Perfect health is desirable, but those who can claim to be perfectly healthy are scanty. Conditions such as the bipolar disorder ensure that the balance that is necessary for perfect health remains elusive. It is a condition that characterized by alternating patterns of depressed and elated moods, which make it difficult for an individual to function conventionally. Its exact cause remains mysterious, but ongoing research shows that it is influenced by genetics, the environment, and the composition of some brain chemicals. Its diagnosis is a complex process. It requires a comprehensive psychiatric assessment to make it easier and more accurate. The disorder is managed through medication, therapy and patient education because it is a lifetime condition.
Every human being desires perfect health. However, in reality, perfectly healthy individuals are hard to come by. The balance that brings about perfect health is always under attack by various disorders and conditions. A person can be in perfect physical health, but still be affected by mood disorders and other mental conditions. Consequently, this discourse explores the link between depression and the bipolar disorder, insofar as their etiology, assessment, diagnosis and treatment are concerned. It seeks to diffuse any confusion associated with these disorders.
According to O’Brien, Kennedy and Ballard (2008), a mood disorder is a psychiatric condition in which the affected individual experiences erratic mood patterns. Those who experience mood disorders go through alternating patterns of depressed and elated emotional states depending on the type of disorder being experienced. A state of extreme sadness coupled with feelings of worthlessness indicates depression while the occurrence of alternating episodes of depression and elation or a mixture of the two is a condition known as the bipolar disorder. It is characterized by surges of energy and activity, known as manic episodes, as well as feelings of low self-worth and sadness known as depressive episodes. It is also referred to as manic-depression. It should be noted that victims of the disorder also go through periods of normal moods during which they are perfectly fine.
Spearing (n.d.) notes that the exact cause of the bipolar disorder has been difficult to identify. However, there is a consensus among researchers that the condition does not result from a single cause. Studies have established that it tends to be common in some lineages than others, leading to a conclusion that heredity is one of its causative factors. Tentatively, there is an element of the human DNA that increases the possibilities of its occurrence. However, whether or not a person suffers from bipolar disorder is not entirely dependent on genes. Some other factors combine with genes to bring about this disorder.
Gene related research also indicates that no single gene attribute causes the disorder. Rather, a collection of different gene attributes combine with other factors to cause the condition (Spearing, n.d.). Consequently, it has been extremely difficult for researchers to pinpoint the particular aspects of the human DNA that are responsible for its development.
Besides genetics, it has been established that the occurrence of the bipolar disorder is linked to certain brain chemicals. In particular, abnormal chemistry in serotonin is suspected to be one of the brain-related factors that contribute to its occurrence (Black Dog Institute, 2012). Serotonin is a neurotransmitter that is closely associated with moods and as such, any abnormality in its chemistry is likely to result in erratic mood patterns.
Finally, another factor that researchers have associated with the disorder is the environment. It has been established that there are certain environmental conditions that trigger the disorder. The Black Dog Institute (2012) observes that in spring, the prevalence rates of the disorder are higher than any other time of the year. Conditions such as the rapid increase in hours of bright sunshine, which occur during spring, are thought to be responsible for the increase in cases of the bipolar disorder. Thus, although the precise cause of the disorder remains unknown, the conditions that facilitate its incidence are known. Additionally, studies that seek to identify its exact causes are ongoing, and it is believed that with the advent of new technology, the answers will be found in due course.
The assessment of the bipolar disorder in a clinical setting is a complex process. It is a psychiatric engagement that can best be carried out by a team of mixed mental health professionals. This combined effort is necessitated by the nature of mood disorders. Their close resemblance with one another calls for a comprehensive psychiatric assessment, which can only be effectively conducted by a diverse team of mental health professionals (Tugrul, 2003). This assessment entails looking at the social, psychological, intellectual, and spiritual aspects of the affected individual. Assessment tools include biopsychosocial history, mental status examination, psychological tests and physical assessment (Tugrul, 2003). The assessment is critical because it helps the nurse to develop an initial concept of a patient’s condition and establish a relationship with the patient. These two processes are invaluable in the clinical setting because they lay the foundation for an accurate diagnosis, which in turn leads to desirable treatment outcomes.
The diagnostic procedure for the bipolar disorder is outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). It follows the typical pattern of mental disorder diagnosis. It requires a free conversation between the patient and the physician to enable the latter to identify the key symptoms that distinguish the bipolar disorder from other closely related conditions. In addition, family members and friends should provide more information about the patient’s symptoms. Finally, an objective self-assessment by the patient should also be incorporated during diagnosis.
This process can be guided by a mood questionnaire or other checklists, which help a physician to assess the patient’s mental status. Blood and urine tests may be conducted to help in eliminating ambiguities. As noted earlier, the bipolar disorder is characterized by major depressive episodes and manic episodes or mixed episodes. Consequently, during its diagnosis, a physician looks for the symptoms of the two. According to Spearing (n.d.), a person can only be diagnosed with the bipolar disorder if they have gone through at least one major depressive episode and a manic episode. The chances of misdiagnosis are reduced by combining the physician’s assessment, self-assessment, information from family and friends and other tests.
The treatment regimen for the bipolar disorder incorporates psychotherapy and education alongside medication (Kahn et al., 2000). None of the three can act as a standalone solution. There are two stages of treatment for the disorder (Kahn et al., 2000). The first stage is also called the acute phase and it concerns itself with curbing the ongoing episode, which could be manic, depressive or mixed. The second stage of treatment is also known as the preventive or maintenance phase. It focuses on the prevention of future episodes. The most common type of medication used to treat the disorder includes mood stabilizers, antidepressants and antipsychotics (Kahn et al., 2000).
Patient education is critical in the treatment of the bipolar disorder. Kahn et al. (2000) argue that education is an important initial step towards the treatment of mental disorders because it helps patients to understand diagnostic information and the conditions that are necessary for their recovery. Phelps (2012) adds that the education of patients is a responsibility that clinicians cannot shun, especially when dealing with chronic illnesses. Victims of the bipolar disorder should be encouraged to make healthy lifestyle choices and strictly adhere to the outlined treatment plan. They also need to understand that the successful management of the disorder does not occur overnight. Finally, they need to know that the medication used to manage the disorder has notable side effects, which may be undesirable, but are inevitable.
Discharge and Goal
The overall goal of the treatment and dissemination of knowledge about the bipolar disorder is to bring it to manageable levels to avoid its devastating effects. Therefore, the kind of treatment given to victims of the disorder is only aimed at reducing its effects since it is a chronic condition and if left untreated, it can be fatal (Miller, Johnson & Eisner, 2009). Once the condition is brought under control, there is a need for a proper discharge plan. If a patient is discharged too early with no proper follow-up, manic or depressive relapses can easily occur (Phelps, 2012). Thus, a strong support system is necessary before and after discharge to avoid such pitfalls.
Although perfect health is desirable, it is hard to come by due to conditions such as the bipolar disorder. Its exact cause remains unknown, but it is dangerous because once it occurs it becomes a lifetime condition. Treatment only brings it to a manageable level. It is therefore a severe illness that needs to be handled with caution when it occurs.
Black Dog Institute. (2012). Causes of Bipolar Disorder. Web.
Kahn, D. A., Ross, R., Printz, D. J., & Sachs, G. S. (2000). Treatment of bipolar disorder: A guide for patients and families. Postgraduate Medicine, 107, 1-8.
Miller, C. J., Johnson, S. L., & Eisner, L. (2009). Assessment tools for adult bipolar disorder. Clinical Psychology: Science and Practice, 16(2), 188-201.
O’Brien, P. G., Kennedy, W. Z., & Ballard, K. A. (2008). Psychiatric mental health nursing: an introduction to theory and practice. Sudbury, MA: Jones and Bartlett Publishers.
Phelps, J. (2012). Educating patients about bipolar disorders. Web.
Spearing, M. (n.d.). Bipolar Disorder. Bethesda, MD: National Institute of Mental Health (NIMH).
Tugrul, K. (2003). The nurse’s role in the assessment and treatment of bipolar disorder. Journal of the American Psychiatric Nurses Association, 9(6), 180-186.