NURS 6521 UMES Bipolar Disorder Manic Depression & Mental Disorders Discussion

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NURS 6521

University of Maryland - Eastern Shore

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Josephine Yoko-Uzomah

Initial Post - Discussion

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Bipolar Disorder

Bipolar Disorder formerly called manic depression is a mental disorder. It causes extreme mood swings that include mania or hypomania and depression (Muneer, 2016). Apparently, when one is depressed, you may feel sad or hopeless and don’t want or have pleasure in most activities. According to Morsel et al, 2018, there are four classifications of this major mood disorder, called manic, major depressive, hypomanic, or mixed. Each of them incorporates unique particularities and eccentricities in behavior, mood, and patient's self-perception. However, they all have similar symptoms like mood swings, hopelessness, nervousness, mistrust, and loss of concentration.

There is Bipolar 1 and Bipolar 11 disorders. Bipolar 1 is described as a current or old experience of a manic episode, lasting at least one week, when one’s mood was abnormally and persistently elevated, expansive, or irritable (Morsel et al, 2018). The episode is severe enough to cause extreme impairment in social and occupational functioning. Whereas Bipolar 11 is the presence or history of one or more major depressive episodes and at least one hypomanic episode and has never been a manic episode. The purpose of this paper is to identify which type of mood the patient has, which symptoms indicate on complication and longitude of the disorder, and which medicines should be used to treat the patient, including education, and establish the recovery process.

A 35-year-old Caucasian female is selected for the interactive media case study, who was diagnosed with bipolar I disorder. She has manic episodes, mood swings, and concentration issues. According to her history patient has been on Risperdal but has been off her medications for a month. Stating that she felt better that’s why she stopped taking her medication.

Therefore, Risperdal was chosen again to start treatment for the patient's bipolar disorder, because it worked for her before. Dosage for the Risperdal - 2mg orally at nighttime, which should help to stabilize the mood and behavior due to the medication effect on dopamine and serotonin rebalancing (Morsel et al, 2018). The patient denies being allergic to any drugs and is started on 2 mg taken at nighttime because of the severity of her illness, and the drowsiness of the medicine. Risperdal is a typically prescribed drug to treat bipolar mania and other several psychological disorders (Rosenthal & Burchum, 2019). The patient complained during her follow-up visit that she gets lethargic in the morning and this started 10 days into taking the medicine. After the assessment, the dosage of Risperdal was reduced to 1mg at bedtime, so that the patient can be less lethargic and return to normal activities (Rosenthal & Burchum, 2019). Other side effects of Risperdal are akathisia, dystonia, tremors, dizziness, anxiety, blurred vision, sleepiness, and fatigue. All these were made known to the patient during education so that she would be aware of them. On the next visit, the patient's condition was better and she stated so herself, with minimum symptoms. The Young Mania Rating Scale is a tool that can be used to assess symptoms of manic and mania at baseline. (Young et al, 1978). This tool can also be used to evaluate how the patient is doing. The patient will continue this regime until further notice since she is doing better on it and will be subject to more assessment if the condition worsens, and other antipsychotic medication like mood stabilizer may be added.

Conclusively, patient’s education is very essential. This patient was educated to talk to the provider or mental health professional if she has bothersome side effects, not to make changes or stop taking her medications without consulting her doctor, otherwise, she will experience withdrawal effect, or her symptoms may worsen or return or she may become depressed, feel suicidal, or go into the -manic or hypomanic episode (Muneer, 2016). Psychotherapy will also be introduced to the patient because it is a vital part of bipolar disorder treatment and be provided in individual, family, or group settings. Risperdal is a good choice of medicine for this patient because it belongs to atypical antipsychotics and works by helping to restore the balance of certain natural substances in the brain.

References

Morsel, A., Morrens, M., & Sabbe, B. (2018). An overview of pharmacotherapy for bipolar I disorder. Expert Opinion on Pharmacotherapy, 19(3), 203-222. doi: 10.1080/14656566.2018.1426746

Muneer, A. (2016). Pharmacotherapy of Acute Bipolar Depression in Adults: An Evidence-Based Approach. Korean Journal of Family Medicine, 37(3), 137. doi: 10.4082/kjfm.2016.37.3.137

Rosenthal, L. Laura, R., & Burchum, J. (2019). Lehne's pharmacotherapeutics for advanced practitioners. St Louis, Missouri: Elsevier.

Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity, and sensitivity. Br J Psychiatry. 1978; 133:429-435.


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Explanation & Answer

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Response to Josephine Yoko-Uzomah’s Discussion Post on Bipolar Disease

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Response to Josephine Yoko-Uzomah’s Discussion Post on Bipolar Disease
I agree with Josephine that there are types of bipolar disease and that both forms of
bipolar disease are characterized by chronic depression and anxiety. Josephine’s presentation that
every symptom of bipolar disease in different patients is unique is accurate. No one patient
displays the same symptoms as the next when they suffer from bipolar disease. In Josephine's
work, what stands out to me is the presentation of a case in her discussion, which I felt makes the
discussion even more understandable and relatable.
Josephine critically defines the two different types of bipolar disease, the onset of each
method, the treatment and associated outc...


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