Diagnosis Bipolar Disorder: “Bipolar disorder is a severe biologic illness characterized by recurrent fluctuations in mood. Typically, patients experience alternating episodes in which mood is abnormally elevated or abnormally depressed-separated by periods in which mood is relatively normal.” (Lehne, 2004, p. 321)

The following is a short synopsis according to the DSM-IV-TR, “Criteria for Bipolar Disorder” includes a distinct period of abnormality and persistently elevated, expansive, or irritable mood for at least: – 4 days for hypomania – week for mania

During the period of mood disturbance, at least three or more of the following symptoms have persisted and have been present to a significant degree: – Inflated self-esteem or grandiosity – Decreased need for sleep – More talkative than usual or pressure to keep talking – Excessive involvement in pleasurable activities that have a high potential for painful consequences.” (American Psychiatric Association [APA], 2000).

Psychodynamics of the Disease The onset of the disease usually occurs during late adolescence or in the mid twenties. However, the disease has been known to occur up into the fifth decade of life. The mood swings that accompany this disorder are of several types. They are as follows: the Pure Manic Episode, evidenced by hyperactivity, excessive enthusiasm, and flight of ideas, constant wakefulness without sleep,

Impairment in normal social functioning usually requiring hospitalization; Hypomanic Episode, evidenced by a milder form of the Pure Mania, without the loss of normal functioning that would require hospitalization; Major Depressive Episode, characterized by depressed mood consisting of symptoms such as anhedonia, avolition, alogia, affective flattening and thoughts of suicide and death; the last episode associated with Bipolar disorders is the Mixed Episode in which, “patients experience symptoms of mania and depression simultaneously. The combination of high energy and depression puts them at significant risk of suicide.” (Lehne, 2004, p. 321)

Case Presentation A Caucasian woman in her mid twenties presented signs and symptoms of self mutilation with a straight edge razor inflicted gash across her lower abdomen approximately six inches below the umbilicus. The depth of the gash just stopped at the abdominal fascia. The patient was sent from the emergency room to the psychiatric floor. Upon meeting the patient one day after her admission to E.R., she appeared dressed in pajama bottoms and a t-shirt, shuffling down the hall in her socks. She was holding her abdomen with one hand and appeared in some discomfort. Her black hair was short and disheveled. When the patient arrived at her room she sat down on her bed. She acknowledged with blunted affect that she cannot stop self mutilation, and described how she cut herself through the muscles in her abdomen almost down to the fascia. Her voice was tremulous and fast paced. This could be due to the fact that she had just been given her first dose of Clozaril. She stated that her mouth was dry and that she needed to drink some water. She then went on to say that she was getting very sleepy. The client felt comfortable with the interview.

She shared personal information in regards to being sexually abused by her bother beginning at the age of seven until the age of fifteen. Her brother was two years older than her and died in an automobile accident at the age of eighteen. She went on to say that her mother never knew or acknowledged the sexual abuse and that she could not tell her because the mother idolized the son. The client was receptive to cognitive reframing; however she was very critical of herself and stated that she felt worthless and ashamed. She appeared very tired and stated that she wanted to sleep.

Table 1 Textbook characteristics of Bipolar disorder versus client characteristics observed

Textbook Characteristics: Pure Manic Episode Hypomanic Episode Major Depressive Episode- Affective Flattening Alogia Avolition-apathy Anhedonia Mixed Episode Rapid-Cycling Bipolar Disorder- Patients experience four or Client

Characteristics Observed: No current symptoms Rapid breathing, rapid speech, however due to medication a client was concurrently exhibiting lethargy Client acknowledged sadness/ worthlessness Facial expression flat Thoughts of dying, hard to focus Hair/clothes unkempt Expressed no interest in children or own

Client’s Symptoms 1. Hypomania 2. Depression a.) Affective Flattening b.) Alogia c.) Avolition & Apathy d.) Anhedonia 3. Mixed Episode 4. Rapid Cycling (Varcarolis, 2004, p. 485)

Nursing Interventions

1. Observe the client every 15 minutes while suicidal, remove all dangerous, sharp objects from room.

2. Reinforce that she is worth while, a.) Assist the client in evaluating the positive as well as the negative aspects of her life b.) Encourage the appropriate expression of angry feelings. c.) Schedule regular periods of time throughout the day for recreational/occupational therapy, encourage client to groom self, offer praise for completing grooming. d.) Ensure client’s participation in taking mood stabilizing medications. Watch client swallow medication. 3. Engage client in interpersonal therapies, cognitive-behavioral therapy, 4. Encourage client to attend group therapy, and journal episodes.

Table 2 Medical Interventions, Bipolar Disorder Drug therapy using Mood stabilizer Antidepressants Antipsychotics Education and Psychotherapy ECT (Varcarolis, 2002, p. 483)

Clients Medical Interventions Drug therapy includes Lithium 300mg every h.s. Not taking any Clozaril Client is receiving psychotherapy, family counseling, group therapy while in hospital, and cognitive restructuring. None

References
Lehne, R. (2004). Pharmacology for Nursing Care. Missouri: Saunders
Varcarolis, E. (2002). Foundations of Psychiatric Mental Health Nursing: A Clinical Approach. Pennsylvania: Saunders

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Although many illnesses are relatively easy to diagnose and treat, disorders that affect the brain are often complicated and difficult to identify. Illnesses like bipolar disorder often have symptoms that vary greatly or are very similar to other problems that plague the brain.

If a medical professional fails to correctly diagnose an illness or disorder, the patient may suffer serious consequences like further injury or even death. It is the responsibility of doctors and physicians to correctly identify and treat bipolar disorder before the patient suffers even more. If you have suffered injury due to misdiagnosis by your doctor, you may be eligible for financial compensation for your pain and suffering.

Bipolar disorder is especially hard to diagnose because many of the symptoms that are commonly associated with the illness are also commonly seen in other brain disorders and problems. Individuals who suffer from manic-depressive illness often report symptoms including:

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There is still no medical cure for bipolar disorder; therefore, people with the disorder have been forced to look elsewhere for a cure. The Internet has gladly stepped forward as a ready source for miracle (natural) cures for bipolar disorder. I’m not saying that some of these cures do or do not help; all I’m saying is to remember the saying, “If something sounds too good to be true, it probably is.”

Some advertisements offering these miracle (natural) cures may actually have harmful information, and this is what I caution you against the most. Be aware of advertisements about herbs, vitamins, natural remedies and other alternative methods (especially if they use the word CURE) as treatment for bipolar disorder, and be forewarned if they encourage you to use these alternative treatments in place of your prescribed medication.

Always check with your doctor before using anything other than your prescribed medication. Using these other treatments in addition to your prescribed medication may be all right, if your doctor gives you the go-ahead; however, you must be aware of advertisements that encourage you to take any of these other alternative methods instead of your regular medication.

I hate those commercials that say, “You need to take this,” or “You need to do that…” They make me feel like if I don’t do it, I’m being left out of something, or something bad is going to happen to me. Then I shake my head out of the advertising propaganda and remember it’s just that – they want me to feel that way. It’s just an advertising ploy to get me to buy something I don’t really need or want. I encourage you not to fall for this ploy.

I’m also realistic. I remember that what works for SOME, doesn’t necessarily work for ALL! That’s why I’m so careful about what I put into my body, and what I recommend to other people. I support a mother with bipolar disorder, and if there really were a miracle cure for bipolar disorder being sold on the Internet, I would have already bought it and given it to her!

There is another saying that goes, “If it isn’t broke, don’t fix it.” If your bipolar medication is working for you and you are stable (without symptoms or episodes), why are you looking for a miracle cure, anyway? This is very dangerous, as some companies will try to take advantage of you, and many on the Internet are running scams when it comes to miracle cures for bipolar disorder.

Especially be careful of advertisements that promote personal testimonials more than they promote actual facts, or hide the ingredients of their product. Think about this fact: There is no, and I repeat, NO natural product, supplement, aid, or CURE for bipolar disorder on the market today that has been approved by the Food and Drug Administration (FDA)!

Joshua D. McDavid, M.D., M.P.H., Acting Director of Psychiatry in the Department of Psychiatry at the University of Washington in Seattle, says, “Thus it is not surprising that some individuals will seek unconventional treatments that emphasize macrobiotic, “holistic” or natural remedies. While keeping an open mind about new developments is a good general principal, we wish to emphasize strongly that the only scientifically proven treatments for bipolar disorder are pharmacologic and we similarly strongly discourage the use of such “natural” remedies, without the collaboration of a competent, board certified psychiatrist.”

If you’re looking for a miracle cure for bipolar disorder, you won’t find one, as none exists, any more than a medical cure. However, if you choose to take nutritional supplements to your regular diet, you MUST get permission from your doctor to make sure they will not interfere with the bipolar medication you are already taking.

In addition, you must understand that any supplements must be taken in addition to your current prescribed medication, and NEVER instead of your medication. This is a very important point, as there are some unscrupulous companies that advertise bipolar “cures” or “natural remedies” on the Internet that might lead you astray.

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Bipolar disorder is provoked by the invasion of the wild side of the human conscience into the conscious realm. This invasion happens many times in all human beings; however each psychological type reacts according to their specific characteristics.

Besides the internal reasons, the conditions of the person’s life, their age and other factors also play an important role in the appearance and the development of the illness.

What usually happens in cases of bipolar disorder is that the person is invaded by the wild content of the anti-conscience when they are too young and unprotected. They have many other problems in their environment, and without knowing how to solve their psychological problems and at the same time the various problems of their daily lives, they accept to do absurd things, which are suggested by the anti-conscience.

The anti-conscience’s suggestions appear like solutions to their problems.

Since they are in despair and they don’t know how to react and deal with the reality they are facing, they accept doing what the anti-conscience suggests, without criticizing their actions.

They acquire a second personality that sometimes appears in the conscious surface, and other times lives submersed in the unknown region of the psyche, far from the conscious field.

This abnormality can be cured if the person follows daily psychotherapy through dream translation, which will help them understand what is happening to them and correct their behavior.

They will recuperate the control of their behavior gradually, until they become strong and self-confident, without a double personality.

However, if the bipolar disorder is not properly treated and the person continues following the absurd suggestions of the anti-conscience, they can end up in psychosis.

Psychosis is the immediate next stage bipolar patients reach, when their illness becomes worse.

Psychosis cannot be cured because the patients completely lose the human side of their conscience, accepting to do barbarous things against their enemies, on revenge to what was done against them.

Psychotic patients are not able to discern the difference which exists in the various levels of the human conscience, precisely because they lose it completely when they become victims of the anti-conscience’s traps and therefore, victims of the other people that live near them.

Only the truth can bring back their lost consciousness. There are many patients that can recuperate their lost human side through regular dream interpretation with the scientific method.

Everything depends on their cooperation, if it exists. When they cooperate with their doctor and follow the unconscious guidance in their dreams, their psychotherapy is possible, even though it is delayed.

They absolutely need more than three years to start feeling better and really understand what happened to them, while neurotic and depressed patients are cured in only 6 to 8 months of treatment.

Psychosis is a very serious mental illness and we should not let it appear and grow in the human psyche. We must prevent it with caution before it is too late.

Bipolar disorder must be treated in its initial stages, so that the affected patients may escape from falling in the anti-conscience’s traps, which may imprison them in the labyrinth of craziness.

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Bipolar disorder goes by many names: manic depression, manic-depressive disorder, manic-depressive illness, bipolar mood disorder, and bipolar affective disorder are medical terms for the same condition.

Bipolar disorder affects both men and women. For many people, the first symptoms show up in their early twenties. However, research has shown that the first episode of bipolar disorder is occurring earlier: It often shows up in adolescence, and even children can have the disorder.

Recent research suggests that kids and teens with bipolar disorder don’t always have the same behavioural patterns that adults with bipolar disorder do. For example, kids who have bipolar disorder may experience particularly rapid mood changes and may have some of the other mood-related symptoms listed below, such as irritability and high levels of anxiety. But they may not show other symptoms that are more commonly seen in adults.

Because brain function is involved, the ways people with bipolar disorder think, act, and feel are all affected. This can make it especially difficult for other people to understand their condition. It can be incredibly frustrating if other people act as though someone with bipolar disorder should just “snap out of it,” as if a person who is sick can become well simply by wanting to. Bipolar disorder isn’t a sign of weakness or a character flaw; it’s a serious medical condition that requires treatment, just like any other condition.

A person with bipolar disorder experiences alternating highs and lows. Both the manic and depressive periods can be brief, from just a few hours to a few days, or longer, lasting up to several weeks or even months. The periods of mania and depression range from person to person many people may only experience very brief periods of these intense moods, and may not even be aware that they have bipolar disorder.

A manic episode is characterized by extreme happiness, hyperactivity, little need for sleep and racing thoughts, which may lead to rapid speech. A depressive episode is characterized by extreme sadness, a lack of energy or interest in things, an inability to enjoy normally pleasurable activities and feelings of helplessness and hopelessness. On average, someone with bipolar disorder may have up to three years of normal mood between episodes of mania or depression.

Bipolar disorder is recurrent, meaning that more than 90% of the individuals who have a single manic episode will go on to experience future episodes. Roughly 70% of manic episodes in bipolar disorder occur immediately before or after a depressive episode. Treatment seeks to reduce the feelings of mania and depression associated with the disorder, and restore balance to the person’s mood.

With treatment, the outlook for bipolar disorder is favourable. Most people respond to a medication and or combination of medications. Approximately 50 percent of people will respond to lithium alone. An additional 20 to 30 percent will respond to another medication or combination of medications. Ten to 20 percent will have chronic (unresolved) mood symptoms despite treatment. Approximately 10 percent of bipolar patients will be very difficult to treat and have frequent episodes with little response to treatment. On average, a person is free of symptoms for about five years between the first and second episodes. As time goes on, the interval between episodes may shorten, especially in cases in which treatment is discontinued too soon. It is estimated that a person with bipolar disorder will have an average of eight to nine mood episodes during his or her lifetime.

However, one thing to be kept in mind is that there should be support from family and friends so that the affected person may feel more optimistic and secure.

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Need for Long term care management of bipolar disorder:

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When you give a bipolar disorder person unconditional love, it can be a tough task. It is never simple for them to express the love they have so they will shun you away.

It not easy for those shunned to loan a hand to those who may think highly of themselves. Yet, it is never uncomplicated to care for and appreciate someone who has been diagnosed with this illness, someone who has muddled thoughts and manners. What people need to do is get an in-depth understanding of the illness. Learn what is happening to the one you love or you won’t understand what it is they are going through.

After going through the understanding and getting associations with the illness, it should be time to work out a plan that should help you work out any problems.

First, recognize the symptoms of the disease.

This is not your fault. How your loved one became inflicted with the illness to the way he or she acts is never your fault. He or she will not have control over their actions. This may be especially hard when it comes to parents to understand particularly when young children are diagnosed.

1. Learn to distinguish the indicators of the disorder. Does the person have sleeping problems?

2. Monitor his disposition, his actions and responses to people. Write it down so you know when and where it occurred.

3. Do not be mortified by the disease especially when the symptoms of it are showing.

4. Do not assume the disorder as a humiliation on your part. When you love someone, it means you love them despite the illness. You see past it. It’s not an illness that can be cured and then reappears. It is omnipresent and treating it like so is better for the loved one. Remember the disease can be extravagance, just not cured.

5. If you feel ashamed because of the infliction, then you are not helping him restore good health and letting him be worse than he is. Build the trust up! Trust is a big part of getting used to the disorder. They want you to conviction them and not send them to others for them to trust or be entrusted too.

6. Sometimes it seems you won’t be able to love your loved one and it would be tempting to call the doctor or the police because you no longer want to care for them. Never say the words where they can hear them. It does more harm than good and it is bound to aggravate the situation even more.

7. Have communication lines open and honest. Always keep it open and have an ear pulled out for them when they want to talk. Once you acknowledge the symptoms, ask yourself what you can do to help Despite what good ways may seem like helping may not actually be. This is where communication is good.

8. Do not suppress how you feel. There are positive ways to tell the person how you feel without making them feel bad. Avoid niggling, preaching or lectures since negative actions can cause them to detach from you. Encourage him in a positive manner and making him realize that there is a rainbow at the end of the darkness. Basically, be gently and reassuring.

9. Do not serve your loved one because it can suppress what he or she can do. Let him think of solutions to the problems he sees himself. Let him live his own way. He will feel better about himself if he does.

10. Above all else… give him or her your love, understanding and support.

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The brain is the most vital part of the human body, as without it we wouldn’t be able to function properly. It is the control centre for the whole of the body, controlling everything so that all the organs are functioning correctly, so you can use your motor skills and for all decision making. Any damage to the brain, depending on which part, will affect an area in the body.

For good health everyone should know the importance of keeping fit mentally as well as physically. If you are unwell mentally it can affect you physically, and vice versa.

There is much more known about the facts which affect all kinds of brain disorders, which can in turn affect your daily life and how you live. Some illnesses can affect your motor skills, whilst some brain disorders can have an effect on your skill to make decisions. Some brain disorders occur as a result of an accident, some by disease in later life and others are acquired at birth.

Bipolar II is known as one of the brain disorders which can affect your moods, and you can also get periods of depression for no particular reason. With Bipolar II, a person is also known to have one hypomanic episode at least. In Bipolar Disorder a person has depressive and manic episodes. With Bipolar II and individual will expressive at least one or more episode of depressive and also had at least one hypomanic episode.

Those who suffer from Bipolar II will suffer a hypomanic episode where the mood is constantly either feeling quite elated, tetchy or the mind is wide open. This episode can last for up to or over 4 days. The behaviour can be seen to be very different from how a person normally is when they are not feeling depressed. Symptoms for Bipolar II Disorder hypomanic episodes are found to be quite similar to those experienced by someone with Bipolar Disorder, but they are not as severe.

In Bipolar II, once a person reaches a big episode of depression, they will start to feel useless. They will have a negative outlook on life with feelings of helplessness. There are some cases which severe enough to make a person think about death or even suicide, and some go further to attempt suicide.

When a person has this illness they get hypomanic episodes, where they can still get on with everyday things like work, studying, their social activities with no psychosis. When a person has depressive and hypomanic episodes of four or more in number in one year, they are considered to be have a bipolar disorder that is rapid cycling. This period of cycling is likely to develop at some during their illness. A person who recognises that are having these kind of symptoms should seek help for treatment, as the longer they leave it, the more likely they will suffer frequent episodes of the illness.

Bipolar II is another version of Bipolar Disorder, where the episodes of depression are more apparent than the mania episodes. This illness is not classified as Manic Depression, but as one where a person has greater mood and energy swings than normal. There are forms which are so severe, that a person is prone to think of committing suicide.

Bipolar II is an illness that should be taken seriously and should never be left untreated. Anyone who experiences any signs and symptoms or if you notice it any other person, should see a doctor as soon as possible before the illness takes hold. The treatments that are available today do help to minimise the effects that a person suffers from, to stabilise their mood so that they feel normal again. Help and support from family and friend do much to help a person to feel better and recover fully.

As in Bipolar Disorder, this illness is long term which needs constant care and management long term. A person needs to learn patience to help themselves get control of their life again, so that the negative effects are minimised.

With Bipolar II you should learn all about the illness as a sufferer so that you can lead a normal lifestyle and not be a victim to it. You are helping yourself by getting treated early.

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Bipolar disorder, according to some experts, tends to prefer those people who are melancholic in nature than other types of people. There are however those experts who did not think the condition can be synonymous with just about anyone. As long as you are the deep thinking type, you could suffer from bipolar disorder, and it could be a difficult one to keep up with. So, your best bet is to go for diagnoses to ascertain if your condition is actually bipolar or something else.

You don’t get a lot of kids that suffer from bipolar type of disorder; usually it begins in you as you reach your late teens or when you clock twenty. Funny enough, a man would likely get too happy first before getting real sad, whereas that lady would be sad first, and then get manic later. But the syndrome is not for kids. At least, this is a fact to a high extent.

In a few instances, very few instances, people suffering from bipolar type of disorder could switch moods within minutes. However in most cases, individual episodes could last several weeks or months. When the ailment is left alone and untreated, the sufferer could be suffering from the syndrome for the whole of ten years or more with only an episode per time.

It is common to have bipolar disorder sufferers endure just four episodes of mania or depression in ten years, without any strangeness in between. However, there are some worse case scenarios in which you could do four episodes within a single year. That one is called -”rapid-cycling” bipolar kind of disorder. And yes, when it comes to strangeness, there are no guarantees in between your episodes.

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In order to become successful in life, it is quite essential to be healthy and wise. While any sort of physical restrictions of the body can be fought with and dealt with, the central processing unit of our body that is our brain needs to be absolutely perfect in order to live a happy & successful life. For all our errands what we primarily need is a sharp brain so as to understand our environment and act promptly & make well evaluated decisions.

Along with a perfectly working brain, what we need is a control over our emotions. Being over excited or unduly angry all the time would not help us in any way. Quoting in the right terminology all our psychological factors must be balanced enough.

And what if you discover that you yourself have or some of you known to has a brain disorder? One such common brain disorder is bipolar disorder. This disease not only effects our emotions and decisions on daily errands, in extreme cases it can lead to suicides as well.

Here are some facts that you must know about this brain disorder:

1. Those suffering with the bipolar disorder often compare their life to the roller coaster ride. Their life is full of immense highs & extreme lows. 2. While as such there is no perfect cure known for this disorder, there are several ways to control the growth and the mood swings that occur. These methods have helped a lot of patients to live healthy and prolonged life. 3. In case you are constantly not able to do the things well enough; in case you feel that your mind is going dull & that you feel virtually hopeless and useless; in case you no longer relish humor; if you have become uncontrollable, irritable, frightened & angry – then you are suffering with the bipolar disorder. 4. Other key symptoms of bipolar disorder are excessive shyness, intense interest in seduction/sensuality, strong sense of ease, power, euphoria & omnipotence. 5. While many people think that these are just temporary symptoms, it is always advisable to go for medical attention. 6. Before it gets too late, the attention towards such ailment must come as fast as possible, to avoid all unwanted & disastrous results.

In case you find such symptoms in yourself or some of your family members, instead of getting despaired and feeling hopeless, you must start working on the therapeutic resources. Some of these resources are as follows:

1. Bipolar Advantage – a book that helps you get through with Bipolar Disorder

Written by Tom Wootton, this book explains all the essential and advanced aspects of the bipolar disorder. While ailment cannot be seen as an advantage, with a two years research Tom Wootton in this book explains a true positive approach towards this condition.

Some of the key features of this book are as follows:

i. Bipolar Advantage primarily helps you accepting the situation and further guides you through the struggle to become a better individual.

ii. This book talks about Introspection – that is how to change your habits to accentuate the positive aspects, and working towards minimizing the negative ones.

iii. The book explains a step by step plan to do so. First you must create & accomplish a vision that is what you want exactly. Next, you formulate a plan so as to achieve your goals.

iv. Tom Wootton was once misdiagnosed as a patient of bipolar disorder. That way he had a first hand experience of both sides of the disorder – good as well as bad. Henceforth, he has learnt and developed several methods to cope with the situations arising due to this disorder. He now also conducts seminars for the benefit of the patients suffering with bipolar disorder.

v. This book consists of Tom Wootton’s personal experiences and several case studies to better explain the therapies and another related aspects of the disorder, almost in the real life situations.

2. Surf through the Bipolar Websites

The World Wide Web or the internet is nowadays the richest source of information that you must bank on. A popular website known as Bipolar Advantage deals all the aspects of bipolar disorder that is all goods & bad. The website is a good source that would provide you all sorts of information needed regarding the ailment. The website also focuses strongly on the situations, symptoms and treatments of the disorder.

Besides, this you can go on your choicest search engine and look for further information regarding the disorder. As the experts advise, it is all the worth spending your time and energy in this sort of a patient research.

3. In Audio

With the help of a computer and internet connection at home, the patients suffering with bipolar disorder can make use the modern technology that is, the radio (that operates rather effectively with a flash player loaded in your computer). Through internet, you can log on to this therapeutic radio at your convenience.

Abhishek has got some great Bipolar Disorder Treatment Secrets up his sleeve! Download his FREE 97 Pages Ebook, “Understanding And Treating Bipolar Disorders!” from his website http://www.Health-Whiz.com/69/index.htm. Only limited Free Copies available.

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