Bipolar Disorder Research and Interventions

This assignment involves researching various studies related to bipolar affective disorder, including collaborative care, integrated risk reduction interventions, health belief models, and psychosocial functioning in depressive patients. The assignment also touches upon the impact of adverse childhood events on psychosis in bipolar affective disorder and the proteomic pathway analysis of the hippocampus in schizophrenia and bipolar affective disorder. Students are expected to review relevant papers and provide a summary or discussion based on their findings.

Running head: BIPOLAR AFFECTIVE DISORDER
BIPOLAR AFFECTIVE DISORDER
Name of the student:
Name of the university:
Author note:

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Introduction:
Mental disorders can be defined as the disorders that cause mild to severe disturbances in
behavior as well as thought process of individuals. This illness results the individuals to suffer
from inability to cope with different ordinary demands and routines of daily life and the different
situations that arise in life. Researchers had noted more than 200 different classified forms of
mental health illness (Hayes et al. 2015). These disorders tend to affect the quality of life of
individuals all over the nation. Therefore, it becomes important for such individuals to take
support form healthcare professionals and follow their interventions to come back to normal
lives. This assignment will depict one such disorder like bipolar affective depression and will
discuss its symptoms and risk factors. It will also show the different interventions that could be
used by the nursing professionals to help patients overcome the disorders and lead normal lives.
The disorder and its impact on the service users and family members:
Bipolar affective (maniac) disorder can be identified by prolonged, deep as well as
profound depressive periods. Such periods alternate with excessively elevated and irritable
moods that are termed as mania by researchers. Researchers have also stated that manic episodes
continue in affected individuals for at least one week of continuous mood disturbance. This
disorder is also characterized by expansiveness, elation as well as irritability (Upthegrove et al.
2015). Different symptoms are often noted in individuals like grandiosity ad clear evidence of
distractibility. Other symptoms mainly comprise of diminished need for sleep as well as
pressured speech and excessive talking. Flight of ideas as well as racing thoughts is also noticed
in such individuals. Such individuals are also seen to exhibit enhanced level of different types of
goal-focused activities at home as well as work. Loss of energy, fatigue, significant weight loss,
decreased concentration, preoccupation with death or suicide and others are symptoms shown by

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such individuals. The family members get depressed and anxious about the condition of their
patient who suffers from this disorder. Their caregiver feels a restricted life, as they have to care
for their patient and feels physically and emotionally strained. Therefore, more effective the
treatment of the patient, the family members can also have better quality lives.
Diagnosis:
Researchers are of the opinion that the most significant risk factor for the disorder is a
family history of either BPAD or depression. About two thirds of the patients with BPAD have
been found to have some forms of family history of mental illness. Researchers are still been
conducted to find or more information about how genetics as well as family history is
contributing to the occurrence of the disorder (Glanz 2014). Doctors who conduct diagnosis
mainly look for certain symptoms for confirmation. These are inappropriate spending, less need
for sleep, poor judgment, increase in goal directed activities and others (Scubert, Focking and
Cotter 2015). When patients come with depression, doctors diagnose them who look for loss of
pleasure, social withdrawal, low mood, decreased libido, weight loss and poor sleep. In order to
rule out chances of other disorders, healthcare professionals conduct differential diagnosis. They
conduct thyroid tests, tests for HIV or syphilis infection, calcium levels, electrocephalogram (to
rule out epilepsy), CT scan (to rule of brain injury) and many others. All these help the
healthcare professionals to diagnose and confirm the disorders (Mehta et al. 2014).
Health belief model:
The nursing professionals follow the health belief model to help the patients overcome
the symptoms of the disorders. With the help of this model, the professional can help patients to
be motivated to carry out preventive health behaviors in response to a perceived threat (Green

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and Murphy 2015). Two important aspects need to be kept in mind. One of them is the
psychological state of readiness to work upon specific actions (Adams 2007). The other one is
the extent to which particular course of action is believed to be significant in reducing the threat.
The demographic variable mainly comprise of perceived susceptibility, severity, benefits,
barriers and cues to action. When the patients with the help of the professionals will handle these
variables properly, these would lead to successful recovery of the patients (Lee et al. 2018). The
nursing professionals should first conduct the health need assessment of the patients with the
disorders. Then they should convey the consequences of the health issues associated with the
disorders. Then the nurses would help the patients to identify the barriers and assist them in
overcoming the barriers (Skinner et al. 2015). The nurse should then demonstrate the skill
development activities providing support to the patient. This would help the patient to enhance
self-efficacy and likelihood of the stressful behaviors.
First intervention: patient education:
The patient and the family members should be educated along with a strong therapeutic
alliance, educational effort increase patient compliance as well as knowledge of the diseases
thereby increasing the quality of their lives. When the patients are explained about the biology
of the disease, it decreases feelings of guilt among the patients and helps in promoting
medication compliance. Also proper information should be provided which would promote
medication compliance. The patients should be also taught on how to monitor the illness in ways
of appreciation of the early warning signs, reemergence and symptoms. Researchers are of the
opinion that identifications of changes can thereby serve as various powerful preventive steps
(Bauer et al. 2015). Education will also help in encompassing the dangers of stressors. When the
patient is helped with identification and working with stressors, it would help the patient and

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family members to large extent. Patients should also be educated about relapses with total
context of the disorders. Therefore, proper patient education would be one of the interventions of
nursing professionals that will follow tee alt belief model (Golightly 2006). The patient could be
advised to take admissions in hospitals if risks of harms are high. Within this period, effective
patient education can be given and patients’ compliance with the treatment can also be monitored
(Hoyle, Eliott and Comer 2015)
Second intervention: Lithium use:
Another effective intervention that the nursing professionals should also apply is the
lithium treatment. It helps in reducing the severity as well as frequency of mania. Researchers
are of the opinion that lithium is successful in reducing the risks of suicides. This medication is
seen to act on the central nervous stem of patients. Researchers are not completely aware of how
lithium helps in stabilizing a person mood but it helps in strengthening the nerve cell connections
in the different region of the brain that are involved in regulating mood, behavior as well as
thinking of patients (Reveley 2006). One important thing that the nurse should keep in mind is
that she should have periodic checks of lithium levels in blood as lithium as the capability of
affecting kidney and thyroid function. Lithium should be maintained at a cost level in the blood
for its best activity (Frank et al. 2015). The patient should take steady amount of fluid as
irregular amount of lithium can affect the individual’s physiological systems. Risperidone can
also be used in this condition.
Conclusion:
From the above discussion, it becomes clear that bipolar affective disorder is one form of
mental health condition that can affect the quality of lives of the people. Therefore, healthcare

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professionals should diagnose the disorder by proper observations and differential diagnosis.
Once confirmed, they can follow the health belief model to cure the patient. Effective patient
education and lithium treatment helps the patients to overcome symptoms. Risperidone can also
be used

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References:
Adams, R. (ed.) (2007) Foundations of Health and Social Care, Basingstoke: Palgrave
Macmillan.
Bauer, M.S., McBride, L., Williford, W.O., Glick, H., Kinosian, B., Altshuler, L., Beresford, T.,
Kilbourne, A.M., Sajatovic, M., Coauthors for the Cooperative Studies Program 430 Study Team
and Brown, G., 2015. Collaborative care for bipolar disorder: Part II. Impact on clinical outcome,
function, and costs. Focus, 13(1), pp.85-93.
Frank, E., Wallace, M.L., Hall, M., Hasler, B., Levenson, J.C., Janney, C.A., Soreca, I., Fleming,
M.C., Buttenfield, J., Ritchey, F.C. and Kupfer, D.J., 2015. An Integrated Risk Reduction
Intervention can reduce body mass index in individuals being treated for bipolar I disorder:
results from a randomized trial. Bipolar disorders, 17(4), pp.424-437.
Glanz, K., 2015. Health behavior: Theory, research, and practice. John Wiley & Sons.
Golightley, M. (2006) Social work and Mental Health, Exeter: Learning Matters Ltd.
Green, E.C. and Murphy, E., 2014. Health belief model. The Wiley Blackwell encyclopedia of
health, illness, behavior, and society
Hayes, J.F., Miles, J., Walters, K., King, M. and Osborn, D.P.J., 2015. A systematic review and
meta‐analysis of premature mortality in bipolar affective disorder. Acta Psychiatrica
Scandinavica, 131(6), pp.417-425.
Hoyle, S., Elliott, L. and Comer, L., 2015. Available screening tools for adults suffering from
bipolar affective disorder in primary care: An integrative literature review. Journal of the
American Association of Nurse Practitioners, 27(5), pp.280-289.

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Lee, H.J., Lin, E.C.L., Chen, M.B., Su, T.P. and Chiang, L.C., 2018. Randomized, controlled
trial of a brief family‐centred care programme for hospitalized patients with bipolar disorder and
their family caregivers. International journal of mental health nursing, 27(1), pp.61-71.
Mehta, S., Mittal, P.K. and Swami, M.K., 2014. Psychosocial functioning in depressive patients:
a comparative study between major depressive disorder and bipolar affective
disorder. Depression research and treatment, 2014.
Newton, J. (2007) Mental Health and Mental Illness. In Adams, R. (ed.) (2007) Foundations of
Health and Social Care, Basingstoke: Palgrave Macmillan.
Reveley, Dr. A. (2006) Your Guide to Schizophrenia, Oxon: Hodder Arnold.
Schubert, K.O., Föcking, M. and Cotter, D.R., 2015. Proteomic pathway analysis of the
hippocampus in schizophrenia and bipolar affective disorder implicates 14-3-3 signaling, aryl
hydrocarbon receptor signaling, and glucose metabolism: potential roles in GABAergic
interneuron pathology. Schizophrenia research, 167(1), pp.64-72.
Skinner, C. S., Tiro, J., & Champion, V. L. (2015). The health belief model. Health behavior:
theory, research, and practice. 5th ed. San Francisco (US): Jossey-Bass, 75-94.
Upthegrove, R., Chard, C., Jones, L., Gordon-Smith, K., Forty, L., Jones, I. and Craddock, N.,
2015. Adverse childhood events and psychosis in bipolar affective disorder. The British Journal
of Psychiatry, 206(3), pp.191-197.