For many psychologists and psychiatrists, the ongoing process of finding a suitable and more effective treatment therapy for bipolar disorder is one rough road to take. The main question that always lingers to these doctors is how to control and avoid relapse of the illness happening to the individual afflicted with it. This question likewise is put into balance equilibrium with the inquiry of the effectiveness of treating the disorder without the use of therapy altogether. Which is by the way is more effective?
But before going to the research proper, it is first important to have an elementary yet fundamental knowledge as to what is the nature of this mental disorder. The question of what is bipolar disorder ought to be given space first. Going by the definition set by Daley and Haskett (1994), bipolar disorder is a recurrent and chronic mental illness that creates disturbances in feelings, thoughts and behavior of a person. It is sometimes called manic-depression illness or “mood disorder” (Peacock, 2000).
People afflicted with the disorder experience alternating occurrence of low mood which is generally described as depression with episodes of extremely high mood and energy called mania. The duo furthermore stated that bipolar refers to the mood shifts, going back and forth, between two emotional extremes or “poles” Daley and Haskett (1994). These symptoms of changing moods may seriously affect the person’s ability to function thus can disrupt his/her relationships with family and friends.
Right now, there is an estimated 1. 2% of the population of United States or roughly 2. million being afflicted by this disorder (“Statistics About Bipolar Disorder,” 2008). But if we would believe Burgess (2006) there are really about 2 to 7% of Americans who are afflicted by this disorder. Like many mental illness, such as schizophrenia, the cause of this disorder is still unknown. Scientists still have a lot to do to understand and discover the workings of the brain, its neurotransmitters and chemical make-up. And like any other mental illness or general illness, like diabetes, for that matter, once diagnosed as a bipolar this is already a life-time condition.
While it is true that there is still a lot to known about the disorder, it is helpful to be acquainted with the driver of this disorder: stress. Since this paper deals on how to treat the illness with or without the help of therapy, understanding this driver can lead to a clearer picture as to how this goal can be achieved. What really is stress, biologically speaking? According to Burgess (2006) stress is the physiological reaction that happens in the body that stimulates the adrenal glands.
When this happens, this results to the overproduction of body stress steroid hormones like cortisol and stress neurochemicals like adrenaline. These stress biochemicals increase “blood pressure, change blood flow, heart reactivity, urinary and bowel function. ” They also increase “breathing rate, body temperature, perspiration, memory and attention. ” Since modern life present a constant stress for man, the stress hormones that should be released by the body in a short time become continuously high in concentration.
When this happens, this produces permanent, “unhealthy changes in the body and brain. ” Available Therapy Treatment As of the present, there are a slew of available therapy treatments to control the symptoms of this devastating illness. First there is the widely known application of cognitive-behavioral therapy. Then there is the psychopharmacology treatments using lithium and other newly formulated medicines, like Olanzipine, that try to mitigate the mood disorder of the bipolar patient. This therapies attempt to avoid the recurrence of episodes of mood shifting from ups and down of a patient.
For several years now, as mentioned above, there are basically two main types of therapy used by psychiatrists in controlling the mood swings of bipolar people; these are the CBT and psychopharmacology therapy. As compared with other mental illness that is a life-condition in this paper, these therapies try to apply the procedure by which the bipolar individual is put under medical maintenance. Below, several of these therapies will be discussed, assessed and given a closer study.
Popular Therapies of Treatment Since bipolar disorder is a chronic and recurrent mental disorder, the individual afflicted with this illness is required to undergo acute and maintenance therapy in order to control and avoid falling in a cycle of mood swing relapse. Nevertheless, in spite of variety of therapeutic intervention, the relapse rates of bipolar disorders though under one or two kinds of therapy ranges from 40% to 50%. This is true especially after a first life-time episode. Many as one-half of patients still experience a second mood episode within a year after therapy (Tohen et al, 2006).
Nevertheless, here are a couple of these therapies. Cognitive Behavior Therapy In the last several decades, psychiatrist are discovering a somewhat evidence of efficacy of psychotherapy to address and control the symptoms of bipolar patients (Miklowitz et al, 2000). There have been studies that reported relapse prevention approach showing short-term effects of cognitive therapy up to one year. During this time, the number of bipolar episodes and bipolar admissions in hospitals are lessened. This has led to the application of CBT as a tool to help bipolar patients.
Nevertheless, it must be understood that during the process of CBT scientists observed that there happens an interplay with the symptoms and the therapy itself (Basco and Rush, 2007). There is normally a great impact of cognitive and affective symptoms that affects the session. What could be a manifestation of positive attitude on the part of the patient could may well be a sign that he is on the state of being manic again. In spite of this observation, CBT as a tool helps in various ways. The psychiatrist gets an intimate interaction with the patient.
Moreover, CBT is flexible in its process. When the patient is easily distracted the therapy can be reduced to a shorter session or the doctor can limit the agenda or give the patient a mental rest between shifting to another subject. When the patient is saying a too much like a slew of plans and objectives, which he/she would normally forget eventually, the therapist takes note of these plans and later on discuss these with the patient on succeeding session. In a way, this keeps track of the number of plans made by the patient (Basco and Rush, 2007).
Furthermore, the psychiatrist can talk one on one with the patient. Through this process, the doctor can learn the patient’s perspectives about certain issues or events by which the doctor can gear towards a more realistic understanding if these issues are incongruent with how the world works. Nevertheless, cognitive behavior therapy is still under the scrutiny of scientists whether it is really effective in addressing the needs of a bipolar patient. Take the case for example the experimental study performed by Lam et al (2005).
His group followed-up an earlier randomized controlled study where the authors found significant positive effects of cognitive therapy for relapse intervention in bipolar disorder patients. Since the study’s time duration is only a year, Lam and his group (2005) extended their study to 18 months and reported overview effects of the study after over 30 months. Lam et al. (2005) concluded that the experimental group had significantly lower bipolar episodes after the effect of medication compliance was controlled.
The group stressed that cognitive therapy had no significant relapse reduction over the last 18 months during the duration of the experiment. They stated further that more study and research should be done about the subject. 2. Psychopharmacology Therapy Probably there is no other medication that is more widely known to control the mood swings of bipolar patients than the use of lithium. Cade (1949) reported in his study that lithium has the capacity to manage the manic symptoms of bipolar individuals. The use of this medication soon became prevalent in the 1960s (Dinan, 2002).
Basing from medical experience, the majority of drugs that we use today are designed through evolution or synthesis, with the aim to interact with single proteins, like a specific receptor or enzyme. But this is not the case with the use of lithium with bipolar patients as a way to stabilize their mood swings, particularly their manic symptoms. Lithium so it seems act or affect multiple sites that contributes to its mood-stabilizing action. The therapeutic action of the chemical to bipolar patients suggests as not a result from an effect to a single target site in the brain.
Rather, the it is the effect or culmination of an integrated re-orchestration of a complex activity and events that adjust neuronal activity at multiple level (Jope, 1999). The multiple therapeutic effects of lithium along with the complexities of mood disorders and multiplicity of affected systems inherent in the bipolar disorder show that these effects is unlikely due to a single biochemical site or action (Jope, 1999). For those who use lithium for treatment and therapy of bipolar patients, their major challenge is to distinguish the critical effects from the varied biochemical actions of lithium.
Another challenge is how to provide a clear picture of how neuronal function is modulated by lithium. Doctors mainly use lithium because of its efficacy as an antimanic agent or as a prophylactic agent for mania and depression. Lithium is also a relatively weak antidepressant and has the quality as an augmenter of the effects of many antidepressants. Non-therapeutic Treatment The question now is whether a person afflicted with mood swing can be treated with or without the use of these known therapies.
Is there any way that can assuage or cure the patient without using any of these popular therapies? In an era where health is strongly considered something one must value, the kind of lifestyle one leads can be the elusive answer to this question. Burgess (2006) stated that lifestyle change can significantly lessen the event of moods swings by 10 to 30%. As he elaborated, lifestyle change is easy to make, cheap and most of all safe. Previous scientific studies prove that if stress level (the driver of bipolar disorder) increases the probability of a bipolar episode increases also.
It thus suggested that every individual afflicted with the illness must and ought to know this fact to prevent a relapse or an event of moods swing. Burgess (2006) did not equivocate in stating that for a bipolar person he must purge the sources of the stress he is experiencing in his life. Along side with this, Burgess (2006) even went further as suggesting that a bipolar should make a commitment to keep new stressors under his control. Burgess (2006) said that stress treatment is a blessing, a godsend gift for bipolar patients.
By way of eliminating stress in a bipolar’s life, this is an effective means – cheap and safe – to control his illness. Moreover, the bipolar patient can learn reducing stress by stress reduction and muscle relaxation. A bipolar must study and learn at least one or more relaxation technique. This can be done by muscle relaxation and meditation. Meditation is a collection of diverse “mental, emotional, and physical” exercises that have been designed way back thousands of years ago with an objective of experiencing life in a new way by increasing control over one’s thoughts, feelings and physical body (Burgess, 2006).
By meditation a bipolar patients can reduce the stress he is experiencing and at the same time gain more aptitude in controlling his stream of consciousness. Recommendation The two main well-known therapies used as a tool to help bipolar disorders cope with their illness are given a closer look in this paper. Likewise the method of what you can call the absence of therapy to help bipolar individuals is also given space. The therapies that are discussed in this paper are outlined and given their advantages and disadvantages – even the effectiveness of one is questioned.
The thesis of this paper is to find out which is more effective in treating bipolar patients: with or without therapy. Using therapy as a variant in an experimental research would be an easy task and with a quick expected result. As discussed in this paper, the research team can use one of the well-known therapies applied to a bipolar patient. This therapy method then can be compared with what is discussed in this paper as the absence of any therapy tool but just plain change of life style and avoidance of stress – the driver of bipolar disorder.
The team will choose a number of participants who are all bipolar and fall under a similar medical history of having the illness with each other. The participants will be divided into two. The first set will be put under the maintenance of a therapy chosen by the group, while the second set will only follow what the treatment ‘without therapy’ as discussed in this paper. The experimental research will run for one and half years and results like times of relapse will be compared with each set.
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