Bipolar is a disorder that affects the mood of a person. It was formerly referred to as a manic depression. Bipolar disorder can further be attributed to resulting to emotional highs and depression. Depression in a person results in the feeling of sadness, and one even loses interest or even pleasure in performing various activities. Bipolar disorder also results in a shift in energy, behavior, and thinking of an individual. The bipolar disorder cycles may last for a week, months or even a year. It is not like the frequent mood swings since, in bipolar disorder, the mood changes are usually so powerful such that it affects one’s ability to function.
In bipolar disorder, an individual may either be under mania or depressive. If one is under depressive, they exhibit signs of diminished activities, being easily fatigued, declined energy, hypersomnia or insomnia and loss of interest in to activities. There is also the aspect of withdrawing socially. On the other hand, one under mania is usually unrealistic, ill-tempered and positive and has impressive beliefs about their capabilities or power. Additionally, they also have racing thoughts, less sleep but have extreme energy, ruined judgment and being thoughtless. They also act in an irresponsible manner without considering the result of their actions. In a severe case, there may be the appearance of hallucinations and even delusions (National Health Service, 2016).
Ann is eighteen years old and has started to exhibit strange moods that have depicted the possibility of bipolar disorder. The signs were first observed when she was in her freshman year. The behaviors were a depiction of change despite the fact that they may have been attributed to change of pace, an overwhelming environment or distress due to school. Her parents thus saw the need for her to get proper treatment. There are other symptoms that Ann depicted that may have resulted in the diagnosis of bipolar disorder. The first indication of abnormal behavior was in her sleep patterns. She had experienced phases of sleeplessness since she was ten years and this extended up to high school. At this point, she had employed the relaxation techniques that even improved her mood and any anger and frustration that she was experiencing (Christophersen & Vanscoyoc, 2013). She often undergoes a phase where her sleep escapes. As such, she has trouble sleeping. Most of the time, she only lies in bed but remains awake for long hours before getting any sleep. Moreover, she has also reported the tendency of thoughts to race through her head. In an attempt to try and fall asleep, she usually plays loud music when in bed. She also believes in her prowess to tackle difficult Mathematics tasks such that in her sleepless periods, she always claims to have come up with a new approach to a certain assignment. She then ends up sleeping late resulting in difficulty to wake up and attend lectures. As such, mornings are usually a struggle for her to get ready for the day’s activities.
Some studies have shown the connection between bipolar disorder and genetics. This form of connection is found in biological psychology that exhibited the knowledge that genetics and evolution have an important function in determining the way humans behave through natural selection. Genes have a strong impact on the behavior of a person. Various studies have been conducted on the first generation relatives who comprise of brothers, sisters, fathers and mothers. Moreover, others have been carried out on the monozygotic twins as well as people who are not related. The studies that have entailed the family and those with bipolar disorder have depicted that if the genetic ties are closer, then bipolar disorder will also be prevalent (Craddock & Sklar, 2013). Ann’s family has been affected by mental illness on both sides. There is the aspect of dependency on substance and anxiety on the one hand and bipolar disorder and depression on another one. She has an aunt who was even diagnosed and hospitalized due to bipolar disorder. There was a case of one of her grandmothers who ran away from home as a result of depression and disorientation. This is a second generation relative.
Furthermore, Ann rarely participates in activities in school. She also rarely mixes with the other class members. She also tends to argue with her peers most of the time when they interact, and this has resulted in few friends or peers that she can socialize with and exchange ideas. Her friends seem to avoid her due to her short-tempered tendency. Ann also takes tings into serious consideration and does not know how to differentiate between a joke and reality. As such, she ends up developing the wrong judgment on various aspects.
Coping Abilities and Defenses
Ann has adopted different strategies that she applies to cope and even defend herself. These habitual modes are ways of managing and coping with stress and emotions that appear to be distressing as well. Some of these strategies that she applies are not quite efficient. One of these strategies is acting out. This is where she exhibits some actions that are unrestrained and improper as well. Acting out usually implies the aspects of throwing fits, fighting, stealing and being antisocial. Although this strategy is generally common among the young teenagers, it is also extended to the older ones. When interacting with her peers, they may oppose her ideas and then end up arguing. As such, Ann tends to enter into a fight with most of them during the times that they are debating. At this point, her anger is usually uncontrollable and she does not seem to consider that her actions could end up wounding the other person in a serious way. At this point before engaging in the fight, Ann usually feels powerless and unable to control the situation and her surrounding as well. In the course of acting out, it makes her feel as if she is in control of her actions (Yew & O’Kearney, 2013).
Suppression is also a common approach that is applied to individuals with bipolar disorder. It has been observed to be common among the people who suffer from the major depressive disorder. However, Ann has also been exhibiting this approach to subdue negative thoughts. This is where she only thinks of positive aspects and ignores any negative undertakings that are present (Miklowitz, Alatiq, Geddes, Goodwin & Williams, 2010). Rationalization is another approach that has been observed in Ann. This is where she justifies provocative behaviors or feelings in a rational way just to avoid the real meaning or description behind their occurrence. In this way, she has only encouraged unacceptable behavior and feelings (Carr, 2015). For instance, she once engaged in a fistfight with a classmate and broke her rib, but then she came out unhurt. Ann refused to apologize because the classmate was the one who had harassed her first resulting in her reaction. Additionally, she failed to see her mistake in the entire situation and claimed that the classmate was the only one at fault. In this cases, Ann reacted due to the anger she had inside her and opted to let it out to her classmate.
Ann has also been exhibiting some coping ways that can be defined as her strengths to manage and go through anything negative that may appear to affect her moods. One of the approaches that are usually used by Ann is primary control coping. This is where Ann faces the issue that is affecting her in a direct way. She does not avoid the matter but instead seeks to solve any form of argument that she may have had with a peer. Moreover, she has also been observed to call upon an arbitrator to mediate in issues that may have caused a shift in her moods or relationship with a friend. This form of problem-solving effort is valid in that it assists in regulating her emotions. She is also able to accept where she may have gone wrong or employed an incorrect judgment (Grassi-Oliveira, Daruy-Filho & Brietzke, 2010).
Ann displayed features of mania and depressive form of bipolar disorder. She is ill-tempered, has insomnia as well as racing thoughts. Moreover, she also acts in an irresponsible manner as a result of engaging in arguments and fights with her classmates. She does this without considering the result of her actions. Various forms of treatments may be employed to ensure there is efficiency in the outcome.
For her moods to be stabilized, it is necessary to give certain medications. The mood stabilizing medication are used to control the various episodes of manic or depressive forms. Lithium is a common mood stabilizer. Lithium is considered a long-term treatment for the phases of depressive and mania. It is necessary for Ann to take the medication for at least six months and should stick to it until the end. The levels of lithium in her body will, however, have to be regularly monitored. This will be done by conducting blood tests on a regular basis. There are others medications such as valporic acid and carbamazepine. With her regular shift of moods, lithium will be quite effective in steadiness (Yatham, Kennedy, Parikh, Schaffer, Beaulieu, Alda & Ravindran, 2013). On the other hand, Ann is also experiencing insomnia and does not feel tired the next day. She can thus be prescribed with sedative-hypnotics such as Lunesta. For the treatment of insomnia and mood shift, a sedating antidepressant may be combined. Other medications that may be used to tackle the issue of insomnia are Xanax, sonata, and Ativan. Once insomnia is treated, her state of mood will improve, and she will be in a position to sleep and function in a better way (Harvey, Soehner, Kaplan, Hein, Lee, Kanady & Buysse, 2015).
Psychotherapy is also significant as a treatment option for bipolar disorder. The mood swings that occur in bipolar disorder are as a result of ones’ thoughts. The withdrawal from friends as has been observed in Ann may have caused her moods to worsen which is then linked to depression. As such, employing the techniques of cognitive behavior will be an effective way to manage these unappealing habits that Ann is displaying. With cognitive behavioral therapy, she will be in a position to learn how to catch, contest and transform any form of false thoughts. Furthermore, she will also correct other behavior patterns that usually lead her to conduct behavior patterns that are worrying. The situations such as getting a negative comment from a peer or classmate that are meant to correct her actions will be received in a calm way. As such, no negative judgments will be developed, and Ann’s moods will be stable. After undergoing cognitive behavioral therapy, the patient will feel better emotionally and even accomplish an enhanced quality of life (West, Weinstein, Peters, Katz, Henry, Cruz & Pavuluri, 2014).
Various techniques of cognitive behavioral therapy are applied to manage bipolar disorder. It is thus vital to ensure that the patient understands and goes through all this in an efficient manner. The first aspect will be to make sure that she accepts her diagnosis. The patient has to comprehend and even acknowledge that she has a disorder which has resulted in the symptoms she is exhibiting. This step may be a problem, and it is thus necessary to teach her various aspects about the disorder. These are such as the signs, symptoms, causes and the course of bipolar disorder. In this way, the patient will accept that she needs help and even go ahead and seek it in the right places (Geddes & Miklowitz, 2013).
Once the patient has accepted that they are suffering from bipolar disorder, they will then begin to monitoring their moods. A journal or worksheet can be provided and then reviewed with the therapist. The sheet will be kept daily during every session. In this case, the patient will be asked to rate her mood daily on a scale from 0-10. 0 will be a representation of depressed while five will depict and okay feeling and ten will mean her mood is highly irritable or she is easily upset or frustrated. The significance of this is to assist her to be aware of elements that cause her feelings to change in a positive or negative way (West et.al, 2014).
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