Bipolar Affective Disorder

In today's society, not just in Australia, but also elsewhere, mental illness is a major problem and it is a complex, potentially fatal condition that occurs within a social context (Buila & Swanke 2010). In the United States, twice as many women as men are affected by a depressive disorder each year and these depressive disorders include major depression and bipolar disorder (Rodriguez 2007). This essay focuses on the care of the patient who is diagnosed with manic depression. Although the condition has long been known as manic depression, the World Health Organization now use the term 'bipolar disorder' to indicate fluctuation of the person's mood between depression and mania (Beech, 2003 p281). Drawing on nursing literature this essay present's a case study analysis of the issues arising for a patient with bipolar affective disorder, covering also the issues raised for the family and staff. The essay considers the impact for everybody concerned. In particular, several possible interventions are considered to help address the issues.

Alexis (45) is a successful General Practitioner. She and her husband Richard have two children, Liam and Allegra. Alexis concedes that she was diagnosed with Bipolar Affective Disorder soon after Allegra was born and she suffered from symptoms of mania and bipolar depression. However, Alexis also have several issues and these include self-prescribing medication, hypersexuality, and reluctant to talk about her mental illness or seek for treatment. In details, bipolar affective disorder is a lifelong mood disorder and also known as manic depressive illness or bipolar disorder, characterized by recurrent manic and depressive episodes (Miller 2006). Pinto & Schub (2010) mentioned that there are 2 types of bipolar disorder, which is bipolar disorder I (mania or a mixed episode) and bipolar disorder II (hypomania and depression). Furthermore, these authors also explain that Bipolar I disorder involves at least one episode of depression and in Bipolar II disorder, the person does not experience full-blown manic episodes instead, the illness involves episodes of hypomania and severe depression.

For instance, symptoms of manic episode include mood changes and behavioural changes such as feeling "high" and overly happy, agitation, racing thoughts, increased energy, spending sprees, talking rapidly, engage in bizarre sexual behaviour or have multiple sexual encounters (Pinto & Schub 2010). Common symptoms of bipolar depression include sadness, anxiety, guilt, hopelessness, sleep and appetite disturbances, fatigue, feelings of worthlessness or guilt, develop insomnia, or sleep more than usual yet feel fatigued (Murphy, 2006p. 59). This author also mentioned that, a mixed episode of bipolar disorder features symptoms of depression, mania and hypomania. All of this indicates the possible signs and symptoms of the disorder of bipolar but yet it does not help us understand what the experience might be like for the person. These symptoms have several implications not only for the patient but also for the family members and the patient's nursing staff.

Alexis suffered from symptoms of mania and bipolar depression as her speech was loud and rapid, her facial expression showed many emotions moving quickly from excitement to outrage then to tears and back to excitement again. She also believes that she might recover after managing her symptoms by self-prescribing medication. However, anti-depressant drugs can be inconsistent in their effectiveness because "different people experiencing depression respond to different drugs in different ways" (Beech 2003, p221). The author also acknowledged that some individuals find their depression lifts after taking medication but some find that after they have try taken a combination of drugs, the results and depression remains. In this case, Alexis might have taken the wrong dose or incorrect medication for her symptoms as she is not a qualified psychologist but as a general practitioner. She should seek help from the health professionals in order to minimise her symptoms and to obtain a better outcome.

People with mental illness have a long history of being stigmatized and considered as ''alien,'' and they may suffer from discrimination with regard to employment, health benefits, and marriage (Rosen et al., 2008). Alexis is reluctant to talk about her mental illness and she is not seeking for treatment because she is afraid upon the viewing of others if they knew about her diagnosis. Alexis also blames her husband for not understanding her and for not being considerate. In other words Alexis may interprets events in a negative way, which brings about negative responses