Bipolar Disorder

Bipolar Disorder

Bipolar Disorder 150 150 Peter

Bipolar Disorder

Share a personal experience that you have had with a mental disorder use bipolar disorder (family member). Give the epidemiology, pathophysiology, and clinical presentation. As a provider, what would your physical exam, diagnostics, and management involve?

Sample Paper

Bipolar Disorder

Bipolar disorder is a major mental health issue in modern society. I encountered the condition when my cousin developed it in her late thirties, five years ago. She still experiences bipolar episodes once in a while, but mainly due to failure to comply with management strategies. Thus, her condition piqued my interest, leading me to explore more about the disease.

Epidemiology

Epidemiological studies show that the disease appears in about 1% of the population across their lifespan (Roland & Marwaha, 2018), though the figures may vary among different communities and nations. There are three major categories: bipolar I, bipolar II, and cyclothymia. One is considered to have bipolar I disorder if their manic episodes last for at least seven days or are intense enough to require hospitalization (National Institute of Mental Health, 2020). The mania occurs alongside depressive episodes, lasting for a minimum of two weeks. The two episodes may also occur simultaneously. Meanwhile, bipolar II is characterized by milder manic and depressive episodes, while cyclothymia occurs when one has hypomanic syndrome for at least two years (or one year in teenagers and children). Bipolar I is more prevalent than bipolar II (Roland & Marwaha, 2018), hence the need for acute clinical care. There is little difference in the condition’s development in adult men and women. However, teenage females (3.3%) reported significantly higher rates of bipolar disorder prevalence than males (2.6%) (National Institute of Mental Health, 2020). Furthermore, the condition causes impairment in 83% of all people with a positive diagnosis.

Pathophysiology

The disease’s pathophysiology remains unclear, though various studies suggest a strong genetic factor. Immediate relatives of an individual with the condition are seven times more likely to develop the disease than other people. Bipolar I appears to have the strongest hereditary link, with a heritability of 0.73 (Soreff, 2022). Some genetic factors, such as MAFD1 and MAFD5, are common among bipolar patients, though the statistics do not show a strong correlation.

Clinical Presentation

Patients can have symptoms for either a depressive or manic/hypomanic episode. The mania manifests through being aggressively sociable, increased sexual drive, absenteeism from school or work, getting little sleep without tiring, being jumpy in conversation, and having impaired judgment (Begum, 2021). Meanwhile, a depressive episode presents through extreme sadness and thoughts of gloom and hopelessness, anxiety, misplaced guilt, unexplained changes in eating habits and weight, and losing interest in one’s hobbies and other pleasurable activities. Patients with concurrent manic and depressive syndromes will manifest contrasting symptoms.

Physical Examination and Diagnosis

People with undiagnosed bipolar disorder hardly present their critical symptoms when visiting a care facility. Hence, the clinician must detect the syndrome and conduct an appropriate physical test. For instance, the Young Mania Rating Scale is an excellent choice among caregivers. It allows them to assess the severity of manic syndrome. It is also brief and easy to administer, hence its widespread popularity. It consists of eleven items: irritability, speech, disruptive behavior, thought content, increased activity, sexual interest, sleep, language-thought disorder, appearance, insight, and elevated mood (WebMD, 2022). The clinician evaluates the scores bases on the Diagnostic and Statistical manual to ensure the symptoms reach the manic and depressive thresholds. Furthermore, the clinician must determine a level of functional impairment due to the syndrome. Hence, the test scores indicate the condition’s severity in the patients.

Management

The condition requires behavioral and pharmacological interventions (Mayo Clinic, 2021). One must ensure that the depressive and manic episodes do not present a real threat to patients and their families. They can engage various psychological therapies to enhance the patient’s outlook of themselves and others, lowering the risk of suicide, homicide, and other harmful aggressive behavior. Medications, such as mood stabilizers, antidepressants, antipsychotics, and anti-anxiety drugs, may help manage the condition.

References

Begum, J. (2021, Oct. 07). Bipolar Disorder. https://www.webmd.com/bipolar-disorder/mental-health-bipolar-disorder

Mayo Clinic. (2021, Feb. 16). Bipolar disorder. https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/diagnosis-treatment/drc-20355961

National Institute of Mental Health. (2020, Jan.). Bipolar Disorder. https://www.nimh.nih.gov/health/topics/bipolar-disorder

Rowland, T. A., & Marwaha, S. (2018). Epidemiology and risk factors for bipolar disorder. Therapeutic advances in psychopharmacology, 8(9), 251–269. https://doi.org/10.1177/2045125318769235

Soreff, S. (2022, Feb. 11). Bipolar Disorder. https://emedicine.medscape.com/article/286342-overview

WebMD. (2022). Young Mania Rating Scale (YMRS). https://reference.medscape.com/calculator/473/young-mania-rating-scale-ymrs