Bipolar disorder diagnosis and treatment

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Abstract

Bipolar disorder is a key community health problem, with diagnosis frequently happening years after the disorder’s inception. Controlling it calls for a lifetime regimen of therapy and medication. The affected families are heavily affected psychologically and socially. Control of mania is well-recognized. Research related to the management of cycling, mixed and depressive episodes, as well as amalgamation therapy had been dynamic in the recent past secondary to the escalating incidences. The condition is an arduous psychiatric syndrome to manage, even for psychiatrists, due to its numerous occurrences and comorbid syndromes resistant to the treatment.

Introduction

Bipolar disorder is also referred to as manic-depressive illness. It is a brain syndrome condition that causes strange changes in brain activity levels, mood, the capacity to perform daily chores and energy. The known types of bipolar consist of marked variations in activity levels, mood, and energy. The moods range from phases of extreme elation and animated behavior to very miserable stages commonly called depressive episodes. Bipolar I Disorder is characterized with hysterical incidents lasting for more than seven days or agitated symptoms that are so serious that the individual requires instant hospital care.  Depressive phases also occur that normally last for two weeks.  Bipolar II Disorder is characterized by a sequence of hypomanic and depressive stages that never develop into full-scale manic episodes such as those of Bipolar I disorder.

Bipolar Disorder Diagnosis Using DSM-5 Criteria

In DSM-5, bipolar and associated disorders are classified between schizophrenia spectrum disorder and depressive disorder, that consists of bipolar I disorder which according to DSM-5 represents definitive depressive syndrome, with the exclusion that neither a psychosis nor a depressive episode must exist and bipolar II disorder. DSM-5 would appear to arise from the notion that bipolar disorder has been under-recognized (Regier et al., 2013).  Nonetheless, the requisite sign (gate A criteria) which must exist to satisfy the standards for a manic or hypomanic occurrence have been quantified in return. Although previously just a distinctive period of persistently and abnormally high, irritable or expansive disposition was needed, these signs must now exist in amalgamation with insistently elevated energy or activity almost every day and most of the day. Whereas several people do not consent with this stage, for logical reasons, it is a prudent approach especially when dealing with bipolar II disorder diagnosis.

Bipolar II disorder happens to be the solitary psychiatric syndrome classically manifested by the lack of the vital elements such as hypomanic periods during diagnosis. Therefore, the analysis is usually consigned to young patients exhibiting their initial big depressive episodes. The diagnosis in these cases is founded on psychiatric account taken as opposed to present psychopathological psychiatrist evaluation. Concisely, any reflective recollection is disposed to recall preconception, especially during a depressive period (Leibenluft, 2011). Moreover, with a hypomanic occurrence, there exists a state which can be described as severe enough to affect deficiency in occupational or social functioning. Consequently, discovering if, at the certain point previously, there has been a mood change, related with a clear adjustment in functioning that is unusual of the person when not showing the symptoms might considerably be contingent to the evidence delivered by others, such as partners, close friends or relative. Regrettably, the evidence delivered by these people is seldom collected in controlled readings comprising subjects associated with the establishment of a bipolar II disorder diagnosis.

Compare and Contrast Bipolar Disorder and Dysthymic Disorder

The key variance between depression and bipolar disorder are the mania signs typified by extreme irritability and excitement, illusions of splendor and extreme elation that are related to the bipolar ailment. In fact, till very recently, bipolar disorder was frequently baptized manic depression, a word that highlights both illness poles depression and mania. Whereas mood fluctuations between depressed and manic states are key characteristics of bipolar disorder, depression is unipolar, implying that there are no up in the ailment.  In its place, depression is categorized by a passionate, protracted “down” condition that impedes an individual’s daily life and the capacity and craving to engage in regular activities and relationships.

Evaluate of Peer-Reviewed Research Studies Using the Research Analysis

“Quality of life in bipolar disorder” by Erin E Michalak, Lakshmi N Yatham and Raymond W Lam addresses the review of studies that target the evaluation of health related and generic bipolar patient’s quality of life (QoL). The paper “A Review of ambivalence in Bipolar Disorder Research” uses participants pooled from those who had not been part of any mental health systems. Instead, they used activist and friend’s network and therefore coming up with study devoid of bias (Liebert, 2013). “The quality of life constructs in bipolar disorder research and practice: the past, present and possible future” by Murray and Michalak (2012) used cross sectional and case study methodology for empirical reflection. The authors posit that the Quality of Life in Bipolar disorder measure was generated to evaluate one’s satisfaction and enjoyment in life.

Intervention and Treatment of Bipolar Disorder

Numerous procedures of psychosocial mediation for intervention have been found effective in the management of bipolar disorder such as social and interpersonal therapy, family-focused therapy, group or individual psychoeducation and cognitive-behavioral therapy. Coupled with pharmacotherapy, these intermediations can lengthen the time to reversion, increase medication devotion and minimize symptoms severity (Geddes, & Miklowitz, 2013). Family-focused therapy strives for the reduction the extraordinary stress and conflict levels in the kinfolks of bipolar patients, thus enhancing the patient’s disorder progress. Social and interpersonal rhythm therapy concentrates on steadying the nightly and daily habits of bipolar patients and solving critical interpersonal complications. Cognitive-behavioral therapy helps patients in adjusting dysfunctional behaviors and cognitions that might worsen the progress of bipolar disorder. Group psycho-education offers a helpful, collaborative environment in which the sick are educated on their illness and how to handle it.

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  1. Geddes, J. R., & Miklowitz, D. J. (2013). Treatment of bipolar disorder. The Lancet, 381(9878), 1672-1682.
  2. Leibenluft, E. (2011). Severe mood dysregulation, irritability, and the diagnostic boundaries of bipolar disorder in youths. American Journal of Psychiatry. https://doi.org/10.1176/appi.ajp.2010.10050766
  3. Liebert, R. J. (2013). A review of Ambivalence in Bipolar Disorder Research. Ethical Human Psychology and Psychiatry, 15(3), 180-194.
  4. Murray, G., & Michalak, E. E. (2012). The quality of life construct in bipolar disorder research and practice: past, present, and possible futures. Bipolar Disorders, 14(8), 793-796.
  5. Regier, D. A., Kuhl, E. A., & Kupfer, D. J. (2013). The DSM‐5: Classification and criteria changes. World Psychiatry, 12(2), 92-98.
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