006), “Managing emotions or feelings is a very important part of recovery from a…mood disorder…” (pp. 110). Additionally, B should get treatment that will be effective—although it is not always a guarantee that certain antidepressants will help him. According to Goodnick (1996), “[P]erhaps 20%-30% of individuals with disabling major depression do not respond fully to TCAs [tricycling antidepressants], whereas many others respond only partially or are unable to tolerate therapeutic doses because of side effects” (pp. 1). B may have to be put on lithium, depending upon the severity of his illness. According to Shorter (2009), “Over the years, no drug has made as much of a difference in the lives of patients with manic-depressive illness, now known as bipolar disorder, as lithium…” (pp. 68). Culture is not a likely factor to affect B. His family seems like they will be supportive of him being on medications, especially because people in his family have mood problems. According to Loue & Sajatovic (2007), “Culture can affect treatment modalities in numerous ways. If people in a society understand a treatment modality and accept its application, they are more likely to accept and comply with the treatment (pp. 69). Compliance with medication is going to be part of B’s successful treatment plan. With treatment, B can overcome the problems that have similarly plagued his family. Even though a mood disorder can be inherited through a few genes, B has the possibility of getting treatment on his side. If he continues on the path of being destructive, B may eventually have a very serious problem, therefore he desperately needs treatment. IV. B’s Discussion Evokes Symptoms of Bipolar Disorder (300 words) B had a horrible “crash” experience. In his depressive episodes, B’s mind grinds to a halt; he loses all interest in friends, work, eating, drinking, bathing, everything. His whole waking life was permeated by an awful sense of dread, he said he felt no connection with anyone, he felt like he was living underwater where everything, all sensations, colours, and feelings were blunted and distant; he was lost in a watery world and nobody could get through to him…he had no energy to move, speak, or even think about taking actions, decisions, and he felt overwhelmingly inadequate. According to Sadock and Sadock (2008), “Mood disorders are a group of clinical conditions characterized by a loss of that sense of control and a subjective experience of great distress…[manic p]atients….[experience] expansiveness, flight of ideas, decreased sleep, and grandiose ideas. [Depressed patients] experience a loss of energy and interest” as well as other symptoms (pp. 200). Other depressive symptoms include having problems concentrating, feeling guilty all the time, having less of an appetite, and having thoughts of ending one’s life. With acceptable treatment, B can live a relatively unfettered, normal lifestyle. According to Bergen (1999), “The day-to-day life of a person with…bipolar disorder is, under stable conditions and with effective medication, not so different from the life of a healthy person” (pp. 28). It is hoped that B will indeed seek treatment that will help him live a full and happy life apart from his bipolar disorder. Bipolar disorder is a diagnosis, but it does not have to be a death sentence. It simply means that medication management must be followed and appropriate health care visits must be scheduled. With these aids, it’s important to realize that B can indeed have a semblance of a normal life, if he complies with his medication. V. Conclusion (50 words) Here it has been discussed: how bipolar disorder is placed within the spectrum of mood disorders; the heritability and treatability of the illness; and how B’s symptoms may or may not align with common symptoms of manic-depression/bipolar disorder. Hopefully B can receive the treatment he needs in order to improve. REFERENCES Amsterdam JD, Hornig M, & Nierenberg AA. (2007). Treatment-resistant mood disorders. UK: Cambridge University Press. Barlow DH & Durand VM. (2008). Abnormal psychology: an integrative approach. US: Cengage Learning. Bergen M. (1999). Riding the roller coaster: living with mood disorders. US: Wood Lake Publishing, Inc. Bogousslavsky J & Cummings JL. (2000). Behavior and mood disorders in focal brain lesions. UK: Cambridge University Press. Daley DC. (200). Addiction and mood disorders: a guide for clients and families. US: Oxford University Press US. Dubovsky SL & Dubovsky AN. (2002). Concise guide to mood disorders. US: American Psychiatric Publishing. Ghaemi SN. (2007). Mood disorders: a practical guide. US: Lippincott Williams & Wilkins. Goodnick PJ. (1996). Predictors of treatment response in mood disorders. US: American Psychiatric Publishing. Griez EJL. (2005). Mood disorders: clinical management and research issues. US: Wiley. Levin J. (2008). Depression and mood disorders. US: The Rosen Publishing Group. Loue M & Sajatovic M. (2007). Diversity issues in the diagnosis, treatment and research of mood disorders. UK: Oxford. Sadock BJ & Sadock VA. (2008). Kaplan and Sadock’s concise textbook of clinical psychiatry. US: Wolters Kluwer Health. Schatzberg AF. (2005). The American psychiatric publishing textbook of mood disorders. US: American Psychiatric Publishing. Shives LR. (2007). Basic concepts of psychiatric-mental health nursing. US: Lippincott Williams & Wilkins. Shorter E. (2009). Before Prozac: the troubled history of mood disorders in psychiatry. UK: Oxford. Schou M. (2004). Lithium treatment of mood disorders. US: Karger Publishers. Read More

 

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