Bipolar disorder exists in two forms, type I and II.It has been estimated that around two percent of the populations in the world are affected by bipolar disorder (Geddes & Miklowitz 2013).
About 37 percent of the patients are said to relapse into depression even with treatment in a period of one year. A study conducted shows that 58 percent of the patients with bipolar disorder type I and II had a recovery but 49 percent got recurrences. It is said that one of the contributors of recurrences in patients is depressive polarity. Depressive polarity consists of interest loss, fatigue or even sad mood (Geddes & Miklowitz 2013). It has been found out that the diagnosis and treatment of bipolar disorder many times takes close to a decade. This is said to contribute to psychosocial morbidity experienced by bipolar disorder patients. The intervals between the first appearance of BP symptoms and the start of treatment is related to bigger successive morbidity and lesser response when it comes to pharmacological and psychological treatment(Malhi, Bargh, Coulston, Das & Berk 2014).
Research shows that cases of bipolar disorder are seen in the late or mid-adolescence or early adulthood. This age period is said to contain big cognitive brain and emotional development. This in return causes a comprehension of self and mold interactions (Malhi, Bargh, Coulston, Das & Berk 2014).
The neural adaptations and brain growth are rapid at this time. Therefore the setting around which the signs and symptoms of bipolar disorder can be recognized and evaluated is hard and always changing. The biopsychological instability seen at this time causes the various occurring symptoms of bipolar disorder to look like other disorders and age-appropriate behavior variants (Malhi, Bargh, Coulston, Das & Berk 2014). Most of the set of symptoms that are seen this period are nonspecific.
A look at the natural course of bipolar disorder shows that it is important to observe the illness course when making a diagnosis instead of just basing on the phenomenology alone. Traditionally, bipolar disorder has been viewed as an illness that is episodic. Evidence has shown that bipolar is an illness that is recurrent and persistent. It consists of high psychiatric comorbidity rates and treatment resistance. It has a lot of course variations and patterns (Malhi, Bargh, Coulston, Das & Berk 2014).
The existence of various presentations in BP, lead to confusion when it comes to its diagnosis. The BP patients can spend almost half of their lives experiencing the symptoms of BP and the possibility of recovering is reduced when they experience severe changes in moods and longer duration episodes. Bipolar disorder starts with occurrences of depression that graduate into mixed states episodes (Malhi, Bargh, Coulston, Das & Berk 2014). When looking at the BD phenomenology evolution, it is seen that mania comes after the occurrence of hypomania. During Hypomania stage, it is hard or normally the existing symptoms are always disregarded (Malhi, Bargh, Coulston, Das & Berk 2014).
The bipolar disorder treatment concentrates on the acute stabilization. Under this, the main objective is to ensure recovery in a patient that is suffering from depression or mania. The symptomatic recovery has to include stable mood and avoidance of any relapse occurring. Among the recovery expectations, are improved occupational and social functioning. When treating BP it is important to note that the treatments that lessen depression can lead to the occurrence of hypomania and mania. And also the mania treatments might lead to the introduction of recurring depressive episodes (Geddes & Miklowitz 2013).
When treating mania episodes, the antipsychotic drugs seem to be working better in comparison to the lithium and anticonvulsants.
Risperidone and Olanzapine appear to have the best profile when it comes to agents available presently (Geddes & Miklowitz 2013).
For short-term clinical treatment, the use of antipsychotic agents is advised. But when continued or long-term drug therapy is planned, the use of lithium agent should be considered (Geddes & Miklowitz 2013).
For bipolar depression, there has been an investigation of the antiepileptic drug lamotrigine that was after a good result was seen in the treatment of bipolar disorder patients. However, it is uncertain whether the lamotrigine can be placed in acute treatment. In relation to placebo, the use of antidepressants in the treatment of BP no different result was seen. Although it is premature to conclude that the use of antidepressants is ineffective (Geddes & Miklowitz 2013).When it comes to the use of the psychosocial treatment in BP, it is important to note that psychosocial stressors such as life events that are negative or excessive family distress are related to relapse. This treatment involves psychotherapy where the patient is educated on the ways to manage stress and also the recognition of relapse signs. The same therapy is given to the caregivers of the BP patients. The psychosocial treatments also stress on the issue of consistency when it comes to psychotherapy. This is in regard to the high non-adherence rate seen in drug treatment (Geddes & Miklowitz 2013).
Non-adherence is a big problem when dealing with bipolar disorder treatment. Research has shown that one in three BP patients lacks to take thirty percent of the medication prescribed. This problem is also seen in cases involving psychotherapeutic treatment. There have been few studies conducted in the past entailing intervention that improves the treatment adherence in bipolar disorder patients (Wenze, Armey & Miller 2014).
Among the few studies, there is a study done to show or rather gauge the effectiveness of computer-delivered interventions expected to enhance BP patients treatment adherence (Wenze, Armey & Miller 2014). In this study, there is the use of fourteen participants selected from private psychiatric hospitals.
It is seen that from the conducted study, the use of Computer-delivered intervention which included the use of personal digital assistants (PDAs) was helpful. The PDAs were seen to assist the patients in remembering their medications and appointments. There is also the facilitation of conversation concerning the therapeutic relationship existing with the providers. All these assists the patients have a feeling of being involved in an activity that is positive for their health (Wenze, Armey & Miller 2014).
From the study on the use of mobile intervention, it is seen that the involved BP participants experienced reduced depression symptoms.
The treatment adherence rates were seen to be on the high as a result of this intervention. The only negative result obtained was logistical and technical issues that can be addressed easily. It is correct to conclude that bipolar disorder even though complex to identify, its symptoms can be seen during the mid/late adolescence or even early adulthood. Phenomenology can be used in the prediction of bipolar disorder. It is important to note the symptoms of BP early and start diagnosis as any delay would result in increased morbidity and resistance to treatment. The advised drug agent for short-term treatment of BP has been said to be antipsychotic agents.
Nonadherence being a common thing in BP patients, a mobile intervention has been mentioned that has shown much improvement in treatment adherence.
A Brief summary of the articles
Wenze, S. J., Armey, M. F., & Miller, I. W. (2014). Feasibility and acceptability of a mobile intervention to improve treatment adherence in bipolar disorder: a pilot study.В Behavior modification, 38(4), 497-515.
This journal talks about the use of mobile technology in the delivery of the treatment to the bipolar disorder patients. A study has been conducted to show how the utilization of mobile intervention helps improve the adherence to treatment in bipolar disorder. There is an evaluation of the acceptability and feasibility of a two week long ecological momentary intervention. This ecological momentary intervention is delivered through the use of personal digital assistants in order to enhance the adherence to treatment in bipolar disorder. The study in the journal concentrates or rather involves fourteen participants recruited from private psychiatric hospitals. The journal outlines a procedure used, measures and the results. There is a discussion of the results and later a conclusion is done.
Geddes, J. R., & Miklowitz, D. J. (2013). Treatment of bipolar disorder.”The Lancet”381(9878), 1672-1682.
This article generally talks about the existing treatments for patients with bipolar disorder. There is inclusion of treatment of bipolar depression, long maintenance treatment and psychosocial treatments for bipolar disorder. The article clearly discusses in detail the procedures and details concerning the mentioned treatments. Finally there is a mention of the future directions in the treatment of bipolar disorder.
Malhi, G. S., Bargh, D. M., Coulston, C. M., Das, P., & Berk, M. (2014). Predicting bipolar disorder on the basis of phenomenology: implications for prevention and early intervention. “Bipolar disorders”, 16(5), 455-470.
The articles entail information on the prediction of bipolar disorder in relation to phenomenology. This is looking at the early intervention and the existing suggestions for prevention of the bipolar disorder. The article does a study on the bipolar disorder and comes up with results on whether it can be prevented or not. In the results, the article concludes that it is not possible to predict who will develop the bipolar disorder.
Comments on how the three articles relating
The three articles related in the sense that one articles speaks of a way to predict bipolar disorder. The second article gives the available treatments of bipolar disorder after the prediction bipolar disorder. Lastly, the third article speaks of an intervention that can reduce cases of non-adherence during the treatment of BP patients.
Wenze, S. J., Armey, M. F., & Miller, I. W. (2014). Feasibility and acceptability of a mobile intervention to improve treatment adherence in bipolar disorder: a pilot study. Behavior modification, 38(4), 497-515.
Geddes, J. R., & Miklowitz, D. J. (2013). Treatment of bipolar disorder. The Lancet, 381(9878), 1672-1682.
Malhi, G. S., Bargh, D. M., Coulston, C. M., Das, P., & Berk, M. (2014). Predicting bipolar disorder on the basis of phenomenology: implications for prevention and early intervention. Bipolar disorders, 16(5), 455-470.