Hca_210_Bipolar_Disorder

Bipolar Disorder By Gabrielle Owen University of Phoenix Bipolar disorder is also known as manic-depressive illness and is a mood disorder that causes dramatic shifts from depression to mania. Depression is the lowest point in the cycle and mania is the over-elevated high. There are different categories of bipolar disorder, each determined by the pattern of symptoms. Bipolar disorder is one of the oldest recognized mental illness. Throughout history the name has changed although the symptoms have remained the same. Ancient writings have talked about people acting a certain way one day and then act drastically different the next day. This event was thought to be a climate related condition. Patients with this disorder were institutionalized to separate them from other people. Electroconvulsive shock therapy, prefrontal lobotomies were acceptable radical treatments in the 1950s. Medications have also evolved throughout the years. Signs and symptoms of bipolar disorders include extreme lows followed by extreme highs, without having been caused by physiologic effects of drug substances. Mania is the term for the extreme highs. Zelmen (2010) explains; “Mania can vary from extreme elation, hyperactivity, and irritability to extreme aggression, with little need for sleep, and risky behaviors that are later regretted. An overly enthusiastic mood at times may attract others; however, mood shifts with delusions may lead to alienation of friends and family and to irresponsible behaviors such as spending one’s life savings or engaging in sexual indiscretions.” Mania symptoms include; increased physical and mental activity and self-confidence, excessive irritability, aggressive behavior, decreased need for sleep without experiencing fatigue, grandiose delusions, inflated sense of self-importance, racing speech, racing thoughts, flight of ideas, reckless behavior such as spending sprees, rash business decisions, erratic driving, and sexual indiscretions, in the most severe cases delusions and hallucinations.” Depression symptoms include feelings of guilt, worthlessness, anxiety and shame along with the physical symptoms of unexplained weightloss or weight gain, disturbed sleep, decreased energy, poor eye contact, monosyllabic speech, and indifference to pleasure or joy. The neurotransmitters associated with bipolar disorder are dopamine, norepinephrine, and serotonin. Dopamine’s regulatory actions include; mood, behavior, thought process, muscle movement, physical activity, heart rate, blood pressure, feeding, appetite and satiety. Dopamine is related to the signs and symptoms of bipolar by mood, behavior and thought process. Norepinephrine’s regulatory actions include; mood, anxiety, vigilance, arousal, heart rate, and blood pressure. Norepinephrine relates to the signs and symptoms of this illness by mood, anxiety and arousal. Serotonin’s regulatory actions include; perception of pain, feeding, sleep-wake cycle, motor activity, sexual behavior, and temperature regulation. Serotonin relates to the signs and symptoms of this disorder by perception of pain, sleep-wake cycle, sexual behavior, and feeding. The diagnosis of bipolar disorder relies on a clear period of unusually elevated mood followed by a clear period of depression. The different categories are bipolar I, bipolar II and cyclothymic disorder and they depend on the pattern of symptoms. Bipolar I is associated with times of extreme mania and depression lasting for weeks. Bipolar II is associated with less intense manic episodes with longer periods of depression. Cyclothymic disorder is the chronic fluctuation between mild mania and depression; this goes undiagnosed often but eventually results in the most severe form of bipolar. Diagnosis involves psychosocial and medical evaluation, and psychometric testing. The types of professionals that can diagnose this disorder include psychiatrists, psychologists, family physician, neurologists, and clinical social workers. Treatment for bipolar disorder is complex and includes prolonged treatment with medications and family and individual patient counseling. Medications proven to treat this disorder include mood stabilizers, anti-depressants, sedative medications, major tranquilizers or antipsychotics. Mulller-Oerlinghausen (2002) “Because of the high risk of recurrence and suicide, long-term prophylactic pharmacological treatment is indicated. Lithium salts are the first choice long-term preventive treatment for bipolar disorder. They also possess well documented anti-suicidal effects. Second choice prophylactic treatments are carbamazepine and valproate, although evidence of their effectiveness is weaker.” A non-stressful environment is essential for someone who has bipolar disorder. A stressful environment will negate the medication and will only do harm to the person with the illness. Diagnosis and treatment have changed drastically over the years. In the past diagnosis of bipolar did not clearly differentiate between normal and abnormal states. Muller-Oerlinghausen (2002) “Diagnostic criteria and definitions for bipolar disorder have changed over the years. Most recently, bipolar disorder has been defined as a continuum of phenotypes, ranging from a pattern of mild depression and brief hypomania to one of severe rapid cycling or predominantly mania with psychotic features. The heterogeneity of bipolar disorder is reflected in the large variation of related pathophysiological, genetic, and other biological and clinical findings.” Treatments were very extreme in the past with the use of electroconvulsive shock therapy and prefrontal lobotomies, Torpy (2009) talks about treatment now; “Because bipolar disorder is a chronic illness, continuous treatment is necessary to prevent relapse of manic or depressive symptoms, to improve overall health, and to maximize the quality of life. Several types of medications may be used, alone or in combination, to treat bipolar disorder.” In conclusion bipolar disorder is one in which the patient experiences abnormal highs called mania and lows called depression. Over time the understanding of bipolar disorder has evolved and the diagnostic process along with treatment protocols have changed. References Muller-Oerlinghausen, B., Berghofer, A., & Bauer, M. (2002). Bipolar disorder. The Lancet, 359(9302), 241-7. Retrieved from http://search.proquest.com/docview/199032516'accountid=35812 Bipolar Disorder, Torpy, Janet M. MD, Writer; Lynm, Cassio MA, Illustrator; Glass, Richard M. MD, Editor. JAMA. 301(5):564, February 4, 2009. Chapter 14 Human Diseases: A Systemic Approach, Seventh Edition, by Mark Zelman, Ph.D., Elaine Tompary, PharmD, Jill Raymond, Ph.D., Paul Holdaway, MA, and Mary Lou Mulvihill, Ph.D. Published by Prentice Hall. Copyright © 2010 by Pearson Education, Inc.