Psychological treatments can be particularly helpful in between episodes of mania or depression. They include:
- Psycho-education – finding out more about bipolar disorder
- Mood monitoring – to help you pick up when your mood is swinging
- Mood strategies – to help you stop your mood swings going into a full blown manic or depressive episode
- Developing general coping skills
- Cognitive behavioural therapy (CBT) for depression
Self help treatments can help with episodes of bipolar, including:
- Recognising the signs that your mood is swinging out of control so you can get help early
- Finding out as much as you can about the condition
- Avoiding particularly stressful situations
- Having at least one person that you can rely on and confide in. When you’re well, make sure that they understand about bipolar disorder
- Balancing your life, work, leisure-time and relationships
- Exercising for 20 minutes or so, three times a week, should improve your mood
- Doing things you enjoy.
A person who is suffering with bipolar disorder, if they were to suddenly stop taking there medications it could trigger another mood swing.
Bipolar disorder can have numerous complications, starting with relationships and financial impact. People with bipolar disorder may experience the world as a loving and embracing place and then shut the world out to isolate themselves from the people around them. They can be mean and hurtful and yet appear as though they feel they are logical. Relationships can be thoroughly tested. Simultaneously, it is possible for a victim of bipolar disorder to experience both a depressive cycle and a manic cycle at the same time, which can lead to psychosis.
Statistics
Schizophrenia and bipolar disorder share genetic roots that appear to be specific to serious mental disorders, and are not shared by non-psychiatric illnesses.
Children with bipolar disorder often present with mixed mania, rapid cycling and psychosis (e.g. delusions and hallucinations). Bipolar disorder was once thought to occur primarily in adults.
Graph 2 is showing the Number of us acute care inpatient discharges per 10,000 children and adolescents with a principle diagnosis of psychiatric disorders (1996-2004).
Bipolar disorder related hospitalization was more common among female adolescents and adults, however, male children were at greater risk than female children which is shown in graph 3 below.
Graph 3 is showing the trends in discharges per 10,000 children and adolescents with a principal diagnosis of bipolar disorder by gender and race.
Risk factors for Bipolar disorder
Depression, cyclothymiacs and hyperthermia
These three types could also be pioneer to develop into bipolar disorder. Studies have shown that children of parents with bipolar disorder were significantly more likely than children of non-bipolar parents to exhibit behaviours such as the following:
- Mood liability
- Low energy
- Anxious/worried
- Hyper-alert
- Attention problems
- Distractibility
- School role impairment
- Easy excitability
- Sensitivity
- Somatic complaints
- Stubborn/determined disposition
http://www.bipolar.com.au/understanding/
Eating disorder
Description on eating disorder
Eating disorders involve self-critical, negative thoughts and feelings about appearance and food, and eating behaviour that harms normal body composition and functioning.
Individuals who wish they were thinner do suffer from a true psychiatric eating disorder, the number of individuals who have of the two major farms of eating disorders are – anorexia nervosa and bulimia, which has risen dramatically in recent years. Obesity can sometimes be considered as a third eating disorder. It is not viewed as a true psychiatric problem, unless attempts to lose weight become abnormally obsessive or concern about body image becomes so severe that it interferes with normal functioning and good mental health. These emotional problems frequently accompany obesity. Anorexia nervosa (severe self-starvation) and bulimia (binge-eating and purging) have striking, sometime life-threatening physical features that must be treated medically. The roots of these disorders are emotionally and psychological and treatment approaches are primarily psychological.
Psychological signs of eating disorders
Eating disorders are disorders in which eating behaviours become distorted from eating too little (anorexia) to eating too much (binge eating disorder) to eating too much and then bringing it back up afterwards (bulimia). Eating disorders usually have psychological signs that may be secondary and result from the eating behaviours or primary such that the eating behaviours result from the psychological distress.
Treatment will vary according to the needs of individuals, but those suffering from eating disorders will need to be more ready to offer their input into the treatment plan so that the best possible routes of treatment are explored.
Psychological signs associated with eating disorders
Common psychological signs associated with eating disorders include low self confidence and poor self image. Indicators of low self confidence include that the individual avoids social events, bows out of competitions (including sports and academics) and criticises oneself repeatedly for example, saying “of course I made a mistake, I always make a mistake, I’m so dumb!” Poor self image can often be observed in deeply critical remarks about one’s own body, indications that one is never satisfied with how they may look and repeated comments about wanting to lose weight or change their image. Depression also commonly accompanies eating disorders, which can be observed in such signs as sleeping excessively or not at all, low energy levels and general apathy.
Psychological illnesses associated with eating disorders
In addition to common psychological signs, there are a variety of psychological illnesses that have been proven to associate with eating disorders, these are as follows:
Causes
There is no single cause for eating disorder, although concerns about weight and body shape can play a major role in all eating disorders. The actual cause of these disorders appears to result from many factors such as:
- Cultural pressures
- Family pressures
- Emotional disorders
- Personality disorder
- Genetic and biological factors may also play a role.
Symptoms of eating disorders
A person who has several of the following signs may be developing or has already developed an eating disorder:
Anorexia:
The individual:
- Has lost a great deal of weight in a short period of time
- Continues to diet, although bone-thin
- Reaches diet goal and immediately sets another goal for further weight loss
- Remains dissatisfied with appearance, claiming to feel fat, even after reaching weight loss goal
- Prefers dieting in isolation to joining a diet group
- Loses monthly menstrual periods
- Develops an unusual interest in food
- Develops strange eating rituals and eats small amounts of food, e.g., cuts food into tiny pieces or measures everything before eating into extremely small amounts
- Becomes a secret eater
- Becomes obsessive about exercising
- Appears depressed much of the time
- Begins to binge and purge
Bulimia
The individual:
- Binges regularly (eats large amounts of food over a short period of time) and purges regularly (forces vomiting and/or uses drugs to stimulate vomiting, bowel movements or urination)
- Diets and exercises often, but maintains or regains weight
- Becomes a secret eater
- Eats enormous amounts of food at one sitting, but does not gain weight
- Disappears into the bathroom for long periods of time to induce vomiting
- Abuses drugs or alcohol, or steals regularly
- Appears depressed much of the time
- Has swollen neck glands
- Has scars on the back of hands from forced vomiting
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Treating eating disorders
Common treatment for eating disorders include counselling/therapy, family counselling/therapy, cognitive behaviour therapy (to change food and eating behaviours), the use of support groups or group therapy, and nutritional counselling and planning.
Medication may also be employed to treat associated condition of an eating disorder, such as depression.
Preventative measures for Eating Disorders
Prevention methods for eating disorders
Eating disorders such as anorexia bulimia and binge eating disorder are most prevalent in countries and cultures which place a high degree of importance about being thin and presenting an appealing image. Most individuals that suffer from an eating disorder feel that they are not as thin, and therefore as successful, as they would like to be and use their eating behaviours to either attempt to restrict their calories which would then lead to them loosing further weight, or find relief from binge eating and then being sick afterwards.
Prevention method
There are a wide range of different prevention methods to avoiding an eating disorder. Maintaining a healthy balance and healthy outlook on life are two keys mean of prevention. A healthy balance in life on an Individual doesn’t just mean on their confidence and etc, it also involves a balance in work/school and personal life, a healthy diet with occasional treats, and exercising for fun with an appropriate amount of rest and relaxation.
A healthy outlook is where an individual can recognise the ‘big picture’, that weight and appearance is just one facet of a person. There is more to a healthy outlook and this is maintaining a healthy outlook which allows an individual to remember that (s) he has both strengths and weaknesses, but does not allow him/her to get caught up in flaws.
Family and friends can help individuals stay strong and prevent an eating disorder by:
- Praising an individual’s talent and strengths
- Listening to, and discuss, an individual’s thoughts, feelings and fears
- Supporting an individual’s hopes and dreams
- Reminding an individual that a healthy body, not necessarily a slim body is best
- Encouraging an individual to explore hobbies in which (s)he shows an interest
- Helping an individual make new friends who are also supportive
- Barring unrealistic and unhealthy diets and excessive exercise regimes
There has been a new term for an eating disorder which is ‘Orthorexia’; this is a relatively newly diagnosed disorder that is diagnosed to an individual when they become obsessive about their eating patterns. Unlike anorexia or bulimia, the person permits themselves to eat but become so engrossed with what they are eating that their thoughts become over taken by their diet.
They have a very strict regime for their diet, which could be that they only allow themselves healthy food and scrutinise the nutritional content of every item that they eat. Calories, vitamins, and nutrient become the central point of the food and anything that is found to contain even just a trace of what is on the ‘not allowed’ list is not to be consumed.
There is a lot of media around that is almost like a peer pressure to be thin and skinny, and to look like what is in the magazines.
Alzheimer’s
Description of Alzheimer’s
Alzheimer's disease is the most common form of dementia, which is a group of symptoms that are associated with an ongoing decline of mental abilities, such as memory and reasoning.
Alzheimer's disease attacks nerves, brain cells, and neurotransmitters (chemicals that carry messages to and from the brain). Although Alzheimer’s disease is often associated with increasing age, the exact cause is unknown.
Alzheimer’s disease is a progressive condition, which means that it will continue to get worse as it develops. Early symptoms include:
- minor memory problems
- difficulty saying the right words
These symptoms change as Alzheimer’s disease develops, and it may lead to:
- confusion
- personality changes
- a total change in behavior
Causes of Alzheimer's disease
Alzheimer’s disease is caused by parts of the brain wasting away, which damages the structure of the brain and how it works. The medical name for wasting away is ‘atrophy’.
The atrophy mainly affects the cerebral cortex, which is the layer of grey matter that covers the brain. Grey matter is responsible for processing thoughts.
Plaques and tangles
As the cerebral cortex wastes away, clumps of protein, known as ‘plaques’ and ‘tangles’, start to form in the brain. The plaques and tangles start to destroy more brain cells, which makes the condition worse. They also affect the neurotransmitters (chemicals that carry messages to and from the brain).
Risk factors
It is still unknown what actually causes the deterioration of brain cells, although there are several factors that are known to affect the development of Alzheimer's disease. These are as follows:
Age
Age is the greatest factor in the development of Alzheimer's disease. The likelihood of developing the condition doubles every five years after you reach 65 years of age. However, it is not just older people who are at risk of developing Alzheimer's disease.
Family history
Alzheimer's disease can also be inherited (run in the family), although the risk is only marginally higher than that of someone who has no family history of the condition.
In cases where Alzheimer's disease is inherited, the symptoms may start at a relatively early age (between 35 and 60 years of age).
Down's syndrome
People with (a genetic disorder that affects physical appearance, as well as the ability to learn and develop mentally) are at a higher risk of developing Alzheimer's disease.
This is because people with Down's syndrome have an extra copy of chromosome 21, which contains a protein that is found in the brain of those with Alzheimer's disease. Therefore, people with Down's syndrome have a higher-than-average amount of this protein, which could contribute to developing Alzheimer's disease.
Whiplash and head injuries
People who have had a severe head injury, or severe whiplash (a neck injury caused by a sudden movement of the head forwards, backwards, or sideways), have been found to have a higher risk of developing Alzheimer's disease.
Aluminum
Aluminum is a naturally occurring substance that is found in food and plants. It is also added to products, such as pans, packaging, and medicines. The body only absorbs a minimal amount of aluminum, which is usually passed out of the body in urine.
It was suggested that aluminum could be a possible cause of Alzheimer's disease because research found that the 'plaques' and 'tangles' in the brain contain aluminum. However, further research has failed to prove a link between aluminum and Alzheimer's disease.
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Symptoms of Alzheimer's disease
Many of the symptoms of Alzheimer’s disease are similar to those of other conditions.
No two cases of Alzheimer's disease are ever the same because different people react in different ways to the condition. However, generally, there are three stages to the condition:
Alzheimer’s disease tends to ‘creep up’ on you, so you may not notice the symptoms immediately. The symptoms progress slowly over a seven to ten year period. However, the rate at which they progress will differ for each individual. The three stages of Alzheimer’s disease are described below.
Mild Alzheimer's disease
Common symptoms of mild Alzheimer's disease include:
- Confusion
- Poor memory and forgetfulness
- Mood swings
- Speech problems
These symptoms are a result of a gradual loss of brain function. The first section of the brain to start deteriorating is often the part that controls the memory and speech functions.
Moderate Alzheimer's disease
As Alzheimer's disease develops into the moderate stage, it can also cause:
- Hallucinations - where you hear or see things that are not there
- Delusions - where you believe things that are untrue
- Obsessive or repetitive behavior
- Thinking you have done or experienced something that never happened
- Disturbed sleep
- Incontinence - where you unintentionally pass urine (urinary incontinence), or stools (faecal or bowel incontinence)
During the moderate stage, you may have difficulty remembering very recent things. Problems with language and speech could also start to develop at this stage. This can make you feel frustrated and depressed, leading to mood swings.
Severe Alzheimer's disease
Someone with severe Alzheimer's disease may seem much disorientated and show signs of major confusion.
This is also the stage where people are most likely to experience hallucinations and delusions. They may think that they can smell, see, or hear things that are not there, or believe that someone has stolen from them or attacked them when they have not. This can be distressing for friends and family, as well as for the person with Alzheimer's disease.
The hallucinations and delusions are often worse at night, and the person with Alzheimer's disease may start to become violent, demanding, and suspicious of those around them.
As Alzheimer's disease becomes severe, it can cause also cause a number of other symptoms such as:
- Difficulty swallowing
- Difficulty changing position or moving from place to place without assistance
- Weight loss or a loss of appetite
- Increased vulnerability to infection
- Complete loss of short-term and long-term memory
During the severe stage of Alzheimer's disease, people often start to neglect their personal hygiene. It is at this stage when most people with the condition will need to have full-time care because they will be able to do very little on their own.
Life expectancy
Alzheimer's disease affects a person's ability to look after themselves when they are unwell, so another health condition can develop rapidly if left untreated. A person with Alzheimer's may also be unable to tell someone if they feel unwell or uncomfortable.
Alzheimer's disease can shorten life-expectancy. This is often due to developing another condition, such as pneumonia (inflammation of the lungs), as a result of having Alzheimer's disease. Therefore, in many cases, Alzheimer's disease may not be the actual cause of death, but it can be a contributing factor.
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Diagnostics
There is no singular test that can definitively diagnose Alzheimer's disease, although imaging technology designed to detect Alzheimer's plaques and tangles is rapidly becoming more powerful and precise. Still, a comprehensive, competent diagnostic workup by a skilled physician can pinpoint the cause of Alzheimer's-like symptoms with over 90% accuracy. Diagnosis of Alzheimer's disease can include the following:
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Medical history -- This should include questions about past illnesses, prior injuries and surgeries, and current chronic conditions in order to identify other possible causes for Alzheimer's-like symptoms. For instance, if you suffered a serious head injury any time in your past, it could account for the problems with memory or concentration that you're currently experiencing. If you’re loved one has heart disease that could be reducing blood flow to the brain and causing forgetfulness.
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Medication history -- This should include allergies, experienced side effects from past medications, and a list of current medications and dosages. Not only will this inform any future prescription decisions; it also might reveal a medication interaction or over dosage that accounts for you or your loved one's confusion and other symptoms.
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Mood evaluation -- The evaluation should include an assessment for anxiety or depression, which can create Alzheimer's-like symptoms in older people as well as occur concurrently with Alzheimer's or another dementia. Depression, in particular, can result in a set of symptoms collectively known as pseudodementia. If a mood disorder is detected, it can be treated alongside other disorders, such as Alzheimer's.
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Mental status exam -- To assess memory, concentration, and other cognitive skills. The mental status exam is a research-based set of questions that results in a score that indicates a general level of impairment. If you or your loved one scores high on a mental status exam, there is less of a chance that Alzheimer's is the culprit; another (possibly treatable) condition may be responsible for the symptoms. However, highly educated individuals have scored high on mental status exams even though they do have Alzheimer's disease.
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Complete physical exam -- To assess hearing, vision, blood pressure, pulse, and other basic indicators of health and disease. A current physical exam can detect acute medical conditions such as an infection that might be causing Alzheimer's-like symptoms.
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Appropriate laboratory tests -- These will vary according to you or your loved one's medical history and current symptoms. Blood tests are the most common laboratory tests ordered. For example, if you are exhibiting pre-diabetic symptoms, a blood glucose test would be ordered. Aside from blood tests, if your loved one's symptoms came on suddenly and include severe confusion, a urinalysis would probably be conducted to rule out a urinary tract infection.
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Neurological exam -- This should include an examination of the motor system (movement), reflexes, gait (walking), sensory functioning, and coordination in order to detect problems with the nervous system that may be causing problems with thinking and behaviour.
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Imaging procedures -- Detailed pictures of the brain, such as a CT scan (computed tomography), an MRI (magnetic resonance imaging), or a PET scan (positron emission tomography) to identify changes in brain structure or size indicative of Alzheimer's, or to look for brain tumours, blood clots, strokes, normal pressure hydrocephalus (NPH), or other abnormalities that might account for Alzheimer's-like symptoms.
There is no particular kind of physician that specializes in Alzheimer’s disease. Many people first seek help from their primary care physician, who may oversee the total diagnostic process or refer the individual to any of the following specialists:
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Neurologist -- Specializes in diseases of the nervous system, including Alzheimer’s, Parkinson’s, epilepsy, and stroke.
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Psychiatrist -- Specializes in mental, emotional, and behavioural disorders.
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Neuropsychologist -- Specializes in the brain-behaviour relationship and can conduct neuropsychological testing to determine the type and level of impairment due to Alzheimer's, head injury, stroke, or other conditions.
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Treatment of Alzheimer's disease
Medicines
Medicines called acetylcholinesterase inhibitors are used to help people with moderate Alzheimer's disease. However, they aren't very effective and most people get little benefit from them. They may slow down the progression of symptoms and delay the need for residential care. Your doctor may prescribe one of the three acetylcholinesterase inhibitors available:
- Donepezil (Aricept)
- Rivastigmine (Exelon)
- Galantamine (Reminyl)
Another medicine, memantine (Ebixa), is for people in the late stages of Alzheimer's disease. However, there isn't enough evidence to show that memantine is effective and the National Institute for Health and Clinical Excellence (NICE) recommends that doctors don't prescribe it. Memantine may be available for some people who are taking part in a clinical trial.
Sometimes, antidepressant medicines are prescribed to help treat the depression that can be associated with Alzheimer's disease. Your doctor may prescribe tranquillisers, which can help with the behavioural problems of Alzheimer's disease such as irritability and aggression.
Talking therapies
Your doctor may suggest other treatments, such as:
- group activities and discussions – these aim to stimulate your mind (sometimes this is referred to as cognitive stimulation therapy)
- reminiscence therapy – this involves discussing past events in groups, usually using photos or familiar objects to jog your memory, although there are conflicting opinions on whether this is effective
http://hcd2.bupa.co.uk/fact_sheets/html/alzheimers_disease.html#5
Bibliography
The concept of mental health
What is mental illness?
Who does mental health affect?
AO2
In this section I am going to give an explanation of three effects of mental-health illness on the person who uses services, their family and society in both short and long term
Living with bipolar disorder from diagnosis to treatment
A person with bipolar disorder often lives for years without being correctly diagnosed. People may not see their high energy or overjoyed periods as a problem, and don’t look for treatment. A person with bipolar disorder usually first seeks treatment because of depressive periods. He or she may then be misdiagnosed as having pure, “unipolar” depression. Misdiagnosis can happen when the patient is not thoroughly evaluated or neglects to discuss the ‘up’ periods, not recognizing anything peculiar or detrimental about the ‘highs’; A physician may also make a mistake in diagnosis by attributing symptoms to depression, schizophrenia, a brain tumour, stroke, substance abuse, poor school performance or trouble in the workplace.
People with bipolar disorder often describe severe ‘mood shifts’ that go from extreme energy to deep despair within a very short period of time. After being diagnosed a person with bipolar disorder may believe life will never be the same. It can be painful to review how the illness has affected his or her life. Someone who needs to be hospitalized may experience feelings of failure, shame or embarrassment due to the stigma of mental illness. At this time, support from the individual’s family, friends and health care providers is very essential.
Treatment can be very effective and positive plans and goal-setting can motivate a person with the condition to take it day by day towards wellness. Friends and family can encourage a person with bipolar disorder towards a healthier lifestyle with reminders to keep a regular sleep cycle, eat well, exercise, avoid alcohol and substance abuse, join support groups and keep regular health care appointments while continuing treatment. Since loss of sleep can precipitate acute manic episodes, it is very important for the individual to maintain regular sleeping hours even when they travel and change time zones.
After adjusting to life with bipolar disorder people who are treated successfully develop more positive feelings about the future. They reach a stage where the illness no longer defines them.
What you should do if someone close to you has bipolar disorder
- Be understanding
- Offer practical help
- Encourage them to seek help if they appear to be becoming unwell
- Take care of yourself
Seek help immediately if:
- Your relative or friend is not able to look after him or herself properly
- You find that they are seriously neglecting themselves by not eating or drinking
- They talk of harming or killing themselves
- They are starting to become manic and you notice that they are happier, more irritable, talking faster than usual, sleeping less than normal and especially if they are behaving in an unusually risky way
Your loved one’s mania or depression can be distressing, exhausting and can leave you feeling completely powerless to help. You should seek help
Having a family member with Bipolar Disorder
When one of your family members suffer from bipolar disorder it can often be difficult to know what to say. They may see everything in a negative way and not be able to say what they want you to do. It is always best to just listen and be patient and understanding with them. During mania, the person could appear to be happy, energetic or outgoing, but the excitement of any social situations will tend to push their mood even higher. If someone close to you has bipolar disorder, your love and support can make a difference in treatment and recovery. A family member can always help by learning about the illness, offering hope and encouraging the individual, keeping track of symptoms, and being a partner in treatment. Caring for a person with bipolar disorder can take a toll and you can often enough neglect your own needs. So it is very important to find a balance between supporting your loved one and taking care of yourself.
Dealing with ups and downs of bipolar disorder can be difficult and not just for the person with the illness. The moods and behaviours of a person with bipolar disorder can affect everyone around that individual especially family members and close friends. During a manic episode, the family members and close friends have to cope with reckless antics, outrageous demands, explosive outbursts, and irresponsible decisions. When the mania episode has passed, it often falls on them to deal with the consequences. During episodes of depression, they may have to pick up the slack for a loved one who doesn’t have the energy to meet responsibilities at home or work.
Majority of people who have been diagnosed with bipolar disorder are able to stabilize their moods with proper treatment, medication and support. The following are different ways a family member or a close friend can help an individual with bipolar disorder:
- Learn about bipolar disorder
By educating yourself about bipolar disorder, you are able to learn about the symptoms and treatment options. The more you increase your knowledge about bipolar disorder, the better equipped you’ll be to help your loved one and keep things in perspective.
- Encourage the person to get help
The sooner the individual has been treated for bipolar disorder, the better the prognosis the individual would have.
It is always great to let the individual know that if they ever need a sympathetic ear, encouragement or assistance with treatment that you will always be there for them. It is always great to remind the individual that you care about them a lot and you’ll do whatever you can to help them.
The individual will take time to get better, even when a person is committed to treatment. It is always best to be patient with the pace of recovery and prepare for setbacks and challenges. Managing bipolar disorder is a lifelong process.
A03
In this section I am going to be researching the preventative and coping strategies and practitioners/individuals that could provide support for the person who uses services, including research on one piece of appropriate current legislation
Preventative measures for Bipolar disorder
Some patients do very well once they are taking medication or having therapy, which then makes them able to achieve a high standard of living. Some patients refuse to stay consistent with their medication and can not tolerate the side effects. Patients who want to achieve a good standard of living must remain active in their own therapies and their own treatment.
Coping strategies
Bipolar disorder: Key recovery concepts
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Hope. With good symptom management, it is possible to experience long periods of wellness. Believing that you can cope with your mood disorder is both accurate and essential to recovery.
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Perspective. Depression and manic-depression often follow cyclical patterns. Although you may go through some painful times and it may be difficult to believe things will get better, it is important not to give up hope.
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Personal Responsibility. It’s up to you to take action to keep your moods stabilized. This includes asking for help from others when you need it, taking your medication as prescribed and keeping appointments with your health care providers.
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Self Advocacy. Become an effective advocate for yourself so you can get the services and treatment you need, and make the life you want for yourself.
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Education. Learn all you can about your illness. This allows you to make informed decisions about all aspects of your life and treatment.
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Support. Working toward wellness is up to you. However, support from others is essential to maintaining your stability and enhancing the quality of your life.
Source:
Tips for successful bipolar disorder treatment:
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Be patient. Don’t expect an immediate and total cure. Have patience with the treatment process. It can take time to find the right program that works for you.
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Communicate with your treatment provider. Keep the lines of communication open with your doctor or therapist. Your treatment program will change over time, so keep in close contact with your provider. Talk to your provider if your condition or needs change and be honest about your symptoms and any medication side effects.
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Take your medication as instructed. If you’re taking medication, follow all instructions and take it faithfully. Don’t skip or change your dose without first talking with your doctor.
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Get therapy. While medication may be able to manage some of the symptoms of bipolar disorder, therapy teaches you skills you can use in all areas of your life. Therapy can help you learn how to deal with your disorder, cope with problems, regulate your mood, change the way you think, and improve your relationships.
My service user
In this section, I am going to talk about my service users coping strategies and what support she encountered when recovering. I may state my service user under the name ‘Lauren’, this is not my service users real name I have changed her name for the purpose of confidentiality and to keep her anonymous.
When my service user was diagnosed with Bipolar Disorder she required certain adjustments. She described herself having to make adjustments like a recovering alcoholic who had to avoid alcohol or diabetics who had to start taking insulin for the first time. My service user stated that she had to make a healthy lifestyle choice for herself, this helped her to cope with having the disorder and it helped to keep her symptoms under control which then meant that if she had her symptoms under control it would then minimize her mood swings and that meant she was able to take more control of her life.
There was no preventative measures for my service user, because it come out of the blue for her, so there was nothing that she could have done to minimize her getting diagnosed with bipolar disorder. Another coping strategy for my service user was that she said being able to change her lifestyle helped control her symptoms, but when she first got diagnosed with bipolar disorder she struggled managing it properly, but then she went through the proper treatment, which included medication and therapy.
My service user also stated that when she was first diagnosed with bipolar disorder, she didn’t have any knowledge about what disorder she had and she refused to participate in her treatment, and this is why her manic and depression episode worsened. After a while it got to the point where my service user needed the help, because it was affecting her family, friends and work. She needed the different coping strategies where she was able to handle her lifestyle in a healthy cycle instead of a constant struggle. As soon as she started her treatment and coping strategy was where she learnt everything there was to know about bipolar disorder, and had full participation with her treatment.
She also looked at the different symptoms that could come from having the disorder, because this then built her awareness on what could happen, and if she ever encountered any of the symptoms she could try and work on controlling them as much as possible. She said if she was to give another individual advice on coping strategies if diagnosed with bipolar disorder it would be the following:
- Fully participate in treatment and medication
- Increase your knowledge about bipolar disorder
- Learn about different ways you can control your symptoms, the more knowledge you have with the different symptoms the more you may be able to control them
- The more prepared you are, the easier you will find living your life like normal!
When I found out the key information I needed to know about the disorder I had been diagnosed with, Lauren then collaborated with her doctor and therapist and together they came up with a treatment planning process.
In order for my service user to control her symptoms, she would do different things such as:
- Monitor her symptoms and moods
- Speak to close friends and friendships
- She would use different tools to stabilize her moods
- Develop a daily routine
- Keep herself stress free as best as possible
- She would watch her diet
Monitor her symptoms and moods
When my service user monitored her mood and symptoms, she would pay close attention to how she was feeling on a daily basis. To start off with she wouldn’t pay attention to her mood swings, but then she didn’t have any idea on what symptoms would occur if she was about to have an episode. So she started to keep a close eye on how she would feel before, during and after a mania or depression occurrence. She kept two different diaries, where one she wrote in to keep up-to-date on how she felt and what she did and etc on a day-to-day basis, and then she would also keep another one where she would keep information about how she felt, sleeping patterns, energy levels and thoughts she had on that day. She felt this was a useful tool for keeping an eye on her mood swings and symptoms. The reason for her doing this, was because she felt that if she monitored this, she would be able to catch on if she was about to have an episode and would be maybe able to prevent a her mood swings for changing instead of it turning into a full blown episode that she used to have when she was first diagnosed with Bipolar Disorder.
She researched the triggers and early warning signs from the internet and wrote them down and this is what she had found:
From this Lauren would then compare herself to following lists and see if she had any comparisons to any of the above. Her lists were much longer, but she has given me a couple of examples of what she would use for a comparison mechanism. She would also have chats with her doctor on a regular basis who also kept up-to-date with her moods and how she had been feeling, if she had any high or low moments during the week and if so how did it make her feel. They would do this so they could also monitor how she was feeling.
Lauren always thought it was best to have regular mood monitoring, because she was then sure that she wouldn’t have any relapses. Her mum also keep a mood chart on the fridge were every morning, afternoon, and just before she went to bed she would log her daily emotional state and symptoms if any had occurred. Her mum always kept on her case so if Lauren ever forgot to fill in her diary or anything then at least she would have a list of how her daughter had been feeling and etc.
Use different tools to stabilize mood swings
My service user would use a wide range of tools to use as a coping strategy to maintain a stable mood or to get better when feeling low or high. Lauren found different coping techniques that worked best for her moods, and her situation. Some would only reduce symptoms and some would maintain full balance of mood and symptoms these were as follows:
- She would always get a full eight hours of sleep
- She would have ‘me time’ so she was able to relax and chill out
- Write in her diary
- She would run twice a week to keep a balance routine
- She cut down on fatty food, sugar, alcohol and caffeine
- Attended a support group, where she would then have individual chats with a support person
- Have regular check ups with the doctor and therapist
Develop a daily routine
Before my service user was diagnosed with Bipolar Disorder, she never had a balance routine for her day, but since she has been diagnosed with it, she knew she had to change her daily routine because it has a significant impact on how she would feel and etc.
She balanced out her sleep, eating and exercise patterns, because these were 3 of the main areas she never looked after properly.
There are many things that Lauren did on a daily basis such as:
- Made a routine to her day
Lauren would do this because she felt that it helped to stabilize her mood swings. She would set times for sleeping, eating, socializing, exercising, working, and relaxing. She felt that if she was to maintain a regular activity, and kept herself busy because she thought it helped to keep her emotions balanced.
Lauren joined a gym and would run twice a week, she thought this reduced the number of episodes she would encounter. Furthermore, she would also walk her dog every day because this was a good fitness level just to relax and reduce any stress or worries.
- Keep to a strict sleeping pattern
The doctor had informed my service user that if she was to get not enough sleep then it could trigger mania, so it was very important for my service user to get plenty of sleep, not too much but not too little. She noticed that if she didn’t get 8 hours of sleep a night, then she would have problems the next day and would start to get symptoms of an episode coming, however if she was to get too much sleep it would worsen her mood swings. So it was appropriate for her to get the right amount of sleep that was just right for her body. She would maintain a normal sleeping pattern, going to bed and waking up at around the same time each day. When she was first diagnosed with bipolar disorder, she found this hard to do, and there would be some days were she wouldn’t keep it on a regular pattern, but it become easier to her the more she tried to stick to it.
AO4
Mental illnesses can take many forms, just as physical illnesses do. Mental illnesses are still feared and misunderstood by many people, but the fear disappears if people learned about their illness better.
Mental health is the positive balance of the social, physical, spiritual, economic and mental aspects of one’s life and is as important as physical health. When people are mentally healthy they are able to live productive daily activities, maintain fulfilling relationships with others, and have the ability to adapt to changer and cope with stress.
Alternatively, mental illness is a psychological or behavioural phenomenon that leads to disorder or disability that is not part of normal development. Mental illness can occur when the brain (or part of the brain) is not working well or is working in the wrong way. When the brain is not working properly, one or more of its six functions will be disrupted (thinking or cognitive, perception or sensing, emotion or feeling, signalling, physical functions and/or behaviour). When these functions significantly disrupt a person’s life, we say that the person has a mental disorder or a mental illness. ()
The more we learn about mental health, the better we understand the impact that mental health problems can have on personal, social, civic and economic development. Addressing mental health problems early in life enhances the opportunity for young people to get well and stay well through adulthood, improving not only the lives of individuals and families, but also enhancing civil society increasing opportunity for socio-economic development and encouraging global acceptance of human and cultural diversity. ()
Myths of mental illness
There are many myths about mental illness. Until people learn the truth, they will continue to deny that mental illness exists at all or to avoid the topic entirely.
Different myths and some true are as follows:
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People with mental illness are violent and dangerous.
As a group, mentally ill people are no more violent than any other group. In fact, they are far more likely to be the victims of violence than to be violent themselves.
- People with mental illness are poor and/or less intelligent.
Many studies show that most mentally ill people have average or above-average intelligence. Mental illness, like physical illness, can affect anyone regardless of intelligence, social class or income level.
- Mental illness is caused by a personal weakness.
A mental illness is not a character flaw. It is an illness, and it has nothing to do with being weak or lacking will-power. Although people with mental illness can play a big part in their own recovery, they did not choose to become ill, and they are not lazy because they cannot just "snap out of it."
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Mental illness is a single, rare disorder.
Mental illness is not a single disease but a broad classification for many disorders. Anxiety, depression, schizophrenia, personality disorders, eating disorders and organic brain disorders can cause misery, tears and missed opportunities.
I did a primary research and made a list of what was the first thing people thought of when they heard of mental illness/health, and here is a couple of the things people thought:-
The above words were from a primary research of just walking around and asking people their opinion of people who are mentally ill. These words to people with an illness can belittle them and offend them. Many people use these terms without intending any harm. When I asked people how much they knew about different illness, many people answered that they didn’t know much, this is meaning that there is a lack of knowledge, so instead of learning about people could be criticised of being stereotypical.
Mental illness in the media
How media portrays people with mental-health needs – positive and negative effects of this portrayal alongside realistic and informed recommendations for improvements
People with mental disorders are, many times, not described accurately or realistically in the media. Movies, television and books are often present people with mental illnesses as dangerous or unstable. News stories sometimes highlight mental illness to create a sensation in a news report, even if the mental illness is not relevant to the story. Advertisers use words like “crazy” to convey that their prices are unrealistically low and to suggest the consumers can take advantage of them. ()
A report by the mental health charity mind says that media coverage has a direct impact on the lives of people diagnosed with psychiatric disorders. ()
Television, radio and newspaper play an essential role in the public perception of mental illness. While the media often spread unhelpful stereotypes of mental illness, if properly harnessed, they are also used to challenge prejudice, inform and initiate debate and can be helpful to combat the stigma experienced by people with mental illness and their carers. ()
The mass media’s power to impact public perception and the degree to which people are exposed to media representations makes the mass media one of the most significant influences in developed societies. When it comes to mental illness, the media tends to skew reality. For those suffering from mental illnesses, the implications of the often negative and inaccurate portrayals of mental health issues are significant. Inaccurate information in the media about mental illness, even if the portrayal of an individual is positive, results in misunderstandings can have considerable and real consequences. Example, inaccurate depictions of schizophrenia (which is often confused in the media with multiple personality disorder) can lead to false beliefs, confusion, conflict, and a delay in receiving treatment.
Understanding television
British television admits that there is an industry heavily influenced by a lack of consideration for others, disingenuity and their importance is to achieve ratings for programmes. Psychiatrist hoping to use television to challenge the stigma of mental illness must, therefore, take account of the intense competition in the world of television. However, much stereotypic portrayal of mental illness is on television, and this is accepted by programmes because it makes viewers acknowledge the common currency in the culture around them; images of madness and distress would attract attention and boost ratings. Stereotypes provide a useful way into dialogue with programme makers. The was a programme on Channel 4, Psychos provides an illustration. The belief that the title and content of the programme could serve only to harm the interest of people with mental illness is the short sighted and unimaginative view. The power of television to reach a large audience so swiftly challenges anyone seeking to alter public opinion about mental health. ()
Changing times for anorexia – the female ‘image ideal’ through media
Up until the late 1800’s, the rubenesque women dominated the ideal female body image. Until the early 1900’s, for a women to have extra weight on her body and look voluptuous was a sign of good health and wealth.
Here are paintings that show what females ideal body looked like, in different times.
In the early 1900’s, the culture changed from women who were plump and voluptuous to a thinner frame with less curves. The new female ideal of the 1920’s was the thin, short haired flapper. Culture began to shape the female body image through cosmetics, fashion, Hollywood and advertisement. Here is a commercial advertisement to the right that portrayed what an ideal female body should have looked like at the time.
In the 1950’s the ideal female body image was Marilyn Monroe. Marilyn was a size 14. In today’s society through the media, she would have been portrayed to be chubby or overweight even though she portrayed a fabulous figure, which is shown in the picture to the left.
In the 1960’s the waif-like look became popularized by the supermodel Twiggy Lawson. This was the first time in history that an underweight women became the standard for the ideal body image.
In the 1970’s singer Karen Carpenter began her battle with anorexia nervosa. She died in 1983 from heart failure related to the disease. America began to pay more attention to eating disorders after this unfortunate loss. Here is a picture of the before and after stages of Karen Carpenter, below.
There was a research on women’s magazines for the number of diet and weight articles they contained. It seemed that the trend in the 1980’s showed from their results, was to become even thinner and more tubular shaped. In this context, tubular shaped means that women’s bust and hips were decreasing as their height was increasing. There is a cultural expectation for women bodies to be ultra thin. Hence, magazines sending out different messages that emphasize exercise and fitness in addition to dieting. There was a study that was conducted in 1992, and today these trends continue even more. Not only are “ideal” women supposed to be ridiculously underweight, but they are also supposed to be physically fit and toned without being too muscular. The picture on the right illustrates how the female image ideal of this time was extremely thin and toned and this was being portrayed to “normal people”.
On the right is the cover of the May issue for Harper’s Bazaar magazine (2002), which looks very similar to the 1988 cosmopolitan cover. Both models are very thin, toned and have very little fat on their bodied.
On the left is a image of what models tend to look like today. It illustrates just how thin the body “ideal” for women has become. Due to the media surrounding women with so many images like these our culture has accepted this body type to be ‘ideal’, it makes sense that most women feel that their bodies are inadequate because they are basing their comparisons to these super slender body images that they come in contact with every day.
Bibliography - Changing times for anorexia – the female ‘image ideal’ through media
More information about media portrayal of the female body
It is not uncommon for people to believe that the media and advertisements have no effect on their beliefs or values they hold. However, it is untrue. Although some people believe advertisements are trivial they have significant cumulative, unconscious effects. A clear-cut example of how our cultural standards are influenced by these advertisements can be is seen in the current emphasis placed on the ultra thing female body. Advertising creates an ‘ultimate standard of worth, so that women are judged against this standard all the time, whether we choose to be or not’ (Kilbourne, 1987).
Advertisement is aimed at doing more than just selling their products, they supply us with ideas and images of normalcy and tell us what we should and should not be. Majority of all advertisement show excessively thin, beautiful, young and flawless models displaying their products and women are repeatedly being exposed to these types of images both in printed ads, television and movies.
In my opinion the negative side of creating this image towards normal women, is it is creating a bad illusion, a fantasy of what they could do if they were to change their diet and exercise more and etc. Furthermore, the pictures that we look at today are not even real, the ads of the very beautiful and thin models are altered through photographic techniques such as airbrushing, soft focus camera’s, composite figures, editing and filters. They basically blur the boundaries between a fictionalized figure and reality.
Here is how nowadays trends are changing people:
As you can see from the 2 pictures of Brittany Murphy, the before picture is from 1995 and the after picture is from 2002. These pictures are showing how movies and Hollywood actresses contribute to the unhealthy, extremely thin body image that is the current trend in our culture.
My conclusion
The negative side of media is that they show unrealistic portrayals of what female bodies should be like. Pictures that are shown and exposed to teenagers about thin, young air brushed female bodies can link to teenage depression, loss of self-esteem and the development of unhealthy eating habits in both women and teenagers. ¼ college aged women uses unhealthy methods of weight control including fasting, skipping meals, excessive exercise, laxative abuse, and self-induced vomiting. The pressure through the media to be thin is affecting all ages of girls and women. Women are sold to the diet industry by the magazines we read and the television programmes we watch, majority of all make us feel anxious or self-conscious about our weight.
There are positive sides to the media such as companies such as Dove, who are spending their advertising money to promote healthy self-images. Likewise there are magazines that focus on healthy lifestyle as opposed to thinness. Another recommendations that I have is that instead of looking at the magazines that show models really thin on the front cover, look the for the magazines that are showing real bodies and beauty, directing your children towards them instead of television shows and magazines that focus on thinness as beauty.
The media today is a contributor to the problem of ‘eating disorders’. Teenage girls see images of super thin actresses and models and then they strive to be more like how they look.
I think one recommendation I would make to combat the media’s portrayal of women is to teach teenage girls to view all media with a critical eye. Furthermore, parents should encourage their children that looks aren’t important they are who they are for a reason and they should be happy that way. One way I think a parent could introduces this is by focusing on their children’s qualities that they have that aren’t related to appearances. Instead of constantly telling your daughter she is cute or pretty, applaud her for being smart or funny. I also think there are other ways of tackling this by parents and friends setting a good example. Mother should avoid complaining about their weight and instead lead a healthy lifestyle that they would like their daughter to follow. Introduce healthy eating and encourage a well balanced meal and regular exercise into the household.
