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Bipolar disorder is a chronic psychological disorder marked by significant mood swing episodes ranging from sadness to intense euphoria known as mania. These mood fluctuations, in turn, affect the patient's energy, mood, and ability to think sensibly or perform correctly. Bipolar disorder gets its name from the occurrence of two mood states in which patients have alternating episodes of melancholy and euphoria that interfere with their everyday activities, necessitating medical intervention. This disorder is categorized into three types: bipolar one disorder, bipolar two disorder, and cyclothymic disorder, based on the severity and frequency of mania and depressive episodes. The disorder is characterized by a myriad of symptoms depending on the type of bipolar disorder and the state of the mood in manic and depressive episodes (Geddes & Miklowitz, 2013).
The symptoms of the disorder can be classified in the two states of mania and depression. Manic episodes of bipolar disorder are characterized by euphoria, high self-esteem, racing thoughts and talkative tendencies. During this period the patient may exhibit impaired judgments, underperformance, engagement in risky behavior as well as a tendency to be easily distracted. On the contrary, during depressive episodes of the disorder, patients experience hopelessness, extreme sadness, anxiety and sleeping problems. Feelings of guilt, eating problems, fatigue, a low attention span as well as easy irritation on slight provocation may also accompany the depression. Whereas these symptoms may occur under normal happiness or depression, their seasonal pattern of occurrence signals a bipolar disorder. Help from a trained psychologist should be sought before any medication or therapy to enhance proper diagnosis and provision of medical treatment, psychotherapy, and care (Geddes & Miklowitz, 2013).
The prevalence of bipolar disorder is between 1% to 2% of the global population of ages above 18 years. According to the National Institute of Mental Health (NIMH), 5.7 million Americans are diagnosed with bipolar disorder every year which accounts for about 2.6 percent of the total USA population. According to the WHO's mental health reports, approximately 1.1% of the global population is diagnosed with bipolar disorder every year with the majority in China and India. This percentage accounts for more than 51 million people across the world. In this way, the disorder is a significant contributor to disability in all developed countries worldwide (Ferrari et al., 2013).
Although bipolar disorder has no well-defined causes, certain causes and triggers are widely accepted to contribute to the occurrence of bipolar disorder. These include biological factors, genetic predisposition as well as many environmental factors that trigger bipolar disorder. The biological causes of bipolar disorder manifest themselves through changes in the brain of bipolar people while the occurrence of bipolar in the first-degree genetic lineage of an individual predisposes them to bipolar disorder. The external environmental triggers include substance abuse, sleep deprivation, medication, stress and seasonal changes.Drugs such as alcohol trigger depression while other drugs such as cocaine trigger mania. Also, medication such as antidepressants and corticosteroids can trigger mania. Seasonal changes of summer, spring, and winter are associated with changing bipolar episodes where summer is associated with mania and winter is linked to depression. These suspected causes of bipolar disorder are not conclusive, and research into the causes of the disorder is ongoing with investigations into neurotransmitters and hormones taking center stage (Geddes & Miklowitz, 2013).
The diagnosis of bipolar disorder can be treated using medication and the various schools of psychotherapy including psychodynamic, humanistic, cognitive and behavioral schools of administering psychotherapy to a patient. These models of psychotherapy can be used independently or combined to achieve the required goals. Psychodynamic or psychoanalytic psychotherapy is an insight oriented therapy that aims to increase the patients' self-awareness through fostering a better understanding of their unconscious processes and the inner world. It can be applied in the treatment of bipolar disorder through the analytical psychology of the client and explanation of their bipolar tendencies to foster knowledge and awareness into the condition and the ways of managing it. This enables the patient to be self-aware and react to minimize effects of the disorder. Humanistic psychotherapy, on the other hand, is a client-centered psychotherapy that aims at creating a good relationship between the client and the psychologist such that the client can benefit and grow. The client benefits from the relationship through mutual trust and understanding that fosters better administration of treatment and therapy. This school of psychotherapy can be applied in bipolar disorder to improve moral support to the client as well as increase self-determination and confidence towards the therapy and treatment of the disorder. Cognitive psychotherapy is a model based on recognition and appreciation of the effect of mental beliefs and thoughts in the development of disorders such as the bipolar disorder. The adjustment of clients' thinking and state of mind reduces the mental triggers and risk factors that accompany such mental disorders. In the treatment of bipolar disorder, this school of psychotherapy can be used to increase objective thoughts and beliefs that help reduce depression and mania in clients. Finally is the behavioral psychotherapy which focuses on the prevailing unhealthy behaviors and the optimum way of changing them for better. It focuses on changing behaviors to modify the feelings and to address psychological disorders such as the bipolar disorder. In this way, the risk factors and environmental triggers can be averted (Geddes & Miklowitz, 2013).
Among the four models, behavioral psychotherapy is most suited for addressing bipolar disorder. This is because it accurately caters for the influence of triggers and risk factors of the condition through behavioral change especially when coupled with medication and cognitive therapy in what is referred to as cognitive behavioral psychotherapy. Resistant to treatment can be experienced in the treatment of bipolar disorder. This includes the failure to respond or partial response to lithium medical care and therapy. In such a case maximum gains should be sought through a combination of schools of psychotherapy and medical procedures that minimize risks and severity of mania and depression.
The Prochaska model of behavioral change can also be gainfully utilized in the treatment of bipolar disorder. Since it is a transtheoretical model of change that appreciates the processes of change with time, psychologists can use the model to interpret the progress of their clients and offer therapeutic support and other relevant care in respect to their prevailing stage of behavioral change. However, manualized therapy is not outrightly desirable due to the diagnostic complications of bipolar disorder as well as the threats posed to the client-psychologist relationship which is pivotal in the treatment of bipolar disorder. It can, however, be exercised minimally to achieve specific goals particularly when the treatment involves medication or defined sessions of psychotherapy. A dual diagnosis of the disorder is highly probable, especially where alcohol and substance abuse problem is present in the client and poses as a risk factor or trigger. In this case, treatment of the new diagnosis should be administered through a separate treatment plan since it represents a significant risk factor for the occurrence of bipolar disorder (Farren, Hill & Weiss, 2012). This addresses not only the primary disorder but also a trigger factor to the disorder.
In dealing with bipolar disorder, I intend to help people between the ages of 18 and 35 years irrespective of their ethnicity or sex to manage and deal with the disorder since they are at a higher risk of developing the disorder. The diagnosis and treatment of the disorder at its onset between this age gap helps them to lead a healthy life. However, in the treatment of clients proper ethical and cultural aspects of professionalism should be adhered to according to the American Psychological Association's Ethics Code (2010) which governs the conduct of mental health professionals in the discharge of their duties. This should also include sensitivity to particular cultures in addressing issues of stigma, discrimination, and culture-bound syndromes. In dealing with these issues, I would exercise professionalism and make myself conversant with my client's cultural background beforehand to prevent misunderstandings due to cultural and ethical beliefs.
In conclusion, bipolar disorder is a significantly harmful disorder which should not only attract more research funding from international health bodies and government than there is currently but also warrant proper medical investment by governments and medical agencies. In this way, it can be diagnosed and controlled adequately to avert its ugly consequences such as suicide or other anti-social behaviors.
Farren, C. K., Hill, K. P., & Weiss, R. D. (2012). Bipolar disorder and alcohol use disorder: a review. Current psychiatry reports, 14(6), 659-666.
Ferrari, A. J., Charlson, F. J., Norman, R. E., Patten, S. B., Freedman, G., Murray, C. J., ... & Whiteford, H. A. (2013). Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS Med, 10(11), e1001547.
Geddes, J. R., & Miklowitz, D. J. (2013). Treatment of bipolar disorder. The Lancet, 381(9878), 1672- 1682.
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