This sample psychology paper explores bipolar disorder. It defines the mental illness, explains the symptoms and treatment options. This APA-style research paper was written at the Master level to serve as a sample for the Ultius blog.
Understanding the symptoms and treatment of bipolar disorder
Bipolar disorder is a mood disorder that presents with symptoms of cycling between periods of extreme excitement (mania) and sadness; it is hereditary and often linked to brain injury (Mitchell, 2013; Duarte, Becerra & Cruise, 2016). Between one and two percent of all Australians suffer from bipolar disorder, although in many the symptoms are mild and have limited impact on functioning (Mitchell, 2013; Kulkarni et al., 2012). For those with severe cases, symptoms can impact all major life areas, including work, school, and interpersonal and community relationships (Bullock, Murray & Meyer, 2017).
This makes understanding important for the social work professional, as social work practice will likely deal with many persons suffering from bipolar disorder, particularly if that practice involves the mental health field. Without a clear understanding of the shifting mood and behavior of those with bipolar disorder, the social worker may attempt to meet the client in their current state, without understanding that this state may be vastly different tomorrow (Grande et al., 2016). In addition, the social worker may form expectations of the ability of the client to undertake certain things independently that are not realistic expectations, leading to poor outcomes (Hampson, Hicks & Watt, 2016). Understanding the nature of bipolar disorder and its effect on client functioning provides social workers a foundation from which to effectively address these clients’ various needs within the consideration of their mental health issues (Martín-Subero et al., 2014).
Diagnosing bipolar disorder
A brief review of literature reveals some disagreement about what constitutes bipolar disorder and its diagnosis (Benti et al., 2014; Grande et al., 2016). This dispute involves the severity of symptoms required to justify a bipolar disorder (Benti et al., 2014; Grande et al., 2016). However, most scholars recognize that periods of extreme mood, often accompanied by psychotic elements, are common in the severe form of the disease (Bullock, Murray & Meyer, 2017). There is also agreement of the effects of these mood swings.
Duarte, Becerra and Cruise (2016) examined English-language research over a 23 year period, and found that bipolar disorder negatively impacted patients’ educational attainment, occupational success, and stability in relationships. Those diagnosed at early ages were more likely to suffer from damaging effects; those with an age of onset of 15-19, the most common range for those with severe bipolar disorder, were less likely to be successfully married, gainfully employed, or have completed their basic education (Duarte, Becerra & Cruise, 2016; Joyce, Thompson & Marwaha, 2016). These findings were consistent with several of the solitary research studies include in this review, such as Chatzidamianos, Lobban and Jones (2015), Hampson, Hicks and Watt (2016), Martín-Subero et al (2014), and Kulkarni et al. (2012).
Symptoms of bipolar disorder
Symptoms of the disease are behavioral, with limited and disputed indications of change of brain activity during certain mood episodes (Bullock, Murray & Meyer, 2017). Bullock, Murray and Meyer (2017), in a study of the effects of environmental factors on bipolar mood episodes, found that few clear physiological tests exist. Further, there are not consistent environmental factors beyond a slight correlation with increased environment temperature that would predict when mood changes might occur. Periods of extreme mood can last anywhere from a few hours to weeks at a time, making differentiation between symptoms and the patient’s normal functioning even more difficult, particularly in early stages of the disease (Joyce, Thompson & Marwaha, 2016).
Treatment of bipolar disorder
This literature indicates social work practitioners act based on some theoretical framework, which guides their decisions regarding how to approach a patient with bipolar disorder (Kulkarni et al, 2012). This may determine both how they approach the client and the treatment plans created to assist them (Kulkarni et al, 2012). For example, Systems Theory maintains that humans are systems, with each component of the system affecting other components (Hampson, Hicks & Watt, 2016). It is therefore impossible to look only at a mental illness without considering the rest of the person (Grande et al., 2016). In addition, the context in which people live involves systems, and these systems impact the systems of the individual (Hampson, Hicks & Watt, 2016). The whole picture must be considered and dealt with when providing assistance to an individual (Hampson, Hicks & Watt, 2016).
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In this framework, the social worker identifies areas of system failure and seeks to assist the client in obtaining the skills, knowledge, or community in which he or she will have the most positive outcomes (Grande et al., 2016). This differs from Ecological Theory, which holds that humans respond to factors in their environments, and environmental change will result in behavioral change (Mitchell, 2013). From this perspective, the social worker is tasked with assisting the client in locating environments and environmental factors that promote their well-being and avoiding those that do not (Mitchell, 2013). Different social workers will practice based on different frameworks, causing varied responses to similar symptoms.
Literature reveals both pharmaceutical and therapeutic treatment is typical in medical provision for bipolar disorder. Lithium is the most common and effective drug treatment for bipolar disorder in Australia (Kulkarni et al., 2012). An element found in nature, it is not clear how Lithium relieves symptoms, but it is known to alter the messenger relays in the brain and change brain activity, and to have an anti-manic effect without increasing depression (Duarte, Becerra & Cruise, 2016).
On the other end of the symptom spectrum, antidepressants may also be used for patients with long depressive mood episodes; however, their effectiveness in treating bipolar is limited and may exacerbate mood periods of excitement (Kulkarni et al., 2012). Other pharmaceutical treatments involve the use of anti-psychotic medications such as Lurasidone, although these are only generally prescribed in more severe bipolar cases (Kulkarni et al., 2012). Of note, Chatzidamianos, Lobban and Jones (2015) found as part of their study in family support that few patients or family members have clear understanding or realistic expectations of the result of medication, making both medication compliance and consistency in therapeutic treatment more erratic.
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This is a concern, as therapeutic treatment is an important component of managing bipolar disorder. Of the six articles examined and the four articles used for additional information, all in one way or another supported the importance of individual and group therapies in maintaining mood stability. In addition, several contend this type of treatment more effective than medical treatment, if only one can be used (Hampson, Hicks & Watt, 2016; Joyce, Thompson & Marwaha, 2016). One study, Martín-Subero et al (2014), found that a naturalistic approach to managing mood swings can be effective without additional medications.
Literature indicates that modern treatments for bipolar disorder combine medication with behavioral therapies for better symptom control (Hampson, Hicks & Watt, 2016). These therapies attempt to support patient self-care, rather than relying on medical providers to manage their illness (Hampson, Hicks & Watt, 2016). One foundational therapy in this approach is cognitive behavior therapy, which is founded on groups involving patients with similar disorders and symptoms (Kulkarni et al., 2012). These groups, led by an experienced counselor, help the patient identify areas of behavioral concern, create plans to address these areas, and improvement and maintain steps to control symptoms in everyday life (Kulkarni et al., 2012).
Another common therapy is family therapy, which involves persons from the patient’s family or support population in a similar process (Chatzidamianos, Lobban & Jones, 2015). Employing the family unit in assisting the patient in maintaining stability was shown to be very effective in studies by Chatzidamianos, Lobban and Jones (2015), who report that the continued presence of family members can lead to quick recognition of symptoms, and assist in timely response to onset of symptoms, as well as help patients become more aware of their conditions and when to act in response to them.
Conclusions
Bipolar disorder remains a difficult mental illness, particularly as it does not present consistently over time. However, useful frameworks for social work practice and appropriate modern therapy approaches can enable the social worker to effectively assist client with bipolar disorder.