Psychopharmacological Treatment of Manic Depression in African Americans - Research Paper Example

? Psychopharmacological Treatment of Manic Depression in African Americans Ernest L. Bell Liberty February 26, African American societies across the United States are more culturally varied now than ever before. Twenty five of African Americans do not have health coverage. This is because of socio-economic factors that hinder them from getting health care. To make sure African American societies access sufficient and reasonably priced health care, a better comprehension of the complexities that cultural conditions and various experiences play in psychological disorders, in these societies, is crucial. These complexities include cultural obstacles between medical practitioners and their patients, African Americans’ dependence on relatives and spiritual community instead of mental health specialists and many other factors. There have been many attempts to tackle psychological ailments among African Americans. Regardless of these efforts, to advance psychological health services for African Americans, limitations in the access to health care remain. These limitations are as a result of laxity of insurance companies to offer cover and other ethnically competent services. For those insured, coverage for mental illnesses and drug use disorders is considerably lower than for other diseases. This study started by an introduction that entailed a brief history of previous discussions on proper descriptions of mental disorders. This also addressed the misconceptions associated with mental ailments. It probed the question of whether or not the definitions should be objective or subjective. The study progressed with the discussion by firstly, defining crucial terminologies in the topic, the theoretical framework, methodology and significance of the study. It further delved into the symptoms, causes, differentiations, diagnosis and treatment of mental disarrays among African Americans. The study concluded by giving a summary of the upshots of the research and the Christian world outlook on the issue. Introduction There is no distinct definition of psychopathology. Its description is complex if not impossible. The definitions of psychopathology and similar terminologies for instance mental disorder have resulted in heated discussions all through the account of psychology and psychiatry. The innumerable debates have not yet been concluded. Despite discrepancies, the discussions have concentrated on one dominant question (Maddux & Winstead 2007, p23). This question is whether psychopathology and other terms associated with it like mental disarray and mental disease can be described in scientific language. It also asks whether these scientific terminologies can be described dispassionately by scientific criteria or they are social creations, which are described wholly by the community and cultural standards. The idea of psychopathology is not a hypothesis of psychopathology (Wakefield 1992, p43). A definition of psychopathology gives one description of the terminology. It does so while outlining those human experiences which are regarded as psychopathological and those which are not. This definition does not attempt to expound the psychological occurrences that are considered pathological, but in its place explains to us what psychological phenomena are pathological and therefore, need to be explicated. A supposition of psychopathology, nonetheless, gives an elucidation of those psychological occurrences and experiences that have been established by the description as pathological. Understanding different notions of psychopathology is crucial for a multiple of reasons. According to medical theorist Lawrie Reznek (1987), concepts have consequences, categorizing things in a certain way other than the other has vital repercussions for the way human beings act with regard to such things. If we replace the term psychopathology or mental turmoil for the term disease then how we visualize psychopathology has widespread results for persons, therapeutic and mental health practitioners, state agencies and programs and, community at large. Several descriptions of psychopathology have been provided over the years. Each definition has its pros and deficiencies, but none is sufficient as the true scientific description. A widespread and commonsense description of psychopathology is that, pathological psychological, occurrences are those that are anomalous or statistically abnormal or sporadic. As a result, the term psychopathology or mental disarray is seen as a digression from psychology normality. One of advantage of this description is its commonsense persuasion. It makes sense to a majority of individuals to use terminologies such as psychopathological and mental mayhem to refer to only to behaviors or incidences that are unusual (paranoid mirages, hallucinations) and not to those that are somewhat familiar like shyness, unhappiness caused by the demise of a loved one. A second advantage of this description is that it lends itself to agreed modes of measurement that give it some appearance of scientific approval. The first stride in utilizing this definition is to evaluate what is mathematically normal. The second stride is to establish how far a certain psychological occurrence or happening differs from mathematical normality. This stride is usually realized by coming up with an instrument or standard that tries to compute the phenomenon and then allocate numbers to individuals experiences of demonstration of the incidence. Scores that are far enough from average are regarded as indicative of unusual or pathological psychological experiences. This process illustrates many tests of aptitude and cognitive power and many regularly used instruments of individuality and emotion. Regardless of its commonsense persuasion and its scientific advantages, this description brings about quandaries. The above description sounds somewhat objective and scientific; however, it has provided room for subjectivity. Definition of Terms Psychopharmacology: It is the systematic study of the actions of drugs and their impacts on temperament, thinking and manners. This field studies a variety of substances with a range of character traits, concentrating mainly on the chemical communications with the brain. Manic Depression: Manic depression describes mood swings from extremely high (manic) to extremely low (depressed). It is also referred to as bipolar disorder. It refers to an individual’s mood changing from poles of mania (highs) to lows. Bipolar disorder is mental disarray that results in abnormal changes, in the individual’s mood, energy, and power to function. This illness affects men and women alike. It can begin at any age, but it commonly starts in late puberty. Bipolar disease is found among individuals of all ages, ethnicities, socio-economic backgrounds and races. It seems to have a genetic connection and tends to run in related people. In addition, this disorder not only affects the victim, but also has the capability to ravage the lives of caregivers and next of kin. Mania: It is an extreme sense of well-being, vigor and buoyancy. It can be so strong that it influences one’s thinking and ability to make rational judgment. One may believe unusual things about him or herself make unreasonable decisions, act in an embarrassing, hurtful and sometimes dangerous way. Abnormal: Different from what is anticipated particularly in a way that is perturbing, injurious or unwanted. Mental: Associated with or happening in the mind; concerning the course of thinking. It is also linked with the health condition of the mind or the management of sickness in the mind. Disorder: It is an infirmity that causes part of the body to discontinue functioning properly. It is also a lack of order or organization. Depression: It is a medical situation in which an individual feels exceptionally poignant and nervous and often has corporeal symptoms such as insomnia. African American: a person from America who is an affiliate of a race of individuals who have dark skin formerly from Africa. Theoretical Framework A theoretical framework is a compilation of interconnected concepts, like a hypothesis but not essentially so well worked-out. A theoretical framework directs one’s research establishing what things will be measured and what mathematical relationships one will look for. Methodology This study utilizes material and resources from researches carried out by other people. These include books, journals, medical reports and other relevant material. Significance of Study A projected 2.3 million Americans suffer from bipolar disorder. The frequency of bipolar disease affecting Americans is the same as that of African Americans. However, African Americans are less probable to seek or get diagnosis and treatment for this ailment. Multiple factors have resulted in a majority of African Americans not getting help for bipolar disorder. The value of this study is to address and understand the issue of treatment of bipolar disorder among African Americans. The study will reveal the role of religion in solving the menace of manic depression. It aims at examining whether religion has contributed to worsening the problem or solving it. The results of the study will aid medical experts making sound decisions on how well to deal with manic depression. Moreover, it will assist the community realize how widespread this ailment is and their role in tackling the challenges associated with it (Sadler 2005, p15). It will also provide solutions and suggestions on how to tell whether someone is sick or not and addresses misconceptions about the disease. Other similar mental disarrays will also be investigated and how they differ from bipolar disorder. Undertaking this assignment will provide suggestions on how well to tackle the issue of why many African Americans do not seek treatment. Additionally, the outcome of the study will assist the medical sector put into place instruments, and incentives to encourage more African Americans to get diagnosis and hence treatment. Results of this study could also help the state in making reforms in the health sector address the different mental ailments. This will entail putting in place the necessary equipment in hospitals to cater for patients. The society often presents numerous challenges ion individuals prompting a solution to be reached to sustain these individuals. Depression is a state that limits individual freedom and choice to participate in variable choices of events. There are societal norms and vices that limit individual freedom and desire to express their will towards societal achievements. These are presented upon several age settings and races that co-exist within the society. The challenges that depression holds on individuals is highlighted when analyzed through medical procedures that have been developed, to identify them at earlier stages before they mature to cause greater harm. Among the most fragile in the society are children and adolescents who are inhibited from reaching their maximum potential. When these symptoms are identified, a solution can be administered to help regulate the grave implications of such conditions on their life. Medical experts have acknowledged medical procedures to be implemented in treating the adverse effects of depression. Psychopharmacology and diagnosis During diagnosis, the use of codes is vital for medical keeping of records (DSM-IV-TR, 2000, p32). In a majority of manic depression disorders, one may use the following guidelines. Mild, few symptoms are present, and they result in minor impairment. Moderate symptoms of mild and severe are present. Severe, symptoms are always in excess to the ones required. Albrecht and Herrick suggest, in partial remission only some signs remain in the disorder. In full remission, signs and symptoms are invisible. It is also vital to note the history of the criteria in each disorder. Substance use is a foremost cause or manic depression, which leads to addictive behaviors. Diagnosing a person as being alcoholic and drug abuser may always not be different from personal opinions. Alcoholism and other drug addiction are social vices. However, problems with drug abuse and alcoholism have become admitted with time. A patient may be diagnosed, check of cognitive impairment, ability level of conceptual, gender, motivated, visit a psychiatric, have a meaning in life abstain from drinking and drug abuse. Change of life events among African Americans is the corner stone in many cases of depression. The study of the medical treatment procedures in drugs and their implication on the body is often key to obtaining the results to difficult conditions that the unstable mind is subjected upon. The study is implemented top articulate the diverse effects of the drugs applied on the brain, and the mode that can be utilize to generate a positive response to the demeaning conditions (Reznek 1987, p34). On interaction with the targets that they are administered to handle, these drugs would cause neurological impacts on the body to induce a response from the physical and psychological aspects of the body. These drugs are established for generating a response that is meant to alter the psychological and emotional approach to the phenomenon that may arouse individual thinking. The modern medical provision has endorsed psychopharmacology to be the key in inducing the depression cases because the patients are capable of being monitored, to evaluate the extent to which he adverse effects can be countered to regulate behavior. Psychopharmacology has been applied to induce relaxation and seduce the patient. Research has since been conducted to develop drugs that can be utilized in regulating various forms of depression with an example lying in lithium carbonate applied to limit the cases of mania. The correct articulation of the cause of the form of the depression is always an effective measurer to be applied in reducing the cases of mental disturbances that may lead to the evolution of graver consequences. The clinician who is diagnosing their patient should possess the right knowledge of the condition that they are relating to, and fit it to the right diagnosis in limiting the reoccurrence the case, suppressing its effects. The other implication that is important to implanting the psychopharmacological procedure lie in the importance of the clinician, to have knowledge of the results of the medication chosen to apply to be administered to the patient. Manic Depression in African Americans The depression, sometimes known as bipolar disorder, is a medical condition that affects most individuals who experience instances of depression at vulnerable stages of their development. Its major characteristics are marred with mood swings that are unexplainable and may vary in the form. These individuals are often characterized with main mood fluctuations that may be hyperactive on the positive and negative ends of the scale. This means that an individual with manic disorder will have cases of extreme happiness and at some period developed a high depression rate. This is mostly confusing and may cause a major accident especially in the community that presents numerous challenges to the struggling individual. The mood swings are not limited to a time or event because they vary in their intervals of occurrence. Mood swings may be suppressed on diagnosis, and untreated cases can be categorized as rapid cycling. However, research has articulated its development to be suppressed at the initial stages of detection with suppressants issued to limit their frequent diagnosis. The other adverse effects of bipolar disorder are contained in their inability to function effectively within the societal setting and false perception of natural entities. Aagaard and Vestergaard articulate the frequency of occurrence of the bipolar disorder among Americans to be affecting estimated 2.3 million dwellers (Vestergaard & Aagaard 2002, p262). Most Americans fail to receive the proper diagnosis of the early occurrence of the symptoms of the condition leading to adverse effects on their development and ambition to lead fulfilling lives. The rate of occurrence of depression varies in age and races depending on the events that they have undergone in their developmental stages. Women have a different case of mania as compared to adolescence because they have a varied tolerance to conditions that limit their development. Men, on the other hand, will have an added tolerance advantage that leads them to find alternatives to their conditions. Regardless of gender or age, manic depression has developed challenges to individuals with cases with majority experiencing extreme results that end in suicide or grave cases of physical damage. The manic depression disorder is included in the depression and manic characteristics that have variable identification forms. They present numerous challenges to these individuals and can be identified using variable symptoms that the clinician uses to identify mild and severe cases. There are various forms of bipolar depression and are identified due to their mode of occurrence. Bipolar 1 This condition is identified when there has occurred at least a main case of a manic episode, having lasted the duration of a week. It is recorded that some individuals with the manic episodes suffer setbacks by experiencing the manic episodes as compared to depression. When not treated, the manic episodes are marked to last a period of 3 to 6 months. In this case, the depressive disorders are marked to the last half to a full year. Bipolar II Individuals with this bipolar type would experience a condition known as hypomania, which is a condition that is characterized by multiple cases of severe depression, with mild manic periods. Rapid Cycling Within a year, an individual with the rapid cycling condition may be subjected to more than four cases of mood fluctuations. This happens to at least one individual out of ten that is diagnosed with bipolar disorder. Both the first and second bipolar types may be witnessed in the case. Cyclothymia This condition is characterized with mild cases of the bipolar disorder that initially present little of minimal effect on the patient, and may later develop into severe case. Causes and forms There has not been a distinct cause of the disorder, but research has articulated that the implications of the disorder are hereditary. Genetic composition has been related to lead to forms of the disorder with the offspring being linked to the characteristic in the parent. This condition is often connected to the condition that may cause damage to the brain part that controls moods, and this attribute leads to bipolar condition whose regulation depends on these conditions. Psychopharmacology is administered to curb the spread and effects of the condition due to the ability of medication to correct the damaged areas. Medicine is applied to heal, and when the appropriate medication is issued, there will be a significant improvement in the condition. Finally, manic depression has been caused by stressful experiences subjected to individuals or illness that breed the entity as a side effect. Depression Normally, depression would be articulated to the bad feeling that individuals obtain from experiences and the desire to met several ambitions in life. However, in diagnosis of bipolar depression, this attribute is a separate entity that is generated from suffering worst cases of the bipolar. It is the worst case of depression and may cause the individual to function fully in implementing daily obligations. Depression is characterized by various symptoms that are used to identify the worst case. It has been attributed that the condition may have adverse effects on the association of individuals and relation to their friends and family members may decline. The symptoms for this condition include: Hopelessness and empty emotions towards societal components and individuals A feeling of worthlessness Possessing suicidal feelings Chronic fatigue Poor sense of concentration Poor memory with majority in forgetfulness Having irregular eating patterns with varied cases of weight loss and obesity Seclusion and depression associated with lack of motivation. Mania This condition is attributed to extreme cases of excitement, energy and higher form of well-being. Its composition may be intense and affect the completion of duties and the judgment that is presented towards their decision-making. An individual may fail to make the right judgment while depicting embarrassing behavioral traits or expecting impossible solutions to the problems. Mania is presented as an opposite to depression, and both have negative consequences to the completion of duties. Extreme cases of mania eventually lead to depression with its mild form recognized as hypomania. The symptoms of the condition may include: Restlessness Hyper thoughts with a feel of uneasiness Abusing drugs Aggressive characteristics experienced after being exposed behavior Increase in sexual agility The individual possesses poor judgment Insomnia Individual is euphoric Manic episodes are initially less noticeable, and the individual with the condition may be fooled into having a comfortable feeling with little belief of the condition. This result into a third party getting involved in the diagnosis of the condition often related to the negative effects that they create in their socialization (First 2004, p64). Aggression is the result when a concerned family member points out the condition. Treatments There are measures to control the spread of the symptoms, but medication is the ultimate solution to solving the problems associated with the condition. Medication is applied to promote a condition termed as prophylaxis, which stabilizes the mood. It may also be applied to treat the manic depression episode that is the key argument of my paper. Lithium There are several mood stabilizers that have been applied to control the condition, lithium being the first to be successful in the treatment. Its application has been administered in the last 50 years but the science involved in the salt presenting a positive result is not clearly defined. A qualified psychiatrist administers the treatment using this element and issues the right amount of the dosage to control the conditions. Low amount would yield negative or little results and a high dosage would poison the body. Lithium is administered to start having an effect after three months. It presents several side effects and may cause an individual to experience physical changes to their physical condition. These may include: Thirsty Passing excessive urine Added weight Impaired vision Diarrhoea Trembling in the hands There is no promise that the medication administered would completely eliminate the depressive disorder. Mostly they are administered to prevent frequent occurrence of or the possibility of experiencing side effects. Carbamazepine May be used singularly or combined to control forms of seizure. Carbamazepine is administered treatment for patients that have Bipolar 1 disorder. It functions by lowering the electrical functioning within the brain. Lamotrigine These are used to advance the period that are between the episodes of depression, and sometimes mania in the cases related to Bipolar 1 disorder. However, the drug has been proved to be less effective in treating advanced cases of depression and mania. Its function is, therefore, linked with that of carbamazepine to be an anticonvulsant. Other forms The other treatment forms that have been administered to patients have been in applying therapy, and support from family members who are utilized to apply advice and care. They help the patients in offering advice taking measure in administering their medication. Discussion One of the most problems facing addicts from treatment providers may be found in relapse. When a person is abstaining, they gain senses of personal control over their behaviors. As long as the person abstains, the rate of his sense of self-efficiency goes higher. A decision like this will make relapse inevitable. Family therapy is also encouraged because it reduces family burden, relapse, and improves understanding between family members. Programs are implemented to support patients in the community. Patients should also be assigned multidisciplinary teams of which they will be available at all times. Social skills should also be enacted to patients hence increase of social skills. Get motivation speeches from pastors and peer counselors. Research has shown that African Americans have been raised in worse conditions associated with low-income families (Arbee 2004, p257). The medication that is utilized to treat the condition may be terminated after periods with limited accessibility in the expenses incurred. A further indication has provided that they have distrusted the tests issued to curb the spread of depression, because most analyst end up issuing false judgment based on their color. They had been unethically experimented on during the Tuskege experiment as an example. Higher form of depression is recorded among the African Americans because the suicide deaths are increasing (Delbello, Soutullo & Strakowski, 2000). This is a contrast because it had been expected that the case be reduced at the time when they advance, in their ambition to raise their economic level to the middle-income earners. The study suggests that the case in the group is unlikely to be treated because their rate of detection is low. There are reasons that have prompted this measure because they have despised the system due to several factors. The history around the Tuskege study prompted the majority of the race being institutionalized. There have been cultural barriers existing between patients and doctors with majority relying on family as a solution in treating depression. These are the major factors leading to little diagnosis in the group with little medical cover prompting retaliation to use cheaper and more familiar strategies. The discussed strategies apply to the cases of depression across variable ethnicities and do not hold any difference in treatment. A measure to apply a fair diagnosis need application and convinces the population on the need to administer treatment. Christianity provides a platform that humanity should be left to express their freedoms and be exempted from the pressures of the world. It was noted that the African American culture preferred to apply these alternative measures to the medication that they considered restricting. There should be a choice in the level of attaining freedom and seek help from sources that they consider comfortable in administering the treatment. There is a choice presented in Christianity for individuals to express their constraints (Dein, 2010). References Arbee, E. (2004). African American women and depression: A review and critique of the literature. Scopus. Vol. 6 (5): pp. 257-265. DOI: 10.1016/088383-9417(92)90036-1. Delbello, M. Soutullo, C. and Strakowski, S. (2000). Racial Differences in Treatment of Adolescents With Bipolar Disorder. The American Journal of Psychiatry. Vol. 157(5). DOI: 10.1176/appi.ajp.157.5.837-a. Dein S. (2010). Religion, Spirituality, and Mental Health Theoretical and Clinical Perspective. Psychiatric Times. Vol. 27 (1). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. (2000). Washington, DC: American Psychiatric Association. Print. First, M. (2004). DSM-IV-TR guidebook. New York: American Psychiatric Pub. Print. Maddux, J.E., and Winstead, B.A, (2007). Psychopathology: Foundations for a Contemporary Understanding. London: Routledge. Reznek, L. (1987). The Nature of Disease. London: Routledge & Kegan Paul. Sadler, J.Z. (2005). Values and Psychiatrist Diagnosis. Oxforn: Oxford University Press. Vestergaard, P. and Aagaard, J. (2002). Five-year mortality in lithium-treated manic-depressive patients. Scopus. Vol. 21 (1): pp. 257-265. DOI: 10.1016/0165-0327(91)90036-L. Wakefield, J.C. (1992). The Concept of Mental Disorder: On The Boundary Between Biological Facts and Social Values. New York: American Sociological Association. Read More