Young Adults with Bipolar Disorder

Biological Factors Strong genetic tie between bipolar and other mental illnesses in a family No specific “causes”, however, certain triggers such as stress or substance use could initiate an episode Prevalence among males and females are equal Individual can manage their episodes by learning the triggers, dealing with the sleep disturbances, and taking prescribed medications Stop taking their medication when they feel better because they think they’re cured Some symptoms can be controlled through diet and/or medication, such as vitamin deficiencies which cause some chemical imbalances (Vitamins and Minerals may be beneficial – http://depression.about.com/cs/diet/a/vitamin.htm?p=1 to read about the specific benefits)

Psychological Factors Often like how they feel and all they accomplish during a manic episode Characterized by variations in mood, from elation and/or irritability to depression causing major disruptions in family, social, and occupational life (Grissold & Pessar, 2000), “Early-onset bipolar disorder (before age 18) carries more comorbidity, suicidality, and substance abuse than later-onset bipolar disorder….The main issue is not whether the … patient is a child or an adult but at what age and stage of development he/she begins to display impairment due to bipolar symptoms.” (Chang, 2007). “Three of the borderline characteristics emerged as potentially useful in differentiating bipolar depression from unipolar depression: ‘I’ve never threatened suicide or injured myself on purpose’...; ‘I have tantrums or angry outbursts’…; and ‘Giving in to some of my urges gets me into trouble’…” (Smith, Muir, & Blackwood, 2005).

Social Factors Considered good workers during their manic episodes, and often don’t want to take medications because it reduces their “production” Often seen as school failures, occupational problems, and poor relationship partners First episode of a male is typically mania, females first episode is most often MDD (major depressive disorder) Have a greater difficulty with job longevity often losing a job during a depressive episode “People at risk for mania have also been found to have high educational and occupational attainment” (Kwapil, Miller, Zinser, Chapman, Chapman, & Eckblad, 2000)

Cultural Factors Risk of suicidal attempts and completed suicides are higher than in many other diagnoses by 10-15% Often co-morbid with eating disorders, panic disorder, substance use disorders, and attention deficit disorder No indication that bipolar disorder is more prevalent in a given racial or ethnic group African-Americans are diagnosed more severe and usually treated unfairly often receiving no access to treatment or are incarcerated for their impulsive activity

Frameworks The individual with bipolar disorder is looked down upon by society and often their family. Often this occurs prior to the individual being diagnosed and society calls them “strange”. Once the diagnosis is known, little changes except that society now believes their reason for shunning this individual is justified. Society assumes the following about individuals with bipolar: you don’t want to be married to them, they don’t make good parents, they’re poor workers, and not very smart. By changing how providers (medical and other professionals) view individuals with bipolar we can change how a person with bipolar views themselves. It is important to equip individuals with knowledge and a good understanding of how their diagnosis may affect their everyday life. By changing how they respond, their family, community, and society may learn that the stereotypical view of someone with bipolar is not the norm. By being open-minded, the professional will be more accepting and understanding about their client’s SCR. Research on why some medications quit working after they’ve been successful for a period of time. Behavioral options for managing uncontrolled, inappropriate behaviors, e.g., the urge to spend as a way of feeling better and ways to help this population discover more appropriate behaviors which would give them equal or near equal gratification. Encouraging this population to discover their strengths, building their support system, and don’t allow them to get away with being “brats”. This comes from personal experience.

Experiences Professionally, my first client with Bipolar disorder said she doesn’t take her medication when she is “manic” because she is able to get a lot done that during her depressive stage she is unable to accomplish at all. Individuals with Bipolar cycle from manic to depression at differing rates. If the cycle is slower, they seem to have longer periods of more normal mood. (Knowledge gained through direct client contact and education.) Most often this population have few close friends and many have mental illnesses. If the spouse of this population has prior knowledge and education, they appear to have a better outlook on what needs to be done. If they discover this after marriage, they not prepared to deal with the problems associated and want out of the marriage.

References Chang, K. (M.D.). (2007). Adult bipolar disorder is continuous with pediatric bipolar disorder. The Canadian Journal of Psychiatry, 52(7), 418-425, Retrieved September 13, 2008, from Academic Search (at EBSCOhost) database. Griswold, K. S., & Pessar, L. F. (2000). Management of bipolar disorder. American Family Physician, 62(6), 1343. Retrieved September 13, 2008, from ProQuest database. Kwapil, T. R., Miller, M. B., Zinser, M. C., Chapman, L. J., Chapman, J., & Eckblad, M. (2000). A longitudinal study of high scorers on the Hypomanic Personality Scale. Journal of Abnormal Psychology, 109, 222-226. Smith, D. J., Muir, W. J., & Blackwood, D. H. R. (2005). Borderline personality disorder characteristics in young adults with recurrent mood disorders: A comparison of bipolar and unipolar depression. Journal of Affective Disorders, 87(1), 17-23. Retrieved September 13, 2008, from Academic Search (at EBSCOhost) database.