Bipolar Affective Disorder (BAD) is one of the most prevalent mental health issues in the US. It is very common among young, adult population. However, children and old adults have also been diagnosed and received treatment as a consequence of the illness. Prevalence statistics indicate that 2.6 percent (at least 5.7 million) of US adult population suffers from BAD. 89.2% of the affected individuals are classified as a severe. BAD is characterized by abnormal fluctuations in mood, activity and energy levels that influence ones ability to perform daily tasks. The shifts in moods vary between highs (mania) and lows referred to as depressive episode (National Institute of Mental Health, 2016). The difference that distinguishes BAD from other dramatic mood swings is that the moods are more severe than that what everyone experiences on a daily basis. The paper will be organized as follows: etiology of the illness, DSM aspects, characteristics and symptoms theories, and treatment approaches and outcomes.
Etiology of Bipolar Affective Disorder
Currently, researchers in the medical field have not identified the specific cause for BAD, explaining the absence of a diagnostic test and cure for the condition (National Institute of Mental Health, 2016). However, the development of the condition has been attributed to psychological, hereditary and environmental factors.
Although a direct linkage between BAD and genetic factors has not been established, several studies have provided an overwhelming evidence which suggests that the condition runs down in some families. The studies reveal that close linkages between BAD and certain points of chromosomes of sampled families. A study involving 1508 individuals of 57 extended families from the US and Israel showed a parametric linkage for the region 2p13-16 using an intermediate disease phenotype and a dominant model of transmission (Juli, Juli, & Juli, 2012, p.113).Other studies reveal that people of close families have predisposing factors to BAD. According to Juli, Juli, and Juli, nuclear family members of bipolar patients have 5-10 times higher risk of developing BAD than the general population. Additionally, monozygotic twins have at least 45 % greater risk of becoming bipolar than the general population (Yadav et al., 2013, pp.34-35).
Alteration of health habits such as the consumption of alcohol and drug abuse or hormonal changes can trigger BAD episodes. For instance, the use of alcohol or abuse of drugs enhance the chances of depressive episodes among bipolar patients (Yadav et al., 2013, p.35).It is important to note that environmental factors have been linked to the occurrence of episodes and should not be interpreted as the cause for BAD.
Psychological factors and bipolar illness do not have a direct relationship. Patients with mental problems stand a higher chance of exhibiting depressive or manic symptoms. Studies focusing on bipolar patients reveal that stressful events often precede the start or recurrence of bipolar episodes (Alloy et al., 2005, p.1048).Whereas stressful events have been found to trigger depressive episodes, the stress itself has not been directly linked to the development of BAD(Yadav et al.,2013, p.35).
DSM and Bipolar Affective Disorder
DSM constitutes a set of guidelines that are employed by medical officers to determine whether an individual is bipolar. For a patient to meet the diagnosis criteria under DSM, they must exhibit certain symptoms over a given period.DSM describes the diagnosis requirements for the different mood episodes; manic episode, major depressive episode, hypomanic episode and mixed episode. The DSM criterion differentiates the diagnosis of bipolar disorder episodes based on their presence, sequence, and history. For instance, patients that experience significant manic and depressive episodes but do not meet the criteria for BAD are diagnosed as positive cases of bipolar disorder. Moreover, in the absence of a maniac episode, the diagnosis is considered as a depressive bipolar disorder (Juvenile Bipolar Research Foundation, 2016).
Characteristics and Symptoms of Affective Bipolar Disorder
Application for the Client
The symptoms of bipolar disorder manifest themselves depending on the episode the patient is undergoing. Patients should observe for the following symptoms for them to make the right decisions in regards to their treatment.
Patients suffering from bipolar depression episode feel sad, hopeless or empty. They tend to have a gloomy picture about the future. The sad or hopeless feelings may degenerate into feelings of worthlessness which often motivates the affected persons to contemplate suicide (Otto, 2011, pp.5-10). Besides, patients experience fatigue and loss of energy. The energy loss is caused by intensified brain activity and appetite fluctuations (American Psychological Association, 2016).
Patients with mania or hypomania episodes experience sleep problems. However, the inadequate sleep does not affect the energy levels. Also, patients develop high levels of optimism or a reduction in ones ability to concentrate even in simple tasks (National Institute of Mental Health, 2016).
Application for the Counselors
Conversations with patients can provide a significant opportunity for counselors to identify symptoms of bipolar disorder for the purpose of designing appropriate counseling therapies. Patients may exhibit:
Concentration and memory challenges
Unrealistic and impracticable beliefs about ones abilities
During conversations or dialogue, affected persons talk rapidly with little regard to others input as well as make interruptions in the middle of conversations
Unrealistic beliefs about ones self. These beliefs are often manifested in delusions, reckless actions, impaired judgments and hallucinations (American Psychological Association, 2016). Psychotherapies may not be effective in treating severe cases of bipolar. In such circumstances, medical should be considered.
Most management strategies for BAD duel on the treatment of acute episodes, prevention of relapses and maintenance of therapies (Elanjithara, Frangou McGuire, 2011, p.283). Treatment of bipolar disorder partly entails administration of drugs that limit the level of depression among patients. For instance, antipsychotic drugs are used to treat acute mania. These drugs are administered to reduce the highs and lows of patient moods which help to stabilize and keep the symptoms in check. Lithium and Placebo are some of the drugs used to minimize acute bipolar episodes. However, research on the effectiveness of drugs reveals that lithium remains the most effective drug in the treatment of bipolar disorder. The mentioned drug has registered better outcomes in the prevention of long-term relapses and mood episodes (Severus et al., 2014, pp.1-2; Geddes & Miklowitz, 2013, 1672).
Despite the success of drugs in the treatment of bipolar disorder, data from treatment outcomes show high rates of relapses among patients. According to Geddes and Miklowitz (2013), the effective ways of long-term management of bipolar disorder can be enhanced by adopting a strategy that combines both psychosocial interventions and administration of drugs. To this end, treatment approaches should consider neurobiological and psychosocial attributes of bipolar disorder and create optimal mechanisms that yield the best results in terms of episode prevention (1672). The mentioned mechanism is ideal considering that accurate diagnosis of BAD continues to be a challenge to many medical practitioners and counselors.
Most recent interventions against bipolar cases have incorporated psychosocial approaches. As indicated earlier, employment of psychosocial mechanisms alongside drugs yields better outcomes. Through cognitive-behavioral therapy, patients are educated on how thoughts affect their emotions and also mechanisms of changing negative behaviors (Otto, 2011, 57-60; 75-80). As a result, patients learn to appreciate their illness and focus on problem-solving strategies that avoid relapses.
Family-based interventions have shown positive results when used alongside drugs. This therapy enlightens family members of bipolar patients so as to provide the emotional support in solving problems in life. Through counseling, family members can provide the favorable home environment for the affected persons to recover or minimize chances of relapses (Otto, 2011, p.33). For instance, stress associated with living a bipolar individual in the family can be avoided through family-oriented therapy.
Bipolar affective disorder is a common mental illness in young adult populations. Despite receiving extensive investigation over the recent years, the cure for bipolar affective disorder remains unknown. Similarly, the cause that can be directly attributed to the illness has not been established. However, available scientific evidence suggests that genetic factors play a major role in the development of the condition. Additionally, a body of research has indicated that environmental factors such as alcohol consumption and drug abuse may be responsible for the development of bipolar disorder. Symptoms of bipolar disorder include memory problems, reckless actions, hopelessness, suicidal feelings, and fatigue. Other patients may show sleep problems, unrealistic optimism, and sadness, among others. Currently, treatment interventions include administration of drugs such as lithium and placebo which help in the suppression of acute episodes. Most recent studies suggest that the most appropriate approach to the treatment of the disorder is the creation of a balance between psychosocial mechanisms and the use of drugs. This area offers an opportunity for future investigation.
Alloy, L. B., Abramson, L. Y., Urosevic, S., Walshaw, P. D., Nusslock, R., & Neeren, A. M. (2005). The psychosocial context of bipolar disorder: Environmental, cognitive, and developmental risk factors. Clinical Psychology Review, 25(8), 1043-1075. doi:10.1016/j.cpr.2005.06.006
American Psychological Association. (2016). Bipolar disorder. Retrieved from https://www.psychiatry.org/
Elanjithara, T. E., Frangou, S., & McGuire, P. (2011). Treatment of the early stages of bipolar disorder. Advances in Psychiatric Treatment, 17(4), 283-291. doi:10.1192/apt.bp.109.007047
Geddes, J. R., & Miklowitz, D. J. (2013). Treatment of bipolar disorder. The Lancet, 381(9878), 1672-1682. doi:10.1016/s0140-6736(13)60857-0
Juli, G., Juli, M., & Juli, L. (2012). Involvement of genetic factors in bipolar disorders: current status. Psychiatria Danubina, 24(1), 112-116.
Juvenile Bipolar Research Foundation. (2016). The Bipolar Disorder Classification as Defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Retrieved from http://www.jbrf.org/
National Institute of Mental Health. (2016). Bipolar disorder among adults. Retrieved from https://www.nimh.nih.gov/
Otto, M. W. (2011). Living with bipolar disorder: A guide for individuals and families. New York: Oxford University Press.
Severus, E., Taylor, M. J., Sauer, C., Pfennig, A., Ritter, P., Bauer, M., & Geddes, J. R. (2014). Lithium for prevention of mood episodes in bipolar disorders: systematic review
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