Bipolar and Bipolar Related Disorders Essay

Bipolar and Bipolar Related Disorders Essay

Bipolar and Bipolar Related Disorders Sample Essay

An individual with bipolar disorder has mood swings between highs and lows. Mania refers to the highs, whereas depression refers to the lows.  There are four basic forms of bipolar disorder: bipolar I disorder, cyclothymic disorder, bipolar II disorder, bipolar and related disorders caused by substances or medications, and bipolar and associated disorders brought on by another medical condition (Miller & Black, 2020). The purpose of this presentation is to evaluate the neurobiology and epidemiology of bipolar I disease, distinguish between bipolar I and bipolar II disorders, and discuss pharmaceutical treatment options.

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Prevalence and Neurobiology

Bipolar disorder affects approximately 4% of the world’s population. There is not a single common gene or observable “cause” among those who have bipolar disorder (McIntyre et al., 2020). Nonetheless, patients with this diagnosis have certain characteristics. Post-mortem examinations have shown a decrease in the quantity or form of oligodendrocytes, the myelinating cells of the nervous system. Neuroimaging has identified alterations in brain structure in persons suffering from bipolar disorder. Among these changes are increased volumes in the striatum and amygdala. Functional investigations have shown that people with bipolar disorder have more brain activity than people without the condition.

Differences in Bipolar I and Bipolar II Disorder

Mood swings are a hallmark of bipolar I and bipolar II disorders, which are psychiatric illnesses. Yet, they vary in how the patient is impacted by these highs and lows. Usually, a manic episode is the main indication for the diagnosis of bipolar 1 disorder. Following these occurrences, depression episodes may occur (Calabrese et al., 2021). An inflated sense of self or grandiosity, a decreased need for sleep, increased talkativeness, compulsive thoughts, attention deficits, and an excess of pleasurable hazardous activities are all required for manic episodes to persist for at least one week. The manic state should also impair functioning which is unable to be explained by a pharmacological or medical issue. The DSM-5 states that mania must occur once in a person’s lifetime for bipolar I disorder to be identified (Miller & Black, 2020).

Bipolar II disorder is typically diagnosed after or during a major depressive episode. Depressive episodes are defined by having a sad mood or lack of interest the majority of the time, along with changes in sleeping patterns, hunger, low self-esteem, guilt, weariness, poor concentration, psychomotor delay, and suicidal thoughts. These occurrences may be followed by hypomania (Kato, 2019). Hypomanic episodes are identified by the same characteristics as manic episodes, although they are milder. They must continue for four days, be visible to others, be strengthened from the client’s baseline, and not significantly impair functional capacity. Although manic episodes are not necessary, a diagnosis of bipolar II requires both a hypomanic episode and one depressive episode.

Special Population and Considerations

Each patient population may have different symptoms even when the diagnostic standards for bipolar illness are the same or fairly comparable throughout the population. Children may cycle more quickly. The symptoms could be dismissed as exaggerated manifestations of typical behavior. Children with a first-degree relative may benefit from proactive treatment (McIntyre et al., 2020). Signs in the elderly may be overlooked. Comorbidities are widespread in the elderly and may influence treatment options. For example, renal failure and antipsychotic effects may demand special doses.

From a moral and legal perspective, the patient must provide permission before being treated. Without the patient’s consent, no information about them may be disclosed. The patient must be informed about both of these. The benefits and risks of the treatment must always be explained to the patient, especially concerning certain medications used. In light of this, despite attempts to lessen the stigma associated with mental illness, most people still feel humiliated or embarrassed about receiving a diagnosis (Gitlin & Malhi, 2020). Several cultures either don’t acknowledge mental health at all or only partially. When instructing patients and their families, this must be taken into account.

According to statistics, those who have mental diseases experience worse social determinants of health. These patients may not have steady employment, be employed in unsatisfying jobs, or be unemployed. The absence of a job usually results in a lack of money and, as a result, in the inability to support oneself (McIntyre et al., 2020). Those with lesser incomes than those with higher wages have also been found to have poorer mental health. This might signal that the patient lacks access to running water, electricity, or money to buy food. Worse effects on mental health follow from this.

Pharmacological Treatment and Monitoring

Among the drugs approved by the FDA to treat bipolar illness are mood stabilizers and antipsychotics (Kato, 2019). As with any pharmaceutical treatment, one medicine should be introduced at a time, with additional medications given as needed. If the patient has an allergic reaction to one of the medications, use the smallest dose possible. It is also simple to determine which medications work best or have the most negative side effects. Risperidone 3 mg, Lamotrigine 200, or Lithium 0.8 mg once daily would be taken as monotherapy, depending on the client’s presentation. Risperidone is a medication that is recommended to manage manic and mixed episodes. Lithium and Lamotrigine are indicated for maintenance. In addition, the patient may choose to pursue psychotherapy, specifically family-focused counseling.

Several medications have side effects, including the prescription used to treat bipolar illness, which might be fatal. Risperidone’s most common side effects include sleepiness, increased appetite, weariness, coughing, urine incontinence, excessive saliva, diarrhea, dystonia, vomiting, dizziness, excessive thirst, tremor, rashes, and dyspepsia (Gitlin & Malhi, 2020). Diabetes patients should use risperidone with care since it might induce hyperglycemia. Regular blood glucose checks are necessary. Since leukopenia, agranulocytosis, and neutropenia, can be brought on by risperidone, frequent CBC testing should be carried out beginning one month after the first dose and continuing every six months. With using risperidone, you may experience seizures, orthopnea, and an increased likelihood of committing suicide.

Conclusion

A person with bipolar disorder may have major declines in quality of life. The most prevalent type of bipolar disorder is the type I because of how severe its manic episodes are. Bipolar II is less common than bipolar I and most individuals can handle it on their own because of the mild symptoms. Nonetheless, the FDA has approved several medications for the treatment of bipolar I illness, including anticonvulsants, lithium, and atypical antipsychotics. To alter the dose and reach the ideal therapeutic level, serum levels must be maintained because the majority of these drugs have severe side effects.

References

Calabrese, J. R., Durgam, S., Satlin, A., Vanover, K. E., Davis, R. E., Chen, R., Kozauer, S. G., Mates, S., & Sachs, G. S. (2021). Efficacy and Safety of Lumateperone for Major Depressive Episodes Associated With Bipolar I or Bipolar II Disorder: A Phase 3 Randomized Placebo-Controlled Trial. American Journal of Psychiatry, 178(12), 1098–1106. https://doi.org/10.1176/appi.ajp.2021.20091339

Gitlin, M., & Malhi, G. S. (2020). The existential crisis of bipolar II disorder. International Journal of Bipolar Disorders, 8(1). https://doi.org/10.1186/s40345-019-0175-7

Kato, T. (2019). Current understanding of bipolar disorder: Toward integration of biological basis and treatment strategies. Psychiatry and Clinical Neurosciences, 73(9), 526–540. https://doi.org/10.1111/pcn.12852

McIntyre, R. S., Berk, M., Brietzke, E., Goldstein, B. I., López-Jaramillo, C., Kessing, L. V., Malhi, G. S., Nierenberg, A. A., Rosenblat, J. D., Majeed, A., Vieta, E., Vinberg, M., Young, A. H., & Mansur, R. B. (2020). Bipolar disorders. The Lancet, 396(10265), 1841–1856. https://doi.org/10.1016/s0140-6736(20)31544-0

Miller, J. N., & Black, D. W. (2020). Bipolar Disorder and Suicide: a Review. Current Psychiatry Reports, 22(2). https://doi.org/10.1007/s11920-020-1130-0

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For this assignment, you will write a 3-page paper on the topic of bipolar and bipolar and related disorders. You will create this guide as an assignment; therefore, a title page, introduction, conclusion, and reference page are required. You must include a minimum of 3 scholarly supporting resources outside of your course provided resources.

In your paper, you will choose one of the following diagnoses: Bipolar I, Bipolar II, Cyclothymic Disorder, Substance/Medication-Induced Bipolar and Related Disorder, Bipolar and Related Disorder Due to Another Medical Condition. Your paper will include discussion for your chosen diagnosis of bipolar and related disorder on the following:

• Prevalence and Neurobiology of your chosen disorder
• Discuss the differences between your chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria
• Discuss special populations and considerations (children, adolescents, pregnancy/post-partum, older adult, emergency care) for your chosen bipolar and related disorder; demonstrating critical thinking beyond basics of HIPPA and informed consent with discussion of at least one for EACH category:  legal considerations, ethical considerations, cultural considerations, social determinants of health
• Discuss FDA and/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for your chosen bipolar and related disorder
• Of the medication treatment options for your chosen disorder discuss side effects, FDA approvals and warnings.  What is important to monitor in terms of labs, comorbid medical issues with why important for monitoring.