Signs of Bipolar Disorder - Essay Example

?Bipolar disorder: Symptoms, Treatment and Post Treatment Care: A case Study Introduction In the modern world, as the science is developing day by day there are various new innovations in the medical science to fight different critical disease. As the time moves on, medical science is now able to develop lots of advance mechanism to combat various diseases-starting from identifying disease, developing proper treatment process followed by the recovery and post treatment care. Bipolar disorder is one such kind of disease which for a long period of time consider as one such kind where medical science have to be more advanced to figure out the reason the treatment process as well as post treatment measurement to resolve the disease. As par the report published in the MNT Knowledge Centre (2013), Bipolar disorder can be define as one kind of mental disorder which is associated with extreme change of mood of the patient along with fluctuation in the energy and activity levels. According to this report, bipolar disorder is one of the most severe mental illnesses which often destroy relationship, affect carrier perspective, and also affect the academics of the patient. Bipolar disorder sometime destroys family structure as well. A patient affected by this bipolar disorder often considers it very difficult to complete its day to day normal work. The research regarding this disease pointed out the fact that people affected from this disease sometimes also suffer from some other more common diseases as well like asthma, high blood pressure, etc. which sometimes make it more difficult for the doctors to carry out the treatment. The disease like bipolar disorder not only need proper medical attention but also need proper care, mental support from the close family member to get over the mental block that they used to be in. In this paper the main objective is to analysis the bipolar disorder-what it means for different medical people, how different medical journal define this, what are the main characteristics of this disease, what are different types of bipolar disorder, the present trend of treatment, post treatment care etc. In this paper a case is being considered where the patient is suffering from bipolar disorder along with anyone other common disease. Overview of the Patient: In this paper, the discussion is all about Susie, a bipolar disorder patient. Her case is represented by Cooper. According to the description of Cooper (nd), Susie is a 20 year old college student whose behavior for the last five days was really strange. She never sleeps in last five days and was busy in “heightened state of activity” which she herself describe as “out of control” activities. In this paper, the discussion will be a basic overview of the disease, different social, medical and mental characteristics of the patient who are suffering from this disease. What is the basic treatment process of bipolar disorder and what are the different after effect of the treatment that the patient used to face and how one can overcome those. Signs of Bipolar Disorder: Cooper in his review pointed out various characteristics which are observed by the medical officials while studying the social characteristic changes in Susie. Some of her thinking is centered on the present political condition. She used to believe that she had changed her soul with the present senator of her state, and also have some theories, in fact six specific theories which according to her can single handedly save the world from nuclear destruction. She used to share her theories with friends and professors in the university and also starts to campaign for an elected position in the US government. Although there were no elections scheduled at that point of time. Cooper in his analysis also pointed out the fact that, from the fear of forgetting, Susie used to note down all the theories that she used to discuss with her friends in her room, computer, notebooks etc. From the feedback of her friends and family it was clear that she used to be very organized and tidy. To see her involved in such action used to make her friends and family more shocked. The above two incidents are only the example of some irregularities shown by her in behavior which forced her friend and family member to believe the fact that she has some problem which needed to be taken care of on immediate basis. Overview of Susie’s Background Information: Susie grew up in a traditional Irish Home. Her parents were over-proactive and also very demanding in nature. Out of her all brothers and sister she used to be the most obedient child of her parents and in her own words she was the little miss perfect of the family. Her mother used to be very strict regarding involving into any kind of relation. She was overdependent on her parents and more over her parents not used to allow her to have any makeup at younger age. She also pointed out the fact that her rest all brothers and sisters used to be more rebellious. Her family history have the record of mood disorder as her grandfather used to receive electroconvulsive therapy (ECT) for depression related disease and her father’s aunt was diagnosed with depression .(Cooper, n.d). Social History of Bipolar disorder: There are several social reasons associated with the bipolar disorder. Galynker (2008), in his paper pointed out the fact that there is no single specific cause of the bipolar disorder. The reasons are a combination of genetic, other biological causes, social causes, and possible vulnerability etc. He in his report pointed out the fact that 90% of the patient suffering from bipolar disorder is having the illness in their family itself. He in his analysis mentioned that high expressed emotion in the family, different stress factors all are the social reason behind the bipolar disorder. (Galynker, 2008). Medical History of Bipolar Disorder: There are some specific medical reasons behind bipolar disorder. The report of WebMD (2013), one of the key reasons behind bipolar disorder is the family heredity. They do believe that the bipolar disorder often runs in the families and there are some genetic factor attached to it. The medical experts do believe that bipolar disorder generally caused by the underlying problem with specific brain circuits and the balance of brain chemicals called neurotransmitters. The genetic factor also has an impact in the bipolar disorder. Different medical practitioner from their study pointed out the fact that if one of the identical twins has bipolar disorder then there is a high chance that the other also gets affected by the same. The chance is as high as 40-70%. Apart from this, less sleep also affects the bipolar disorder. (WebMD, 2013). Another factor associated with the bipolar disorder is the suicidal rate associated with this disease. According to Baldessarini, Pompili, Tondo (2006) and Valtonen et.al. (2007), the suicide rate associated with this disease is as high as 15.6%. According to their review, the rate of suicide associated with this disease is much higher than any other psychiatric disorder. Medical review suggests the fact that the rate of suicide is highest in the bipolar disorder during the stages of depression or in the mixed state. The hopelessness mindset also sometimes affects the suicidal behavior during depression. In their review it has been proven by the medical science that people of a younger age who are suffering from the bipolar disorder are more susceptible to the suicide or other dangerous life threatening steps. (Baldessarini, Pompili & Tondo, 2006, pp. 466-469; Valtonen et.al, 2007, pp. 102-105). Problems of Bipolar Disorder with Susie: In case of Susie, there are some prominent symptoms of bipolar disorder. Her change in behavior, considering herself as the politician, imaginary election speech, being untidy at rooms, less sleep at night, suicidal attempt all this pointing towards the fact that she is suffering from bipolar disorder. Different types of Bipolar Disorder: There are several kinds of bipolar disorder according to medical science. Merrill (2010) in his review pointed out that it is a disorder that include anger, depression, and also swing in the energy level of the patient. Another key factor associated with this disease is the degree of mood swings. It generally affects both men and women in a same level as there are no differences in the symptoms. Bipolar disorder has 3 different levels: type 1, 2, and 3. Merrill in his discussion discusses about all these types. In case of type 1 bipolar disorder patients used to have one bad anger episode and a small episode of depression. Type 2 involves full potential stages of anger and also phases of increased energy switching off with depression states. The third type is known as Cyclothymia, which involves the least severe moods but can accidentally diagnose as lone depression. (Merrill, 2010, pp. 1-3). He in his review mentioned that some symptoms of anger phase such as irritability, cockiness, little sleep requirement, less self-control, over activity etc. The state of depression include stages like less focus, bad mood, weight loss and gain, being tired, no confidence, passiveness, isolation from family, friends, activities and suicidal thoughts . (Merrill, 2010, pp. 4-6). Jacobsen (2011), in his review pointed out the fact that like any other disease bipolar disorder also has certain risk factor associated with it. The study of the genes of the bipolar disorder affected people can give more detail about this disease. He in his review mentioned that these genes are also in mice which are affected by the bipolar disorder syndrome, involved in neuronal adhesion and migration is strongly expressed in brain areas associated with cognition and the regulation of emotions. In case of mice this gene is responsible for the memory and learning. So, a detail study can give more inputs about the fact that how this disease affects the memory and other general behavior of the human beings.(Jacobsen, 2011, pp.7-9). General Diagnosis of Bipolar disorder: Various medical practitioners believe that if proper diagnosis can be done then disease like bipolar disorder can also be cured. It is a very common fact that often people consider bipolar disorder as common depression therefore they didn't use to treat it seriously. Laino (2010) pointed out the fact that almost 33% people who generally have the problem of depression might be affected by bipolar disorder. He pointed out that there are five distinct characteristic differences between bipolar disorder and depression such as certain mood swings and other psychological symptom. Other diseases also looks like bipolar disorder as the people affected from those make them depressed or angry, sometimes hyper and excited also. His analysis reveals the fact that 40% patients used to get treated for depression, and the medicine is generally antidepressant when they are originally suffering from bipolar disorder and the requirement at that time is drugs which can act as Mood- Stabilize. To distinguish between the normal depression and bipolar doctors used to follow some specific process like examining the family history of bipolar disorder, whether there is evidence of at least 2 swings of mood incidents, existence of example of first psychiatric symptoms before the age of 30, the occurrence of extreme mood swings, Mixed states in which symptoms of mania and depression occur together. (Laino, 2010, pp. 12-16). In this case Susie also has shown the signs of extreme mood swings. She is generally very organized but her present actions are more disorganized. Her thought process also very much scattered moreover she is not sleeping at night which indicated towards the bipolar disorder. Laino(2010), in his review pointed out the fact that people correctly diagnosed with bipolar disorder have 200%-400% chance of getting affected by other disease as well. In most of the cases, the bipolar disorder patient used to suffer from hypothyroidism, fever, migraine headaches, obesity, asthma etc. according to his review this disease generally causes due to the side effect of several medicine used to cure the bipolar disorder. (Laino, 2010, pp. 17-19). Schoenstadt (2008), in his review mentioned that it is up to doctors after knowing that someone is suffering from bipolar disorder how to treat him or her. It can be better treated if there is no gaps or pause between the treatment In the absence of any break also, if something unusual happens to the patient it is a must for the family to inform the doctor as the medicines or the therapeutic use for treating bipolar disorder have lots of side effects. There is also a developing theory that talk therapy is a key in the treatment of the bipolar disorder. A healthy talk between patient and family members is always helpful to stabilize the condition of the patient, improve the functionality of their brain and other parts of the body. (Schoenstadt, 2008, pp. 25-26). While analyzing the effect of different chemical in the bipolar disorder disease Purse (2010), in his review mentioned that amino acid and uridine both play important role in the development of brain and muscle which can effectively tackle bipolar disorder. (Purse, 2010, pp. 27-28). Another drug that acts very well in the treatment of bipolar disorder is Ketamine. In Charles (2011) opinion , “Ketamine is normally an anesthetic but some studies like at Mount Sinai reveal that it works better and more reliably than some other antidepressants. (Charles, 2011, p.31). Woznicki(2010), in his review mentioned that Ketamine not only act fast to increase the stage of depression but the effect of this drug also stays for 2 days which is good in the treatment of bipolar disorder. In his review he also mentioned about other two drugs, Lithium and Valproate which have appositive effect in the treatment of bipolar disorder. (Woznicki, 2010, pp. 32-35). Warner (2011), pointed out the fact that despites so many developments, there are a number of patients who are mistreated in bipolar disorder and almost 2.4% remain untreated.(Warner, 2011, p.36). Suggestive Treatment for Susie: Susie is suffering from bipolar disorder, where there is a clear indication of mood swings. As per the analysis of Krishnan (2005) and Kupfer (2005, people who suffer from this disease used to suffer from some additional disease simultaneously like thyroid disease, migraine headaches, heart disease, diabetes, obesity, and other physical illnesses, According to both of their review this diseases may appear as a symptom of bipolar disorder and even sometimes due to effect of medicine as well. (Krishnan, 2005, p.4; Kupfer, 2005, pp. 2528-2530). The present trend clearly suggests that there is no full cure of this disease but the continuous medication and support from the family help Susie to have a control on her mood swings. As bipolar disorder is a lifelong and repetitive disease therefore Susie needs a long-term treatment to have a control of bipolar symptoms, especially in her mood swing and depression. An effective conservation treatment plan for her also includes medication and psychotherapy for preventing relapse and reducing symptom severity in her. (Miklowitz, 2006, pp. 30-31). Among different medicine that Susie can take for her treatment are Lithium (sometimes known as Eskalith or Lithobid), Valproic acid or divalproex sodium, and different anticonvulsant medications, including gabapentin (Neurontin), topiramate (Topamax), and oxcarbazepine (Trileptal) are sometimes prescribed. Among all this medicine valporic acid is considered as an alternative to lithium for the treatment of bipolar disorder. Calabrese et.al (2005), in their review pointed out the fact that this medicine Valproic acid is as effective as lithium for the treatment. (Calabrese, 2005). Another best medicine for her can be Olanzapine (Zyprexa). It helps patient with an antidepressant medication, may help relieve symptoms of severe mania or psychosis. But the use of this medicine sometimes causes diabetes as a side effect. As she is a patient of diabetes so she can’t take this medicine. Apart from this medication therapy Susie’s treatment can also be carried out by other methods like Electroconvulsive Therapy (ECT), Sleep Medications. Pandya, Pozuelo, and Malone (2007), mentioned that ECT is previously known as shock therapy or shock treatment. This can be implemented if the normal medicine does not work effectively. It can give her relief from bipolar disorder. Generally this treatment last for 30-90 seconds, and Susie can be recovered from the effect of shock within 5-15 minutes and can go home in the same day. This shock treatment might have some side effect in Susie like confusion, disorientation, and memory loss etc., but proper care from the family member will help her to recover from those after shock. Apart from this treatment, sleep medication is also helpful for her to recover from this disease. . (Pandya, Pozuelo, and Malone, 2007, pp.679-683). Mental Support from the Family: Susie needs mental and moral support from her family members and friends while she is going through the treatment of bipolar disorder. Her family member should talk to her on a regular basis while her treatment is going; they must have detailed knowledge of the disease and must ensure that Susie is not going through any kind of tension while both the medication as well as ECT is going on. The treatment guideline for bipolar disorder also suggests that for better treatment of bipolar disorder integration of pharmacotherapy with targeted psychotherapy in modern time is very much important. Psychological approaches developed based on the evidence that psychosocial stressors, together with excessive family discord or distress, negative life events, or events that interrupt sleep are associated with relapses and worsening symptomatic status. In the process of adjunctive psychotherapy for bipolar disorder several steps are involved like education of patients, and when possible, caregivers, about strategies for the management of stress, the identification and intervention of early signs of recurrence, and how to keep regular lifestyle. (Goodwin, 2009, p. 346; Kessing, Hansen, Hvenegaard, 2013, p. 212; Miklowitz & Scott, 2009, p. 110) “Family-focused therapy is frequently based on the virtual association between criticism and hostility in caregivers (so-called expressed emotion) and an increased likelihood of relapse in mood disorders and schizophrenia”. (Hooley, 2007, p. 329). Family-focused therapy involves the patient and chis or her close ones (parents or spouse) in up to 21 sessions of psychoeducation, training of communication skills development also problem-solving skills training. The application of the family-focused therapy also revealed the fact that after 1 or 2 years of manic, mixed, or depressive mental state, patients with bipolar disorder who received family-focused therapy and pharmacotherapy both had at least 30-35% lower rates of relapse and re-hospitalization and also far more less severe symptoms than did patients in case management or equally intensive individual treatment. (Miklowitz, 2008;Stoll, 2006, p. 407). Conclusion: From the above analysis it is very clear that for any individual bipolar disorder is a critical disease and efficient medical treatment as well as family guidance is necessary in order to make him or her properly cure from this disease. Bipolar disorder is a very critical disease and along with this disease there are numbers of additional disease can also affect the individual as a side effect of the medicine. So proper medical treatment is important for treating bipolar disorder along with post treatment care from the family’s part is necessary. In case of Susie, family’s guidance is also important to make sure that she able to fight the depression and the thought of suicide never should come to her mind. Support from family and friends will help her to live a comfortable life. References 1. Baldessarini R J, Pompili M, Tondo L. (2006), Suicide in bipolar disorder: Risks and management. CNS Spectrums, 11 (6), pp. 465-471. 2. 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WebMD, (2013), Causes of Bipolar Disorder, 26.12.2013 from http://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-causes?page=2 Read More