Breckinridge School of Nursing
August 19th, 2013
Bipolar disorder is a mental illness that causes extreme mood swings. This condition is also called manic-depressive illness or manic depression. Both men and women can have bipolar disorder. People of all age can have it. At times, a person who has bipolar disorder may feel very happy, full of energy and able to do anything, this feeling is called mania. At other times, a person who has bipolar disorder may feel very sad and depressed; the person may not want to do anything, this is the depression part of the disorder (Griswold, 2000). Sometimes, a mood episode includes symptoms of both mania and depression; this is called a mixed state. Bipolar may be caused by a chemical imbalance in the brain, it sometimes runs in families. The DSM-IV2 recognizes several subtypes of bipolar disorder. Bipolar I disorder is the classic subtype: to qualify, patients must have had at least one major depressive episode and at least on manic or mixed episode. In addition, at least three of the following symptoms must be present: - Inflated self-esteem or grandiosity - Decreased need for sleep - More talkative than usual, more rapid speech - Flight of ideas of racing thoughts - Distractibility - Increased goal-directed activity or psychomotor agitation - Excessive involvement in pleasurable activities with potential painful consequences
Bipolar II disorder is define as one or more major depressive episodes and at least one hypomanic episode. Patients with bipolar II disorder have never experience a full manic or mixed episode. Hypomania distinct from mania in several ways: - General impairment is less severe in hypomania than in mania - Hypomanic patients may have fewer and milder lapses of judgment than manic patients do - Many patients with hypomania respond to outpatient treatment, whereas many with mania need to be hospitalized initial stabilization (Muzina, 2007).
Bipolar disorder often develops in late teen or adult years. At least half of all cases start before age 25 (National Institute of Mental Health). Some people suffer for years before they are properly diagnosed and treated, it is a long-term illness that must be carefully managed throughout life. There are many treatments available for Bipolar Disorder. Nancy Brahm, a Clinical Associate Professor from the University Of Oklahoma College Of Pharmacy, wrote an article on the efficacy and tolerability of Seroquel (Quetiapine) in the treatment of acute mania. In comparing Seroquel to other drugs likes haloperidol, lithium and placebo. Quetiapine was superior to placebo and showed comparable efficacy in one study, Haloperidol was superior to Quetiapine. She concluded by saying "while Quetiapine treatment demonstrated efficacy in the majority of the studies, it is still questionable. The use of Quetiapine as first line therapy for acute mania is not recommended". Nevertheless, it may be a useful second-line agent, particularly when sensitivity to extra pyramidal symptoms limits treatment options (Brahm & Gutierrez, 2007).
Aside from medications, good nursing care can be prove to be beneficial to patients with bipolar. Psychiatric nurses are increasingly being involved in the provision of care for outpatients with bipolar disorder (Goosens, 2007). When bipolar is not adequately treated, it can have major consequences for both patient and community because patient with bipolar disorder could be a danger to themselves and or others. Moreover, we could not end our work without talking about culture. The development and maintenance of the interpersonal therapeutic