Bipolar Disorder

Course Project Part II'Practice: Bipolar Disorder
Bipolar disorder is a very complex mental disorder. The boundaries for this disorder can be unclear, which causes confusion when making a diagnosis. The manic episodes include symptoms of depressed mood, irritable mood, guilt, and suicidal thoughts. Depressive phase some symptoms are daily sad mood, fatigue, or lack of energy, feeling of worthlessness or thoughts of death or suicide (Butcher, 2009).
Dr. Stern has a Ph.D. in psychology, employed with an agency, which provides intensive treatment residential programs, that serves adults with severe and persistent mental illness. The programs provide services that help the client manage the symptoms of illness and develop daily livings skills and learn to use natural community supports services. The center offers several programs for adolescent, adults, pregnant women who are diagnosis with mental illness and substance use disorder.
Demographics
The agency provides service to approximately 300 adult men and women. Bipolar disorder affects an estimated 150 of the 300 consumers. The majority of women suffer from bipolar than the men who attend the center. The center has a therapeutic, structured, residential treat program for adolescents, from 13 to 17 years old with substance abuse issues and or co-occurring mental health disorders. The agency provides substance abuse/addictive disease treatment programs. A service offered at the recovery center includes aftercare, case management, childcare, family, group, and individual therapy. HIV education and prevention, medical nurse services, multi-family education, parenting classes, psychiatric referrals, substance abuse evaluation and trauma recovery (Stern, 2014).

The National Institute of Mental Health website are the following statistics: bipolar disorder affects about 5.7 million adult Americans, median age 25, spans all ages, races ethnic groups and social classes. It can be inherited, sixth leading cause of disability, 1 in 5 individuals commit suicide, 1 million children and teens have this disorder and manic children and teens in contrast to adults are more likely to be irritable than euphoric.
Diagnosis
Bipolar disorder is very difficult to diagnose; it is frequently confused with unipolar depression or with schizophrenia. There is no blood test to diagnose this disorder, so the most important diagnostic tool is communication with individual consumers. The diagnose of bipolar disorder hinges on having periods of elevation or irritability that is coupled with an increase of energy, sleeplessness, fast thinking, or speech.
Treatment
Treatment with lithium has a 50% success rate. However, a patient- patient support group improves the 50% to 86%. The diagnosis of bipolar is so complex that it might take ten years to come up with an accurate diagnosis. Unfortunately, there can be a gender bias where women is most likely misdiagnosed with depression; men with schizophrenia; as well as side effects can result in non-compliance with medication regimens (DBSA, 1999).
Differential diagnoses
According to Dr. Stern: Anxiety Disorders; Hyperthyroidism; Hypothyroidism; Multiple Sclerosis; Neuro-ophthalmic Perspective Migraine Headache; Neurosyphilis; and Pediatric Attention Deficit Hyperactivity Disorder are differential diagnoses for bipolar disorder. This obviously depicts how difficult it is to, not only differentiate between psychiatric conditions, but also many medical conditions must be 'weeded out' by a very competent psychiatrist to eventually not only diagnose bipolar disorder, but the correct bipolar disorder.
Cross-cultural
Unfortunately, there can be cross-cultural issues. African and Hispanic Americans are at a greater risk for misdiagnosis with schizophrenia. The Chinese require lower dosages of antidepressants and antipsychotics that metabolized by liver enzymes. Pregnancy are perceived differently in different culture. Females may prefer female physicians; ethnically speaking, African Americans may prefer African American physicians. Be it as it may, treatment of consumers as individuals with proper communication will avoid most cross-cultural issues.
According to Dr. Stern (2014): a psychiatrist should provide treatment or and therapist with experience in treating bipolar disorders. Treatments are based upon the particular bipolar disorder diagnosis and its severity. Many with the hyper mania/hypomania/depressive characteristics enter treatment through psychosocial intervention group and family psychotherapy. Bipolar disorders are difficult to treat, most believe they do not have problems, (denial) and need to make any changes. Psychological techniques are utilized to learn about their condition, change ways of thinking, learn healthy ways to manage thoughts, feeling, and behaviors that interfere with functioning and relationships.

Conclusions
Based on the findings, this author firmly concludes that Bipolar Disorder is a complex mental disorder that requires great competence of the psychiatrist in order to 'sift' through the many differential diagnoses, finally diagnose the appropriate bipolar disorder.


References
Bipolar Diagnosis, WebMD.com Web Site. Retrieved from, http://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-diagnosis
Bipolar Disorder Statistics. (1999). DBSA.org Web Site. Retrieved from, http://www.dbsalliance.org/site/PageServer?pagename=education_statistics_bipolar_disorder
Butcher; Mineka; Hooley, James N.; Susan M.; Jill M. Abnormal Psychology. 14th Edition. Pearson Learning Solutions, 2009. VitalBook file. Argosy University.
Hirschfeld, M., et al. (2012). Practice Guideline for the Treatment of Patients with Bipolar Disorder Second Edition. Retrieved from, http://psychiatryonline.org/content.aspx?bookid=28&sectionid=1669577
What is bipolar? National Institute of Mental Health website. Retrieved from http://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

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