Course, Cause and Treatment of Bi-Polar disorder - Research Paper Example

? Running Head: Cause and Treatment of Bi-Polar disorder Cause and Treatment of Bi-Polar disorder s [Course name] [Date] Course, Cause and Treatment of Bi-Polar disorder Bi-Polar disorder or Bi-Polar affective disorder is classified as a mood disorder in DSM-ID TR and was previously known as Manic-depressive disorder. It is a psychiatric condition whereby, the mood of the individual follows an episodic pattern. Hence, due to the contrasting episodes of mood experienced by the individual the disorder became known as Bi-polar disorder; as the mood fluctuated between mania and depression that high and low points of mood. Before delving in greater detail regarding the disorder the substance of this prose will explore the symptoms that characterize and aid in the diagnosis of the disorder and the various types the disorder has been divided into. I. Symptoms Manic episode The symptoms that characterize the manic episode include elevated mood, hyperactivity that involves high levels of energy, lack of self control, flight of thoughts and grandiosity. During this stage the individual may have an inflated self-esteem and the individual becomes over-involved in activities; particularly, over-indulgence in sexual activity and promiscuity that can be seriously detrimental for the individual’s personal health and well-being. (Moore & Jefferson, 2004) The individual may also get involved in other kinds of reckless behavior such as binge eating, drug abuse, impaired hindsight or judgment and may even shop excessively. Due to lack of self-control, the individual exhibits an irritable mood and is prone to lash out at other people; in other words, they lose their temper quite often that causes them to behave in a manner that has heavy and often debilitating consequences. They experience inability to concentrate on their work, as a result are easily distracted and may even have little or no need for sleep at all. On the other hand, the depressive phase has symptoms that are exactly the opposite of the manic phase and the symptoms are similar to that experienced by the sufferers of Major depressive disorder. Depressive episode The symptoms experienced during the depressive stage are low mood, anhedonia; which is complete lack of interest in activities that were previously found pleasurable, difficulty concentrating, faces problems in remembering things and indecisiveness. The individual faces gross psychomotor retardation; as his movements slows down, he or she may feel tired all the time and loses his or her self-esteem. The phase is characterized by crying spells, persistent sadness, negative thoughts; which are usually about death and suicidal ideation. (Moore & Jefferson, 2004) The individual’s social life is hampered as well and begins avoiding social situation. The individual experiences increased and often displaced amount of guilt along with feelings of worthlessness and dejection. The individual may either lose weight due to lack of appetite; however, in some cases the individual may indulge in binge eating and may gain excessive amount of weight that may result in obesity if the depression is not treated in time. The individual has sleep disturbances and like the eating disorder, he or she may either experience insomnia or hypersomnia that is the individual either sleeps too little or excessively. Either way, individuals are likely to commit suicide during the depressive and during the manic phase, they can do serious damage to their health by abusing drugs and alcohol or indulging in unsafe sexual activity. (Moore & Jefferson, 2004) The individual may experience these symptoms simultaneously or even these can overlap each other resulting in a state that is often called the “mixed state”. Throughout the course of the disorder, the individual may also have a phase, which is normal and may experience normal level of mood. However, before making the diagnosis that an individual suffers from bi-polar disorder, clinicians must rule the following disorders. II. Diagnosis There are numerous psychological and physiological differentials involved in the diagnosis of Bi-polar disorder. Clinicians must make sure that the individual is not suffering from Borderline Personality disorder or Major depressive disorder. As the symptoms experienced by the individual during the manic stage are very similar to the symptoms an individual suffering from Borderline Personality disorder would experience. (Sagman & Tohen, 2009) Same is the case with Major depressive disorder as the symptoms experienced by the individual during the depressive stage are similar to that in major depression. Other differential include Attention Deficit Hyperactivity Disorder, schizoaffective disorder; as there is a schism between the individual’s affect, and schizophreniform disorder. (Sagman & Tohen, 2009) Clinician must exercise extreme amount of caution and often clinicians overlook the symptoms of Bi-polar disorder due to other co-morbid disorders. Disorders that are co-morbid with Bi-polar disorders include Obsessive Compulsive disorder, panic disorder, social phobia and substance abuse. Clinicians must also rule out the possibility that the disorder is not the result of a general medication condition; because in that case, the treatment focus will be solely on treating the medical condition and not just the disorder as it may relapse. The main problem in the process of diagnosis lies with coexisting disorders that may overlap with the symptoms of Bipolar disorder. (Sagman & Tohen, 2009) Hence, family and friends need to give a full account of the behavior exhibited by the individual to help the clinician choose the right psychological paradigm to help him decide a treatment regimen that will not only target the root of the disorder but also alleviate the symptoms of the co-morbidities. Many sufferers of the bipolar disorder also experience residual symptoms and some may experience chronic disorder. (Schiffer, 2007) Hence, for the diagnosis of a full-fledged bi-polar disorder the individual should experience these symptoms for a period of six months or more. The individual must have experienced a full fledged manic episode and depressive episode with bouts of normal emotional behavior in between. The signs and tests involved in the diagnostic procedure include interview with the client and his or her family and friends. (Schiffer, 2007) The client is put through an extensive physical test to check for any physiological anomaly that can be triggering the disorder. The individual must go through a drug test as well, because sometimes Bipolarity in an individual’s emotions is largely due to intake of drugs. However, it should also be noted that in certain cases substance abuse is the result of the disorder and not the other way round. Therefore, even more thorough examination is required to make sure that the symptoms are actually the result of the disorder; the individual is placed under observation and his or her mood swings are thoroughly scrutinized. A medical history must also be obtained and the psychological and physical well-being of the parents and siblings must also be assessed. III. Course As mentioned earlier, the course of the disorder involves the individual experiencing the symptoms in an episodic pattern. Some individuals may experience bouts of a normal mood state and even residual symptoms. The symptoms of a full blown bipolar disorder is a chronic one and therefore, in a classic onset of a bipolar disorder the individual experiences these episodes in a recurrent fashion and the disorder is divided into types by researchers to further elaborate upon the course and nature of the disorder in individuals. The individual suffers from ample amount of social and occupational dysfunctions; as the individual inconsistent emotional behavior affects both his social and professional performance. There is ample amount of distress as the individual’s insight is intact and they may realize that their behavior is not normal. Both behaviors during a manic and depressive episode represent two extremes and either way, the individual’s behavior becomes highly unpredictable and it is a violation of norms as well. It may be a source of discomfort and distress for people around the individual as it gets really hard for them to tackle their mood swings. (Benazzi, 2007) Therefore, the disorder fulfills the criteria to classify the behavior of the individual suffering from Bi-polar disorder as an abnormality. There are essentially three types of Bi-polar disorder; type I, type II and type III is a mild form of Bi-polar disorder that is called “Cyclothymia’. (Benazzi, 2007) Individuals suffering from type I bi-polar disorder usually experience at least one full-fledge episode of mania of depression and the intensity of the symptoms is much higher. Whereas, Type II Bi-polar disorder is characterized by a much milder symptoms and the individual usually experiences periods of hypomania; which is a state characterized by high levels of energy and frenzy. (Benazzi, 2007) The symptoms are not experienced in Hypomania are not as severe as the ones involved in a full-fledged manic episode; however, the state of Hypomania alternates with severe bouts of depression. As mentioned earlier, Cyclothymia is the mildest form of bi-polar depression; it involves less severe mood swings that are hypomania and mild depression. People suffering from Type II or Cyclothymia are susceptible to getting a misdiagnosis and clinicians may often identify their problem as unipolar depression or major-depressive disorder. Clinicians have also come up with another subtype called Bi-Polar Disorder NOS (Not otherwise specified) and this subtype is applicable on people experiencing symptoms that do not fall in the category of other subtypes of the disorder. (Benazzi, 2007) IV. Etiology There has not been much research conducted into the subject of identifying the etiological variables involved in the disorder. As there are numerous variables involved that trigger the disorder; researchers have proposed various hypotheses to expand upon the subject of the disorder’s etiology and they have concluded that Bi-polar disorder is not triggered by just one factor in the individual’s life but there are countless variable that act in tandem that trigger the disorder. (McGuffin, 2003) According to the biological paradigm, psychological professionals and clinicians have discovered that a genetic diathesis is involved in the development of the disorder. In other words, if an individual comes from a family with a history of the disorder then it increases the likelihood that the individual will suffer or develop the disorder at a later age. (Kato, 2007) The disorder affects women more than men, but the statistical variation may be insignificant and this may largely e due to the fact that women are more health conscious and there is higher reporting on their part. Even adolescents are more susceptible to developing the disorder as puberty can trigger hormonal changes which are likely to trigger the disorder. (McGuffin, 2003) There is substantial amount of evidence collected by researchers that point towards the fact that the disorder runs in the family but it only refers to the individual’s susceptibility to the disorder. For instance, a twin study regarding bi-polar disorder showed that in case of identical twins if one twin exhibited symptoms of Bipolar disorder, the other twin did not show any symptoms. Therefore, other than genes there are other factors involved as well. (Kato, 2007) The factors may exist in one’s environment and the individual may develop the disorder as a result of a stimulus that exists with in the person’s environment or certain events in the life of the individual. For instance, the development of the disorder may be the result of a life-changing event such as childbirth, recreational drug use, sleep disorders and medications. There is a strong correlation between the neurochemical imbalances and the disorder. This hypothesis is also related to the biological paradigm but is often caused by an environmental variable. For instance, women during childbirth experience significant amount of hormonal imbalance that may in turn affect the neurochemical balance in the brain that can be responsible for triggering the disorder. Furthermore, even recreational drugs cross the blood brain barrier, which result in the abnormal behavior and the neurochemical that is closely related to the behavior that the exhibit during the manic and depressive episodes is Serotonin. Researchers believe that a depressed mood is the result of low serotonin levels and high serotonin levels are associated with mania. (Trinh & Forester, 2007) Other paradigms that are cognitive, cognitive behavioral and behavioral models do not provide ample amount of insight into the etiology of the disorder. Due toe the fact that it is not only the cognitions that trigger the change in mood. In case of depression and mania, there is a combination of erroneous thought processes and cognition that work in tandem to trigger the abnormality in the individual. Hence, cognitive paradigm provides an alternative explanation of the disorder and it states that erroneous thought process and inconsistencies in cognitions are responsible that causes the individual to develop the disorder. Therefore, the treatments for the disorder primarily lies in the cognitive and biological paradigm; a combination of elements is taken from these two paradigms that help clinicians develop an efficacious treatment regimen that effectively alleviates the symptoms of the disorder and helps the individual lead a normal life. V. Treatment As mentioned earlier, since the treatment regimen is largely derived from the biological and cognitive psychological models of abnormality. Therefore, in order to provide the client with quick alleviation of symptoms, in order to restore a semblance of normalcy in his or her behavior the clinicians prescribes psychotropic or mood stabilizing drugs. Drug therapy may be the first line treatment method for bipolar but for second line, even support groups are deemed helpful in order to help the client meet people who suffer from the same ordeal. A one-on-one session with the therapist can seriously help the client get rid of the erroneous thought processes and cognitions that are responsible for the disorder. (Morris et.al, 2007) Drug Therapy Drug therapy for Bipolar disorder is considered to be the first-line treatment for bipolar disorder and the commonly used mood stabilizers include lithium, Valproate, Carbamazepine and Lamotrigine. However, other drugs are also used such as antidepressant drugs such as Fluoxetine or its generic name that is Prozac. Many clinicians also advise their client to use anti-anxiety drugs as well and the most commonly used drug is Benzodiazepine. (Sachs,2007) In recent years, researchers have discovered that Electro Convulsive therapy is highly efficacious in dealing with the disorder and it involves passing electric through the central nervous system to cause a small seizure while the client is under the influence of anesthesia. This is considered to be the ideal treatment for people suffering from depression. A derivative of this mode of treatment is called the Trasncranial Magnetic Stimulation, which uses high frequency magnetic pulses to bring about the change. (Sachs, 2007) Support groups and Therapies As mentioned earlier, support groups and therapy sessions are also an effective way to help the client overcome the disorder. The main premise behind all these method of treatment is to provide the client with the social support and remove the feelings of social alienation that comes along with the psychological disorder. Therapies target the erroneous thoughts, whereas support groups provide them with an outlet to express their problems in front of people who can actually relate to it. (Morris et.al, 2007) VI. Historical Context and Prognosis Due to the historical background of the disorder and the fact that many infamous people such as Adolph Hitler have known to be diagnosed with the disorder. As a result of this, people suffering from Bipolar disorder are known to be extremely violent and reckless; as a result they are often subjected to a lot of stereotype and social stigmatization. Considering there is widespread prejudice against the sufferers it is important for them to get the prior social support to take the medication. As for prognosis, many clients stop taking their medications as soon as their condition alleviates. Clinicians must keep on encouraging them to take their medications. Often suicide is another problem, and therefore they must keep on doing follow-up studies on their client to make sure they are doing well.(Davis, 2010) References Benazzi, F. 2007. Bipolar Disorder: Focus on Bipolar II and mixed depression. Minneapolis: Lancet Publication Davis, A. 2010. Handbook of Pediatric Disorders. Springer, Publishing Company. Kato, T. 2007. Molecular genetics of bipolar disorder and depression. Psychiatry and Clinical Neurosciences  McGuffin, P et.al. 2003. The Heritability of Bipolar Affective Disorder and the Genetic Relationship to Unipolar Depression. Archives of General Psychiatry  Moore, J.P & Jefferson, J.W. 2004. Handbook of Medical Psychiatry. Philadelphia: Mosby Elsevier. Morris, R.K. et.al. 2007. Interventions for helping people recognize early signs of recurrence in Bipolar disorder. The Cochrane Collaboration Reviews. Sachs, G.S. et.al. 2007. Effectiveness of adjunctive antidepressant treatment for bipolar depression. England Journal of Medicine. Sagman D and Tohen M. 2009. Co-morbidity in Bipolar Disorder: The Complexity of Diagnosis and Treatment. Psychiatric Times. Schiffer, R.B. 2007. Psychological Disorders in Medical Practices. Philadelphia: Saunders Elsevier. Trinh, N.H & Forester, B. 2007. Bipolar Disorder in the Elderly: Differential Diagnosis and Treatment". Psychiatric Times Read More