Bipolar Disorder: Causes, Symptoms & Treatment

This assignment delves into the multifaceted nature of bipolar disorder, examining its underlying causes, diverse range of symptoms, and various treatment approaches. It draws upon a collection of scholarly articles to illuminate the complexities of this mental health condition, encompassing aspects such as genetic predispositions, diagnostic challenges, and evidence-based therapies. The aim is to provide a comprehensive understanding of bipolar disorder, empowering readers with valuable knowledge about this prevalent yet often misunderstood illness.

Running head: AN OVERVIEW ON BIPOLAR DISORDER
An overview on bipolar disorder
Name of the Student
Name of the University
Author Note

1AN OVERVIEW ON BIPOLAR DISORDER
Introduction
Bipolar disorder which is also known as manic-depressive illness is a type of brain
disorder representing change in mood, levels of activity, energy and the ability perform daily
activities (Robillard, R., Naismith, L., Hickie, & B., 2013). There are four main types of bipolar
disorder such as Bipolar l disorder, Bipolar II disorder, Cyclothymic disorder and other specific,
non specific and related disorders (Whiteford, et al., 2013). This disorder can develop in
individuals of any age starting from early teen lasting for lifetime. Doctors are still unaware
about the actual cause of this disorder but there are several factors that contribute to this illness.
The factors can be genetic, neurological or any kind of environmental stress (Zucker, et al.,
2012). This disorder should be diagnosed properly as the symptoms can be mistreated with other
problems and with improper medication and side effects can worsen the condition further. Thus
proper diagnose with exact medication and therapeutic measures can provide better life to the
patients with bipolar disorder. In this assignment we will analyze the case of Susan, a 56 year-
old lady who is suffering from bipolar disorder. She lacked concentration and sleep. Her bipolar
episodes comprised with mixed mood expressions with unrealistic thoughts. Due to irregular
intake of prescribed medicines her condition had worsen and had been hospitalized twice. Apart
from Susan her brother was also reported with bipolar disorder and committed suicide 10 years
ago. So in order to combat this complex disorder, Susan must be diagnosed and treated with
proper management strategies. Therefore, we will discuss the underlying biopsychosocial cause
for the recurrence of bipolar disorder in Susan’s case and implementing proper nursing
intervention in order to provide her effective recovery with healthy lifestyle. And finally we will
also discuss about the ethical considerations that should be considered in her case.
Analysis: Discussion of biopsychosocial factors

2AN OVERVIEW ON BIPOLAR DISORDER
Evidential studies have showed that there in not a single cause for bipolar disorder. Many
biopsychosocial risk factors are responsible (Zucker, et al., 2012). The possible risk factors are
genetic, environmental and neurological factors. This kind of disorder is genetically inherited
through families. If one parent is suffering from bipolar disorder, there is a chance of ten to
fifteen percent that children will be affected by this disorder too. If both parents suffer from this
disorder chances tends to rise by thirty to forty percent in their children. In identical twins, if one
twin is affected by bipolar disorder, then there is forty to seventy percent risk of being diagnosed
with this same disorder in the second one (Veltman, A., Brunner, & G., 2012). Genetic factors
such as deformities in certain parts of brain are also responsible for causing this disorder.
Environmental factors linked with inheritance including stressful life events such as suicide in a
family, disrupted sleep cycle and a hostile environment can cause this disorder (Wasserman, et
al., The European Psychiatric Association (EPA) guidance on suicide treatment and prevention,
2012). Neurological factors such as any chemical disturbance in neurotransmitters with several
environmental factors can cause this disorder. Misuses of drugs do not cause this disorder but
tend to worsen the situation (Vega, et al., 2011). Apart from these factors, several identified
genes found to be associated with this mental illness (Gershon, S., Alliey-Rodriguez, N., Liu, &
C., 2011). The probable cause of Susan’s suffering can be genetic factors as the same disorder
was reported in her brother who committed suicide 10 years ago. So there was a chance of
heredity that got inherited through previous generation. Environmental factors can also be related
to Susan’s case (Leboyer, et al., 2012). As she had a stressful life with a family history of her
brother conducting suicide can also impact on her behavioral change. Past history of smoking
and non adherence to prescribed medicine had made her situation worse. Both the symptoms of
bipolar disorder that are mania and depression were found in Susan’s behavior (Leibenluft & E.,

3AN OVERVIEW ON BIPOLAR DISORDER
2011). During the episode of mania, Susan developed a feeling of “high” with an increased
attitude with outgoing mood. She stopped her medication which was prescribed to her in her
previous admission to hospital. The behavioral changes noticed in Susan were making frequent
calls to her friends in the middle of the night and making animated conversations about planning
a trip. She was even found risking her reputation by engaging in pleasant talks with male
neighbors. Depression is another symptom that was also prevalent in her followed by sometimes
high and sometimes whilst in the middle of a “high” feeling (Kernberg, F., Yeomans, & E.,
2013). In depression episode she slept for few hours. Other behavioral changes in Susan included
loss of concentration loss and problem in decision making that made her lose job. These episodes
occur at a regular interval lasting minimum for 2 years, in children for 1 year and in adults for 1
year. Rapid cycling is caused in people with bipolar II disorder and people are found to be 35
times more depressed than hypomania (Geddes, R., Miklowitz, & J., 2013). And the people with
bipolar disorder undergo more time with an average episodes of 0.4-0.7 per year (Hanford, C.,
Sassi, B., Hall, & B., 2016). In mixed episodes, patients suffer mania or hypomania and
depression and individuals might try to commit suicide to get rid of such symptoms.
Analysis: Discussion of nursing management or interventions
Susan represented mixed episodes of bipolar disorder showing symptoms of mania and
depression. During mania she felt at top of the world with unrealistic and irrational plans. She
even started smoking in order to cope up the symptoms of bipolar disorder which she had quitted
previously. She even lacked sleep with increased mood. During her maniac cycle she tends to

4AN OVERVIEW ON BIPOLAR DISORDER
talk to more friends and got engaged with irrational talks with male neighbors. She even shopped
a lot in her maniac periods. Due to previous history of depression led to her inability to
concentrate at work and finally resulted her to leave the job. During her mixed episodes caused a
threat to her life as the patients in this stage can even commit suicide suffering from mixed
emotions (Souza, et al., 2015). Susan was admitted to hospital with recurrent occurrence of this
disorder to stabilize her mood and maintain it. Most of the time bipolar disorder is not diagnosed
properly with sometimes being diagnosed as having major depression (Severus, E., Bauer, & M.,
2013) .There are many reasons for it. One main reason is depression is much common and the
other reason is that depression is diagnosed through same means as depression in case of bipolar
disorder. Patients are sometimes embarrassed to tell about their manic symptoms. They are much
comfortable in telling about their depression part of the disease (Mynatt, S., Cunningham, & P.,
2007). Thus, the nursing staff should encourage her to represent both her negative and positive
thoughts (Barney, J., Griffiths, M., Banfield, & A., 2011). As wrong diagnosis of the bipolar
disorder can worsen her situation, thus the management level should be well defined with well-
trained staffs by setting up a system to regularly conduct follow-ups with proper monitoring in
order to diagnose the exact cause of Susan’s disorder (Branford, D., Bhaumik, & S., 2015).
Improper diagnosis leads to inaccurate prescribing of medicines and thus worsens the symptoms
to a large extent (Goodwin, et al., 2016). Thus the medicines prescribed to Susan should be
monitored to report any side effects. Susan was prescribed with 250 mg Lithium in the morning
and 500mg at night. She was also prescribed 100mg Sertraline in the morning. Susan usually
tolerated the medication with no reported side effects but she reported a history of non adherence
to medications. Thus the management should encourage her to take medications regularly. If any
symptoms of feeling suicidal and mania are observed in Susan, she should be referred to proper

5AN OVERVIEW ON BIPOLAR DISORDER
supporting services conducted with pharmacologic expertise. She should be given proper respect
and counselors should listen to her attentively. The bipolar disorder in Susan should be
diagnosed with accurate screening in order to understand the stage of disorder by obtaining
social and family history of her. She should be made aware by educating her and her family
members regarding the disorder and the required treatments corresponded with adherence
treatments. Whenever necessary, monitoring of Susan with psychiatric collaboration should be
initiated in the early stage of symptoms. While treating Susan other clinical co morbidities such
as cardiovascular problems, diabetes, and metabolic abnormalities should be checked and treated
aggressively (Velligan, et al., 2012). Apart from forming a managed health care system the
Susan should also be included in the treatment by counseling and supporting her to self-monitor
by trying to improve her problems. She could be connected with certain supportive groups to
carry out the treatment in a more progressive and effective way (Brohan, et al., 2011). Helping
her to improve her lifestyle can contribute towards her recovery by having a good sleep, good
diet, exercise, meditation and body exercise. All these nursing interventions can enable Susan to
live a healthy life (Suto, et al., 2010).
Analysis: Discussion of ethical Implications
The nursing management plays a crucial role in dealing with the mentally disordered
patients, especially in managing them (Kaufman, et al., 2012). These nurses are more frequent to
encounter ethical conflicts which arise during the time of helping and treating the patients with
proper respect to their autonomy. In this case, the nurses taking care of Susan should always
monitor to see if the patient is doing well clinically. Her autonomy should be respected and

6AN OVERVIEW ON BIPOLAR DISORDER
should be provided with fair choices. Bipolar disorder is a complicated mental disorder that
usually brings out psychological problems with it. Therefore the consequences of this disorder
followed by certain physical condition restrict the patient from making the right decision about
their underlying health (Gross, C., Schübel, T., Hoffmann, & R., 2015). Ultimately, the nurse
faces extreme difficulties in treating the patients showing complicated mental issues as it gets
impossible to encourage and convince them to undergo the medical interventions.
In this case, Susan was going through a mood disorder. She sometimes felt high with
unrealistic thoughts and fully energized and sometimes she went to depression with deprived
sleep for continues stretch of time. This situation can be alarming to the nurses dealing with her
as this fluctuating behavior can affect them. Considering on ethical point of view, the nurses
should not be allowed to deal with these kinds of patients in their vulnerable situation. The
nurses should be very much sensible towards the patient who reported histories of violence,
psychotic in nature, delirious or demented, intoxicated or unstable. In Susan’s case, though she
did not show any history of violence and got engaged with the nurses in an overfriendly manner
but can be vulnerable in near future (Cleary, et al., 2012). Susan was found to show non-
adherence to medicine which worsen her situation more with recurrent occurrence of this
disorder followed by several admissions in the hospital. Thus she should be encouraged to
continue her medication with proper rest and for this various techniques should be implemented
to connect more effectively with the patients under the healthcare. She should be made aware
and encouraged about the training session for the well being of her mental and physical condition
and enable her to work cooperatively with the nurses to settle the treatment choices. Other
alternatives that exist to increase the adherence provide psychosocial abilities to be prepared and

7AN OVERVIEW ON BIPOLAR DISORDER
get focused on preparing the adherence. Proper counseling by professionals can also help her to
recover and lead a better life (Kane, M., Kishimoto, T., Correll, & U., 2013).
Conclusion
Thus from the following case it was found that Susan suffering from bipolar disorder was
assumed to be due to genetic factors as her brother was detected with the same disorder. Susan,
who had been scheduled twice to a public hospital under the Mental Health Act, was not
adhering to the required medicines. In Susan’s case, non-adherence to medication resulted in
repeated cycles of the disease. So, to recover, she needed proper counseling sessions with regular
therapies, proper medicine with family support followed by a healthy diet. Clinicians play an
important role in curing and treating these patients by subscribing proper medicines. Incorrect
medicines leads to side effects and smoking during medication worsen the disorder. Thus, Susan
should be encouraged to undergo counseling and adhere to her medications on time. She should
also be encouraged to quit smoking as this can affect during medication period. Apart from
clinicians, her family should also understand the disease and support in her recovery. Thus it can
be concluded that the management of this disorder revolves several challenges to the healthcare
providers. For treating her disorder many therapeutic measures are available to maintain it
accurately. It is the duty of the healthcare provider to properly diagnose and make her aware
about the efficacy and safety standards about the treatment interventions thereby making her
avail the best approach.

8AN OVERVIEW ON BIPOLAR DISORDER
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