BiPolar Paper for College Class

According to the National Institute of Mental Health, http://www.nimh.nih.gov/index.shtml , mental disorders are common in the United States and internationally. An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year. When applied to the 2004 U.S. Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people. Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion — about 6 percent, or 1 in 17 — who suffer from a serious mental illness.  In addition, mental disorders are the leading cause of disability in the U.S. and Canada.  About 56 percent of individuals with bipolar who participated in a national study had experienced drug or alcohol addiction during their lifetime.  Approximately 46 percent of that group had abused alcohol or were addicted to alcohol.  About 41 percent had abused drugs or were addicted to drugs.  Alcohol is the most commonly abused substance among bipolar individuals ( http://www.dualdiagnosis.org ).

What is bipolar disorder?  “Bipolar disorder is a biological illness that affects your ability to regulate your mood and leads to feelings of extreme happiness, intense sadness, or heightened irritability” (Caponigro, Lee, Johnson, Kring 2012).  It is considered a disease because of the biological change that occurs in the body and the distress and disability it causes those who suffer from it.  In the U.S., mental disorders are diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) (Albrecht & Herrick, 2007).  What is the DSM-IV?  It is considered the standard diagnostic manual for establishing the diagnosis for various mental disorders (Albrecht & Herrick, 2007) According to the National Institute of Mental Health, more than 90 percent of people who kill themselves have a diagnosable mental disorder, most commonly a depressive disorder or a substance abuse disorder (Conwell Y, Brent D., 1995).  Many people suffer from more than one mental disorder at a given time. Nearly half (45 percent) of those with any mental disorder meet criteria for 2 or more disorders, with severity strongly related to co-morbidity (Kessler RC, Chiu WT, Demler O, Walters EE, 2005).  What causes bipolar disorder?  Causes are not as easily defined as are other medical issues.  According to Albrecht and Herrick, many physicians don’t talk about cause, but rather risk factors.  Bipolar, for example, is more apt to run in families but is not 100% inheritable.  It may run in families or a person may develop it with no family history of the illness at all.  Many psychotherapists utilize the biopsychosocial model which considers biological, psychological, and social factors that may contribute to the onset of the disorder. 

What is the course of treatment for people who suffer from bipolar disorder?   I sat down and spoke with Christina Leitman who is a Social Worker with The DuPage County Public Health Department in the Westmont location.  “Here in DuPage County, Illinois a person who is struggling and thinks they may have a mental illness can call the crisis line at (630) 627-1700 and talk with someone to schedule an intake evaluation” (in person interview 3:30 pm, 9-19).  It is not always easy to get the appointment, which can sometimes take up to three months because of the sheer number of people needing the public (i.e. Low to no cost) assistance.  The person will link the “client” up with the location they need to go based on where they live.  There are locations in West Chicago, Addison and Westmont just to name a few.  Once the appointment occurs, the clinician, or social worker will do an intake evaluation that consists of a series of questions that range from queries about mood, stability, job security all the way to queries involving ability to maintain proper diet, hygiene and other assorted self care.  After the evaluation, the client is then moved on to a staff psychiatrist whom discusses the symptoms the client is feeling or suffering from.  According to Caponigro et. al, Psychiatrists hold medical degrees so they can prescribe medication, however they also have specialized training in diagnosing and treating mental illnesses like bipolar disorder.  Therefore it is important to seek out the assistance of a psychiatrist rather than a family physician.  Doctor Steven K. Sauerberg from the Family Medical Center of LaGrange stated, “I am comfortable treating simple depression issues, but when it comes to dual diagnoses and a need for multiple medications, I feel more comfortable if the patient see’s a psychiatrist for proper diagnosis and support” (phone call 11:38 9-26).  Once the diagnosis is established then a course of medication will begin. 

People who suffer from bipolar or other mood disorders are usually started on a mood stabilizer.  According to WebMd.com, some of the common ones are Lithium, Tegretol, Depakote and Lamictal.   Each of these medicines works similarly to treat bipolar disorder. Mood stabilizers balance certain brain chemicals (neurotransmitters) that control emotional states and behavior (http://www.webmd.com/bipolar-disorder/mood-stabilizing-medications-for-bipolar-disorder).  For people who suffer from anxiety in addition to bipolar, a benzodiazapine like Xanax, Valium, Ativan, or Klonipin may be prescribed.  Since most people who suffer from a mental illness have what is called a dual diagnosis, usually several medications are prescribed to manage symptoms.  Sometimes finding the right medication and dosage requires some trial and error, and of course these medications have a wide variety of side effects, so the pros and cons must be discussed with the person prescribing.  Wes Burgess M.D. says, “I encourage a good working relationship with my patients where we both equally participate in making decisions (Burgess 2006).  Usually in conjunction with medication, psychosocial treatments are introduced.  This may involve simple talk therapy with a therapist or social worker, but according to Caponigro et al, psychoeducation, cognitive behavioral therapy, family focused therapy, and interpersonal and social rhythm therapy are very effective.  All four of these treatments have been shown to decrease symptoms of depression, while psychoeducation seems to decrease mania and depression.  Caponigro et al also feels that, “medication is the best and quickest treatment in reducing symptoms of mania and preventing their return.  Talk therapies can be used as a supplement to medication.  Christina Leitman of DuPage County Public Health Dept., states that, “Cognitive Behavioral Therapy is the most common therapeutic approach we take with clients.”  
 So although bipolar disorder, as with other mental illnesses, can be debilitating, emotionally draining, and cause a person to become emotional and mentally unstable, at risk for suicide and addiction, all hope is not lost.  With proper diagnosis, coupled with the correct medication or medications in conjunction with some sort of talk therapy and support from family, friends, employers and support groups, a person who suffers from bipolar disorder or any other of the many mental/mood disorders, can go on to live a happy and productive life.