Essay Example on Bipolar I Disorder: A Global Mental Health Crisis

Introduction

According to Bonnin et al. (2019), bipolar I disorder is one of the most critical mental illnesses that affect a plethora of people across the world. The mental condition occurs in people with a history of at least one instance of a manic episode in their lives. A manic episode refers to a period characterized by abnormally increased levels of thoughts or irritable mood and high energy, combined with unusual behaviour that disrupts the ability of a person to function normally (McCornick et al., 2015). This report aims to provide a comprehensive discussion of a person diagnosed with bipolar I disorder. The report begins with a detailed description of the order, outlines its signs and symptoms, and pathophysiology before looking at its contemporary treatment approaches. Lastly, the discussion covers the nursing approaches used for the management of the disorder within a multidisciplinary team and the anticipated treatment outcomes.

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Description of the Disorder

Bipolar I disorder is one of the mental illnesses surrounded by a wide range of myths and beliefs among people living in contemporary society (Philips & Kupfer, 2013). For instance, many people tend to think that bipolar I disorder is majorly a mood disorder while exempting the impact of depression in its manifestation. However, it is highly critical to have a detailed comprehension of this condition to distinguish between the existing myths and facts alongside figures to understand its prevalence (Baldessarini et al., 2020). First, it is critical to understand that bipolar I disorder occurs as a result of experiencing manic disorders that last for at least one week. People who demonstrate manic symptoms that are not only severe but life-threatening to the extent that they may require immediate hospitalization could also be suffering from bipolar I disorder. Secondly, this mental condition occurs alongside depressive episodes that may last up to 2 weeks (Rajasurya et al., 2010). Lastly, most of these depressive episodes arise with a wide range of mixed features, including incidences of having co-occurring symptoms of despair and manic.

Rowland and Marwaha (2018) found that the prevalence of bipolar I disorder across people's lifetime in the contemporary world is 1%. However, the overall lifetime prevalence of the bipolar spectrum disorders stands at 2.4% across the entire population with that of bipolar I and II reaching 0.6% and 0.4%, respectively (Baldessarini et al., 2020). The prevalence of bipolar I disorder in the United States remains alarming. Bonnin et al. (2019) ascertained that bipolar disorder, which includes type I and II affects approximately 5.7 million adult Americans. This prevalence rate transforms to about 2.6% of the United States population of people ranging from 18 years and above (Shah et al., 2017). The median age of in which bipolar spectrum disorders begin among people in the United States stands at 25 years despite the probability of the disease starting in early childhood and late adulthood (Severus et al., 2014). Lastly, an equal number of men and women suffer from bipolar I disorder, and it spreads through all ages, ethnic groups, social classes, and races.

Signs and Symptoms

Understanding the signs and symptoms of bipolar I disorder is crucial in helping physicians to diagnose it and identify appropriate treatment as well as management strategies. According to Miller et al. (2014), manic episodes are often the first signs and symptoms of bipolar I disorder. People usually experience an elevated mood in the form of euphoria and irritability. Patient having bipolar I disorder also have a wide range of unusual manic episodes, including changing suddenly from one thought to another, use of rapid and loud speech, and inflated self-image. Such patients also demonstrate increased levels of energy accompanied by hyperactivity and an overall decrease in the need for sleep. Indulgence in substance abuse is also a significant symptom of people suffering from bipolar I disorder, alongside increased spending of money (Pavlickova et al., 2013). People with manic episodes, which is a significant attribute of bipolar I disorder, may spend money beyond their means, indulge in sex with people they never planned for, and pursue unrealistic and grandiose plans.

According to Bobo (2017), the probability of people with bipolar I disorders losing touch with reality increases with the severity of their manic episodes. Such patients may become bizarrely and delusional with these feelings lasting from 7 days to several months when untreated. Depression follows shortly and may disappear after some days, which makes it difficult to diagnose a person with bipolar I disorder. Research indicates that a plethora of people diagnosed with bipolar I disorder usually experience elongated periods without seeing its symptoms between various episodes (Rowland & Marwaha, 2018). A minority of these patients have rapid-cycling symptoms of depression and mania alongside mood episodes. Most of the depressive episodes experienced by patients with bipolar I disorder have unique similarities with the regular clinical depression, which include loss of pleasure, reduced amount of energy and activity, feelings of being valueless, and suicidal thoughts (Solomon et al., 2010). These depressive signs and symptoms of bipolar I disorder can last for several months, but can rarely go beyond one year.

Pathophysiology

According to Ayano (2016), the pathophysiology of bipolar disorders, including type 1, has a unique connection to the changes in normal biochemical and physiological functions associated with it. Understanding the pathophysiology of this condition remains an ultimate goal of numerous clinicians and psychiatrists, but to date, it remains partially understood. Many scientists still do not know all the pathophysiological factors involved in the development of all forms of bipolar conditions (Pavlickova et al., 2013). However, little available knowledge shows that the pathophysiology of this condition relates to various biological factors, neurotransmitters, hormones, and genetics. Multiple studies, including family, twin, adoption, and linkage, emphasize that genetic factors have a far-reaching impact on the occurrence of bipolar I diseases (Tiller & Schweitzer, 2010). For instance, family studies indicate that all forms of bipolar disorders run from parents to their offspring.

The first degree relatives of people with bipolar I disorder are seven times likely to develop the same disorder than the general population (Ayano, 2016). Children whose parents suffer from bipolar I disorder in their lives have a 50% chance of experiencing another critical psychological disorder (Ayano, 2016). Twin studies reveal that identical twins have a higher probability of suffering from bipolar I disorder, especially if their parents had the condition. However, adoption studies indicate that environmental factors play a vital role in the development of bipolar I disorder (Bonnin et al., 2019). Children born with parents diagnosed with bipolar I disorder have a higher probability of developing the condition, especially when adopted and left to grow in stressful environments. Linkage studies indicate that bipolar I disorder has a critical genetic component with evidence of various genes, including CACNA1C and CLOCK (Ayano, 2016). Therefore, genetics play a vital role in the development of bipolar disorders.

Perinatal factors, which entail multiple complications occurring during pregnancy and birth, such as structural brain abnormality, early onset of schizophrenia, and obstetric complications may also lead to the occurrence of bipolar I disorders in children (Rajasurya et al., 2010). Furthermore, neurotransmitters and biochemical factors have a critical role to play in the development of bipolar I disorder. Multiple biochemical pathways contribute to the development of this condition, which, in turn, makes it difficult to detect one particular abnormality. Drugs used in the treatment of depression and those abused, such as cocaine, and, in turn, increase the levels of monoamines can trigger mania, which culminates in bipolar I disorder. Some of these neurotransmitters include norepinephrine, serotonin, and dopamine. Recent life events, such as traumatic experiences that lead to depression and mania, are significant etiological factors in the occurrence of bipolar I disorder (Renk et al., 2014). Such events include accidents, rape, injury, and death of a loved one.

Contemporary Treatment Techniques

Patients seeking for the treatment of bipolar I disorder must present themselves at the right facility with an adequate number of highly-talented medical professionals (McCornick et al., 2015). These professionals should have the right qualifications in terms of skills, knowledge, and experience needed to handle a wide range of issues associated with bipolar I disorder. Psychiatrists specialized in the diagnosis and treatment of a wide range of mental disorders related to bipolar conditions can provide appropriate directions on the most effective treatment strategies (Philips & Kupfer, 2013). There are two strategies of treating the bipolar I condition as discussed below.

Pharmacological Approaches

Pharmacological strategies often entail the use of medications to treat patients with bipolar I disorder after appropriate diagnosis (Bonnin et al., 2019). Patients need to take medications to balance their moods and journey out their path to recovery. Multiple groups of evidence-based drugs can help the effective treatment of bipolar I disorder. The first group of medications, mood stabilizers, seek to help the patient to control manic as well as hypomanic episodes. Examples of these drugs include lithium, carbamazepine, and valproic acid. The second group of medications comprise majorly of the antipsychotics (Miller et al. (2014). Such drugs include, such as olanzapine, aripiprazole, and ziprasidone.

Antipsychotics are crucial in conditions involving persistent symptoms of mania and doctors may direct the patient to combine them with other drugs or use them exclusively. The third category, antidepressants, helps in the effective management of depression and operate alongside mood stabilizers and antipsychotics because they can trigger episodes of mania in patients with bipolar I disorder. The fourth group entails a combination of antidepressants and antipsychotics to treat depression and stabilize the mood of the patient (Solomon et al., 2010). Lastly, doctors recommend the use of anti-anxiety drugs, such as benzodiazepines to help in calming down the patients' anxiety and improve sleep.

Non Pharmacological Strategies

According to Bobo (2017), the non-pharmacological approaches used in the treatment of bipolar I disorder entails psychotherapy initiatives provided through individual, family, and group settings. The first approach, cognitive behavioural therapy (CBT), aims to identify and replace negative and healthy beliefs as well as practices among patients and replacing them with positive ones. CBT helps in the effective management of stress and how to cope up with upsetting conditions. The second strategy, interpersonal and social rhythm therapy (IPSRT) allows patients to balance their daily activities such as eating, sleeping, and movement (Pavlickova et al., 2013). IPSRT also helps in the effective management of patients' moods. Thirdly, psychological education provided by counsellors is crucial in increasing patients' understanding of bipolar I disorder in terms of its implication, diagnosis, causes, prevention, and treatment strategies. This knowledge is critical to the effective management of the condition and ensuring that the patients return to their normal health (Rowland & Marwaha,...