BD 2 Running Head: BD 2 Bipolar Disorder February 29, 2020 [Company name]

BD 2 Running Head: BD 2 bipolar disorder February 29, 2020 [Company name] [Company address] February 29, 2020 [Company name] [Company address] Introduction 2 Task 1 2 Bipolar disorder 2 Task 2 4 Potential impacts 4 Task 3 5 Principles support recovery 5 Task 4 6 Strategies 6 Task 5 7 Therapeutic interventions 7 Conclusion 9 References 11 Introduction Mental health comprises our emotional, mental, and societal well-being. One of the mental health issues is Bipolar disorder which is recognized as the mental health

Running Head: BD 0
bipolar disorder
FEBRUARY 29, 2020
[Company name]
[Company address]

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Table of Contents
Introduction...........................................................................................................................................2
Task 1....................................................................................................................................................2
Bipolar disorder.................................................................................................................................2
Task 2....................................................................................................................................................4
Potential impacts...............................................................................................................................4
Task 3....................................................................................................................................................5
Principles support recovery...............................................................................................................5
Task 4....................................................................................................................................................6
Strategies...........................................................................................................................................6
Task 5....................................................................................................................................................7
Therapeutic interventions..................................................................................................................7
Conclusion.............................................................................................................................................9
References...........................................................................................................................................11

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Introduction
Mental health comprises our emotional, mental, and societal well-being. It disturbs
how people think, sense, and act. It also benefits regulate how individuals manage stress,
relate to other individuals, and make decisions. Mental health is essential at every phase of
life, from infantile and teenage years through adulthood. One of the mental health issues
is Bipolar disorder which is recognized as the mental health issue that triggers dramatic shifts
in an individuals' mood, strength, the capability to think clearly. Individuals with this
condition experience high and low mood frequently, this condition is known as mania and
depression, which is different from the common ups and down the majority of individuals
develop. It has been identified that the average age of onset of this condition is 25, however,
it can also be caused in teenagers or more infrequently in children (Grunze, 2015). It has been
reported that in New Zealand, 1 in 6 adults had been detected with a usual mental health issue
(such as bipolar disorder, and anxiety disorder) at some time in their lifespan. It has been
reported that mental disorders like bipolar disorder are the 3rd leading cause of health loss in
New Zealand (around 11.1 per cent of overall health loss). If left untreated, this condition
commonly worsens. Patients with this health issue often may face trouble in managing daily
life activities or managing relationships. Although there is no cure for bipolar disorder, there
are several treatment options are available that can be used to manage different symptoms of
this health issue (Van Meter et al., 2011).
Task 1
Bipolar disorder
Aetiology
Bipolar disorder does not occur due to a single cause but is more probable to result
from a variety of factors. Bipolar disorder is commonly inherited, and the genetic factors

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account for around 80 per cent of the cause of these health issues. some of the environmental
factors include stressful life and seasonal factors. Some of the biological factors responsible
for the occurrence of this mental disorder include neurotransmitter imbalance, and hormonal
problems (Anderson et al., 2012).
Diagnostic criteria symptoms
Bipolar disorder is divided into 3 different conditions: bipolar 1, bipolar 2 and
cyclothymic disorder. Bipolar 1 disorder is recognized as the manic-depressive disorder that
can occur both with or without the psychotic episodes, bipolar 2 disorder includes episodes of
depression and mania which are commonly less serious. Cyclothymic disorder is the cyclic
type of disorder that triggers brief episodes of hypomania as well as depression (Phillips &
Kupfer, 2013). There are different diagnosis criteria symptoms that are included in DSM 5.
To be diagnosed with mania, the increased, and irritable moods must remain for seven days,
and to be diagnosed with hypomania, the mood must last a minimum of 4 days. During this
period the person must be present with at least have three symptoms. Some of them are
inflated self-esteem or grandiosity, reduced need for sleep, increased talkativeness, racing
thoughts, and easy distractions (Mitchell, 2012).
Treatment
The treatment of this health issue aims to reduce the occurrence of manic and
depressive issues. and to decrease the symptoms. Medication treatment available for BD
includes Lithium carbonate, anticonvulsants, antipsychotics like Aripiprazole, olanzapine,
and risperidone. Lithium carbonate is recommended as a long-term drug to treat chronic
episodes of depression and mania. Some of the patients are provided with antidepressants
before being diagnosed with BD, which can trigger manic episodes (Alda, 2015).

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Psychotherapy applied to treat BD aims to improve and help the patient to manage the
symptoms. The individual can learn to recognize the symptoms before the onset of an
episode. Cognitive-behavioral therapy is focused to prevent relapses. CBT with Interpersonal
and social rhythm therapy can also help the patient with depressive symptoms.
Electroconvulsive therapy is used if the other treatment options are not effective. Keeping the
patient on a regular routine with a favorable diet, sufficient sleep, and daily exercise, the
carers can help the affected person to maintain stability (Geddes & Miklowitz, 2013).
Task 2
Potential impacts
Bipolar disorder can impact individuals negatively across the lifespan. it can occur in
infants. When it begins in childhood or initial adolescents, it might be dissimilar, a probably
more serious form of the disorder than when diagnosed in late adolescents or adulthood.
Symptoms of this health condition in kids might be different from the symptoms in adults.
Mania in kids commonly appears as high irritability or rage. Kid and teenagers are more
probable to have destructive outbursts rather than to be excited or euphoric (Latalova et al.,
2011). Depression in the initial period of life might have symptoms such as tiredness, muscle
aches, headaches, absenteeism, isolation, and poor communication. It impacts of this health
mental health issue can be worsening in college students. the number of university students
detected with BD has alleviated mood changes. The onset of this disorder tends to increase
between the age of fifteen and 24.
Bipolar disorder among teenagers or college students commonly remain untreated,
and several students might attempt to avoid or hide their problems associated with BD
because of societal or academic pressure. Bipolar disorder is responsible for psychosocial
morbidity, as it often affects the patient's relationship with their loved ones or family. It also

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affects an individuals' ability to work effectively in the workplace. It has been reported that
people diagnosed with BD face more work and relationship issues compared to those found
negative in Mood Disorder questionnaires (MDQ) (Vieta et al., 2011). The patients diagnosed
with this condition also show a greater burden of comorbid medical disease than those who
are negatives for BD. In uncommon scenarios, bipolar disorder can start in older age,
however different individuals might have some symptoms of BD throughout adulthood and
remain undiagnosed until old age. For older individuals, it is essential to have an overall
medical examination and to express all the mental health issues, family history, and present
medications with health care providers. Many conditions affecting individuals in later life
include depression, dementia, stroke, and other psychological conditions. However, the
symptoms of BD in later life are not severe (Alda, 2015).
Task 3
Principles support recovery
Mental health recovery is intended to recover the individuals and improving their
health and wellness, live a self-directed life, and strive to attain their full potential. Living
well with BD is difficult, and individuals often face severe diminishing in functioning.
However, individuals can and do recover over time. One lately published investigation
demonstrates that self-management of BD symptoms plays a robust role in the personal
recovery. Empowering individuals to handle their mood and observe mood fluctuations as
normal might simplify recovery. the reduced negative opinions about the disease are
meaningfully correlated with better recovery results. Self-esteem and confidence are
important to attaining recovery (Grunze, 2015).
Tangata Whaiora are the individuals with the experience of mental health issues, who
are looking for wellness or retrieval of self. For Tangata whaiora, the recovery support

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workers provide an array of retrieval-focused help services in a range of community-based
settings. There are six different principles that support the recovery for Tangata Whaiora in
Aotearoa New Zealand: effective engagement, correct identification of ethnicity, utilizing key
individuals, specific issues impacting on ratings, interrelationships between different items to
improve outcome, and information analysis, interpretation and utility (O'Hagan et al., 2012).
Effective engagement of Tangata whaiora/motuhake and whanau in the recovery
process is the foundation for improving outcomes. Effective involvement, which concentrates
on understanding how the Tangata whaiora and whanau understand the process, and on using
skills which allow presenting activities and disorder symptoms to be discovered within the
broader cultural setting and environment of the Tangata whaiora and their whanau, is vital to
archive accurate outcome measurement. The right identification of the culture of Tangata
whaiora is essential when performing outcome measures. The recognition of culture is a
significant first step in identifying differences in cultures which may have an impact on
medical engagement, assessment, evaluation and recovery scheduling (Barber, 2012).
Though the clinician delivers the final evaluations for HoNOS, it is essential to
include additional individuals to update the ratings specified. Additional individuals can also
contribute to demonstrating the complex communications between cultural activities, societal
conditions, and community standards, principally in relation to recognizing culturally focused
behaviors, understanding behavior from the perspective of the Maori world and classifying
differing exhibition of symptomology (Roberts & Boardman, 2013). The definite problems
impacting rankings include influences of categorizing on the outcome valuation ratings,
culturally focused habits and demonstration of disease symptoms, Maori culture notions of
health. It is significant to differentiate the scale ratings from medical interpretation and scale
management. measurement of Outcome is more than just completing the assessments. There
is a significant change from rating achievement to a recovery schedule. This simplifies an

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understanding of the hands-on application of outcome interpretation ratings. It comprises a
focus on collaboration and on recognizing problems that should be discussed with Tangata
Whaiora and their families (Boulton et al., 2013).
Task 4
Strategies
There are different types of strategies can be used for individuals with bipolar
disorder. One of the main strategies used in New Zealand to support this population is the
Suicide prevention strategy 2019-2029. Individuals diagnosed with bipolar disorder are at
increased risk of suicides if remain untreated. Depression and mood changes are the most
common psychiatric conditions linked to an increased risk of suicide. Approximately 25 to 50
per cent of individuals diagnosed with BD also attempts to commit suicide one or more time
in a lifespan (Stubbing & Gibson, 2019). The suicide prevention strategy 2019-2029 outlines
the model or framework and planned direction for how health care providers can work with
patients collaboratively to achieve the goals already set for the affected population. Although
this strategy allows a whole-of-society method to suicide stoppage, it similarly reminds
government organizations they all have accountability to improve the surroundings where
individuals live, work with and play a key role to support their overall wellbeing. Every life
matter concentrates on establishing a solid platform to make efforts towards suicide
prevention. One of the actions taken by the New Zealand government is establishing a suicide
prevention office intended to lead, and confirm the implementation of every life matters
(Shahtahmasebi, 2019). There are some initiatives applied to support this strategy such as life
keepers, and FLO Talanoa. Lifekeepers are the national suicide prevention training initiative
of the New Zealand government. it was created by the Le Va particularly for communities of
New Zealand. The main aim of this initiative is to provide people the skills essential to
recognize and help those at high risk of suicide. Another initiative of the New Zealand

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government was FLO Talanoa which is the nationwide pacific suicide stoppage program for
different communities run by Le Va. This particular program specifically planned to
encounter the requirements of the families and societies in Aotearoa New Zealand. One of the
main objectives of this initiative is to empower and provide the communities with culturally
specific information and tool to stop suicides and react safely and efficiently to the suicide
cases (Pridmore, 2019).
Task 5
Therapeutic interventions
Nurse is recognized as the core professionals of the health care team generally
assigned for individuals with specific health issues as they interact with the client more
compare to other health care providers. Nurses play a key role in assessing, administrating
drugs, and providing psychological supports to that they can achieve recovery goals quickly.
Nurses act as a link between the patients, their families, and other health care providers
(Evans et al., 2016). Assessing the patient's health condition on a daily basis can help health
care providers to predict any health concerns. The nurse must also assess the risk of delusion
thinking and auditory hallucinations that can pose a threat to self and others. Prn medication
can be provided to the patient if the hallucination is highly distressing. They can develop a
therapeutic relationship with Tangata Whaiora and their family and help them to address
stressors that might worsen bipolar disorder and suicidal ideation (Chia et al., 2019).
Therapeutic communication is built between health care provider and patients in
order to achieve a common goal. To develop a therapeutic relationship, a nurse must have
effective communication skills. some of the components of this skill include active listening,
being emphatical, addressing the patient with respect, have knowledge of the patient's culture
and spiritual beliefs. Suicide rates among patients with bipolar disorder are twelve times

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higher compared to those without any mental health issue. thus, the relationship between the
patient and nurse can be crucial and can predict treatment outcome (Novick & Swartz, 2019).
It has been identified that a therapeutic relationship is associated with increased variance in
outcome compared to psychotherapy or drug therapy. A patient diagnosed with mania have
short attention spans, therefore nurses must use simple and clear sentences when interacting.
They should also break medical information in small parts so that it can be understood easily.
While establishing a therapeutic relationship with the client nurses must consider some
advice such as keeping the conservation short, confirm whether the patient understood what
is said, avoid dismissing the patient, avoid any argument or debate with the diseased person.
One of the primary responsibilities of a nurse to provide patient safety (Evans et al., 2016).
Nurses can also educate the patient and their families about the disorder and
management strategies that can be used by the patient and families. It has been reported that
patients with BD often need a great deal of data about the disorder. Without nursing
education, adherence to the recommendations is uncertain, but including this, the outcome
will probably be better and improved. Reducing the environmental stimulation might assist
the patient to feel relaxed, the nurse can provide a quiet atmosphere. They can also encourage
the patient to discuss what they are feeling and involve in community activities such as
arranging tables and chairs for the society meetings. Managing medication is another
essential intervention nurse can apply for patients (Tangata whaiora) with bipolar disorder.
The periodic lithium degree is used to manage the safety of the patient and to make sure that
the medicine does given has augmented the serum lithium levels to the management level or
decreased it to a manageable level.
There are some barriers might experience in providing nursing therapeutic
intervention to the patients with bipolar disorder. The stigma of psychological illness is one
of the leading barriers discouraging individuals who require treatment from receiving it. The

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price of care is amongst the most regularly cited blockades to mental well-being treatment.
About 60–70 per cent of patients in large, community- founded reviews say they are
concerned about price (Chia et al., 2019). One predominant barrier to discovery of suicidality
is the absence of specialised guidelines for both the assessment and management of the
patient with suicidal thoughts in the field of mental health recovery. Other barrier includes
reduced access to care, little help seeking behavior, low consumption, problems with doctor
detection of suicidal thoughts and problems with transfer or devotion to care (Stubbing &
Gibson, 2019).
Conclusion
Bipolar disorder is the mental health problem that stimulates the dramatic shifts in the
patient's mood, energy, thinking ability. It is recognized as the third leading cause of health
loss in New Zealand. Bipolar disorder is caused by a range of factors. It is commonly
inherited, and different environmental factors may take part in its occurrence. The diagnostic
criteria symptoms of this health issue include irritable mood, inflated self-esteem, decreased
needs of sleep, and racing thoughts. The treatment options available for BD include
medication (such as antipsychotics), CBT, and electroconvulsive therapy. Potential impacts
of this condition include chronic depression, suicidal thoughts, affects the ability to cope with
stressor, and relationship issues. some of the principles that support the recovery for Tangata
whaiora in Aotearoa New Zealand include effective engagement, right identification of
culture, using key individuals, and interrelationships. one of the strategies that can be used for
BD patients is suicide prevention strategy 2019-2029. Two different initiatives supporting
this strategy are lifekeeprs and FLO Talanoa. Therapeutic relationship is the one of the best
approaches to manage bipolar disorder symptoms. Nurses can use some effective
communication skills like empathy, respect, and active listening to build therapeutic
association. Nurses can assess encourage and educate the patient. They can also motivate

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them to take part inn community events or tasks, and help the patient with medication
management and avoid suicidal thoughts.

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Ali, B. (2019). What works? Individuals’ Experiences and Knowledge of Suicide Prevention
Interventions in Aotearoa/New Zealand (Doctoral dissertation, ResearchSpace@
Auckland). https://researchspace.auckland.ac.nz/handle/2292/46315
Anderson, I. M., Haddad, P. M., & Scott, J. (2012). Bipolar disorder. Bmj, 345, e8508.
https://doi.org/10.1136/bmj.e8508
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Boulton, A., Tamehana, J., & Brannelly, T. (2013). Whanau-centred health and social service
delivery in New Zealand. Mai Journal, 2(1), 18-32.
http://journal.mai.ac.nz/sites/default/files/Vol%202%20(1)%20024%20Boulton.pdf
Chia, M. F., Cotton, S., Filia, K., Phelan, M., Conus, P., Jauhar, S., ... & Ratheesh, A. (2019).
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Evans, K., Nizette, D., & O'Brien, A. (2016). Psychiatric & Mental Health Nursing. Elsevier
Health Sciences.

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Geddes, J. R., & Miklowitz, D. J. (2013). Treatment of bipolar disorder. The
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