Friday, October 4, 2019
Treat and Identify Bipolar disorder Essay Example for Free
Treat and Identify Bipolar disorder Essay Thesis Statement: Bipolar Disorder is a disorder that roots from the genes and upbringing of the parents with their kids. This disorder can be brought until adulthood and greatly affects the social, emotional, psychosocial life of the concerned individual. Introduction:                        Over the centuries, authorities have distinguished a variety of psychological disorders, each characterized by its own set of symptoms. Hippocrates devised the first system for classifying psychological disorders, which include mania or excitement, melancholia or severe depression, phrenitis or disorganized thinking. In 1883 German psychiatrist Emil Kraepelin devised the first modern classification system, combining Hippocrates categories of mania and melancholia into a disorder called Manic Depression. Today Manic Depression is called Bipolar Disorder (Hirschfeld, 1999).                  A Biblical story describes how King Saul stripped off his clothes in public, exhibited alternating bouts of elation and severe depression, and eventually committed suicide. Though the story attributes his behavior to evil spirits, psychologists might attribute it to a Bipolar Disorder. A Bipolar disorder, is formerly called manic depression, is characterized by days or weeks of mania alternating with longer periods of major depression, typically separated by days or weeks of normal moods.                        Mania, from the Greek term for â€Å"madness†is characterized by euphoria, hyperactivity, grandiose ideas, incoherent talkativeness, unrealistic, optimism and inflated self- esteem. Manics are sexually, physically and financially reckless. They may also overestimate their own abilities, perhaps leading them to make rush business deals or to leave a sedentary job to train for the Olympics. At some time in their lives, almost 1 percent of adults have a bipolar disorder, which is equally common in males and females (Spitzer et al., 2001). Discussion:                  The Biopsychological Viewpoint:                   Mood disorders have a biological basis, apparently influenced by heredity. Identical twins have higher concordance rates for major depression and bipolar disorder. Identical twins have the same genetic inheritance; this provides evidence of a hereditary predisposition to develop mood disorders                       Some of the evidence for a hereditary basis of bipolar disorder has been provided by a study of the Amish community in Lancaster County, Pennsylvania. Because the Amish have a culturally and genetically isolated community, only marrying among themselves, they provide an excellent opportunity to study the influence of heredity on psychological disorders.      Moreover, there must be other mechanism for the inheritance of Bipolar Disorder because other studies of families in which Bipolar Disorder follows a hereditary pattern have failed to find a genetic marker on the eleventh chromosome. The hereditary predisposition to develop mood disorders may manifest itself by its effect on neurotransmitters. Major depression is related to abnormally low levels of serotonin and norepinephrine in the brain. Serotonin seems to moderate norepinephrine’s relationship to both mania and major depression. Mania is associated with a combination of low levels of serotonin and high levels of norepinephrine (American Psychiatric Association, 2003)                  The Psychoanalytic Viewpoint:                        The traditional Psychoanalytic viewpoint holds that the loss of a parent or rejection by a parent in early childhood predisposes the person to experience depression whenever he or she suffers a personal loss, such as a job or a lover, late r in life. Because the Child feels it is unacceptable to express anger at the lost or rejecting parent, the child learns to turn anger on himself or herself, creating feelings of guilt and self- loathing.                        The Behavioral Viewpoint:                        Behavioral explanations pf depression stresses the role of learning and environmental factors. On of the most influential behavioral theories of depression is Peter Lewinsohn’s Reinforcement theory, which assumes that depressed people lack the social skills needed to gain normal social reinforcement from others and may, instead, provoked negative reactions from them. For example, depressed people stimulate less smiling, fewer statements of support, more unpleasant facial expressions, and more negative remarks from other than do nondepressed people (Wallace, 2000).                        The Humanistic Viewpoint:                         Those who favor the Humanistic viewpoint attribute depression to the frustration of self- actualization. More specifically, depressed people suffer from incongruence between their actual self and their ideal self. The actual self is the person’ subjective appraisal of his or her own qualities. The ideal self is the person’s subjective judgment of the person he or she would like to become. If the actual self has qualities that are too distinct from those of the ideal self, the person becomes depressed (Wallace, 2000).                        Mania and the Bipolar Affective Disorders:                        Before considering the symptoms of mania, we must point out that few individuals who experience mania seem to avoid depression. Much more frequently an episode of mania is associated with one or more episodes of severe depression. Because of this, when one or more episodes of mania are manifested but no depressions have been present, the individual is still given a diagnosis of bipolar affective disorder. A presumption is made that sometime in the future a major depressive episode will occur. That such a depressive episode will always occur (Spitzer et al., 2001).            Manic Behavior:                       The typical signs of Mania involve a period when an individual is unusually elated and expansive, and often irritable when frustrated. The manic mood usually fluctuates over time. Mood             The manic has been described as on a natural high. Mood is euphoric and cheerful. The person often feels that anything is possible if only one puts one’s mind to the task. Great plans are often made, and if these plans are disrupted by external frustration, the mood may change to one of anger and irritability (Wallace, 2000). Thought             In a manic phase, the individual ha san overwhelmingly positive self – image. Belief in one owns abilities are boundless, and expectations of success are unrealistic. Failure is blamed on others, problems are denied and Manics often insist they have never felt better, thought clearer, or been more powerful. As the mania becomes more pronounced, there may be delusions of grandiosity: beliefs that one has special powers or talents. Hallucinations may occur, and usually consist of voices telling the person that he or she ha special mission or ability. Behavior             In manic episode, the individual’s energy seems boundless. Often only a few hours’ sleep is required per night. The individual may be very active, planning many events, taking on new duties, developing new relationships. Vacations may be started only to be broken off so that the individual can return to work. There may be buying sprees, high risk money investments, and hyper sexuality. Behaviorally, the individual appears â€Å"supercharged†. Judgment is often impaired. Dress may become bizarre, and women may apply their makeup in unusual and odd ways, using strange colors that make them appear to be wearing war paint. A notable characteristic of manic behavior is speech that is loud and rapid, as if spewing out under some internal pressure. The manic may manifest â€Å"flight of ideas,†a continuous stream of speech may become disorganized, and the individual may be extremely distractible by environmental stimuli (American Psychiatric Association, 2003). Bipolar Affective Disorders:                 When the mood swings of the Bipolar Disorder are mild, the behavior is called Cyclothymic Disorder. Major Bipolar Affective Disorder: In Bipolar disorder, mixed, the manic and depressive mood and behaviors alternate. The individual goes from one extreme to the other with periods of normal mood in between. It is obvious that a major feature of the bipolar disorder is the change from one mood extreme to another. III. Treatments:            Biological Treatments Electroconvulsive Therapy An electric current is applied to the patient’s brain in order to reduce seizures. The manifestations of the seizures are â€Å"softened†by the use of muscle- relaxant drugs; and the patient is also given a drug which results in unconsciousness to avoid the unpleasant and often frightening experience of the treatment. ECT appears to be effective with major depressions. It lifts depression rapidly within days or weeks. This is advantageous when there is a plan for a suicide. Although it has adverse effects like significant memory impairment, which may be long lasting and also depression may recur. Drug Therapy          The use of chemical compounds to treat affective disorders is very common. The unipolar disorders are typically treated with drugs of the tricyclic class like antidepressants which increase the availability of         Norepinephrine in the synaptic cleft. A commonly used tricyclic drug is named Elavil. Bipolar disorders are often treated with both tricyclic and lithium, depending upon whether the individual is depressed or in a manic phase. Once the individual’s mood has been changed by the chemical, the drug may continue to be taken for maintenance purposes. When an individual manifest a bipolar affective disorder and is in a depressive episode, the anti depressant drugs are sometimes used to lift the mood, but this sometimes precipitates a manic episode. The bipolar disorder is most commonly treated today through the administration of lithium carbonate. Many studies indicate that this lithium salt is highly effective in reducing the exaggerated mood of mania in about 80 percent of the persons who take it. After having been used for mania, lithium was discovered to have some utility for the depressive episodes in bipolar disorders and in recurrent unipolar disorders (Hirschfeld, 1999). The Psychological Approaches Psychological approaches o the affective disorders, including traditional psychotherapy and the cognitive and behavioral therapies, have focused on the unipolar depressions and especially on the non psychotic depressions. Dynamic Psychotherapy Treating severe depression with psychotherapy is a difficult task. Such patients rarely have enough energy to participate actively in an interpersonal interchange with a therapist. Behavior Therapy  In spite of its high incidence, bipolar disorder has received little attention from behavioral clinicians. However, if it is due to a reduction in reinforcement, one approach to the problem would be to teach a patient to engage in activities that is more self- reinforcing. Another approach is to train the individual to behave in ways that maximize the likelihood of reinforcement. Cognitive Therapy The behavior therapies mentioned involve the modification of cognitions, for example, the belief that one is helpless to change oneself or to control the environment. It focuses on modifying the erroneous, irrational cognitions held by depressed individuals. These persons have predominately negative view of themselves: they are self- blaming, exaggerate external problems, devalue themselves, and are pessimistic about their future. Cognitive therapy intervenes with this through a variety of techniques. Therapy is structured an directive, and usually short – term. The therapists used behavioral techniques, which include planning productive activities and scheduling potentially enjoyable events, to break the mania (Wallace, 2001).         References: American Psychiatric Association, (2003). Diagnostic and statistical manual of mental disorders (6th Ed.). Washington, DC: Author. Beck, A. T. Depression: Clinical, Experimental and Theoretical Aspects. New York: Harper and Row, Publishers. Hirschfeld, R. M. A., Cross, C.K. (1999). Epidemiology of effective disorders. Psychosocial risk factors. Archives of General Psychiatry, 39, 35-46. Spitzer et al., (2001). DSM-III case book: A learning companion to the diagnostic and statistical manual of mental disorders (5th Ed). Washington, DC: American Psychiatric Association. Wallace, E., IV. (2000). What is â€Å"truth†? Some philosophical contributions to psychiatric issues. American Journal of Psychiatry, 145, 137-147
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