The Effects of Bipolar Disorder on Ones Personal, Social, and Workplace Adjustment
Keywords bipolar disorder, personal, social, environmental life, workplace, guidance therapist
Social stigma, stereotypes, and prejudice are widespread against people who are diagnosed with bipolar disorder. Although there has been a growing interest and research conducted with bipolar disorder unfortunately however, there is a critical need to improve awareness and remove the social stigma associated with this growing condition so that others, who do not feel comfortable seeking medical support, can obtain appropriate treatment and, as a result, dramatically improve their quality of life(Preston Garrison, Chief Executive Officer of the WFMH). Because there is a difference between typical mood changes the average person experiences on a daily basis the HYPERLINK httpwww.associatedcontent.comtheme1481symptoms.html o symptomssymptoms of HYPERLINK httpwww.associatedcontent.comtheme430bipolar_disorder.html o Bipolar disorderBipolar disorder often leave people with ruined lives, and high tendencies of suicide (Cassano, G.B., Rucci, P., Frank, E., Fagiolini, A., et al. 2004).
The two stages of Bipolar disorder, mania and depression, both have individual characteristics that are vastly different than their counterpart. Both can have detrimental effects on the individuals personal, social, and financial life. Bipolar disorder has been found to be equally prevalent in men and women, and is found across all cultures and ethnic groups (Goodwin Jamison 1990).
On another note, recent research found that bipolar disorder appears to increase the risk of early death from medical illnesses, according to a literature review study published as the lead article in the journal Psychiatric Services. (Dr.Katon, Roshanaei-Moghaddam2009). The possible reasons for this higher risk of premature death are manifold. Many factors could be contributing to poor physical health among people with bipolar disorder, according to the published report. These include unhealthy diet, binge eating, lack of exercise, smoking, substance abuse, social deprivation, living alone, homelessness, lack of access to health services, biased attitudes of health professionals towards people with psychiatric illnesses, failure among psychiatrists to address their patients medical problems, or delaying medical care because of the overriding need for psychiatric treatment.
The impact of Bipolar disorder in society, as identified in a community sample using the Mood Disorder Questionnaire, was significantly associated with negative impact on the performance of work-related, leisure, and interpersonal activities. (HYPERLINK javascriptAL_get(this,20jour,20J20Clin20Psychiatry.) o The Journal of clinical psychiatry.J. Clin Psychiatry. 2003). In comparison with normative subjects, bipolar subjects reported lower levels of work productivity measured by the Endicott Workplace Productivity Scale (EWPS). Bipolar subjects also reported more frequent outpatient visits and more prescribed pharmaceuticals. Bipolar subjects were more likely to miss work, have worked reduced hours due to medical or mental health issues, receive disability payments, been involved in a crime, be uninsured or covered by Medicare, or have been fired or laid off. The study groups were age and gender-matched to reduce the impact of selection bias associated with a non-randomized study design. Other potential limitations affecting the results of the study include recall bias and possibly an impact of different data collection methods (e.g. Internet versus telephone). Bipolar subject have more difficulties with work-related performance, socialleisure activities, and socialfamily interactions compared with normative. Women with bipolar disorder were reported to have more disruption in social and family life, while men with bipolar disorder were reported being jailed, arrested, and convicted for crimes. (McMorris , Downs, Panish, Dirani 2010)
While these statistics are on a general level on a personal level people with bipolar disorder face a conundrum at work, with their friends and acquaintances. If they disclose their condition, they may face damaging stigma. Since evidence suggests that environmental factors play a significant role in the development and course of bipolar disorder, and that individual psychosocial variables may interact with genetic dispositions. There is fairly consistent evidence from prospective studies that recent life events and interpersonal relationships contribute to the likelihood of onsets and recurrences of bipolar mood episodes, as they do for onsets and recurrences of unipolar depression. (Alloy LB, Abramson LY, Urosevic S, Walshaw PD, Nusslock R, Neeren AM. 2005). Very often, people with the disorder have trouble recognizing that their behavior is becoming strange said Dr. Gary Sachs, director of the Bipolar Clinic and Research at Massachusetts General Hospital in Boston. So it helps to confide in close co-workers, as this could provide a support network. Colleagues in the know may even be able to help those with bipolar disorder monitor their moods. Co-workers and friends are often the first to see the signs. The most obvious indication of an oncoming episode is a change in personality. The diagnosis of HYPERLINK httpwww.associatedcontent.comtheme430bipolar_disorder.html o Bipolar disorderBipolar disorder is not ultimately a death sentence to ones productive life, for there are innovations and treatments that can help one suffering with the disorder lead a productive and to some extent enjoyable life.
Attribution theory - is concerned with the ways in which people explain (or attribute) the behavior of others. The theory divides the way people attribute causes to events into two types. External or situational attributions assign causality to an outside factor, such as the weather. Internal or dispositional attributions assign causality to factors within the person, such as ability or personality.
Methodology
The research was conducted through empirical work using the theories of social psychology as a framework.
HYPERLINK httpen.wikipedia.orgwikiSocial_psychology o Social psychology Social psychology is a highly empirical field. Rather than seeking global theories of human behavior, as are frequently found in personality theory, social psychologists utilize a wide range of specific theories for various kinds of social and cognitive phenomena. Here is a sampling of some of the more influential theories that can be found in this branch of psychology.
Cognitive dissonance - was originally based on the concept of cognitive consistency, but is now more related to self-concept theory. When people do something that violates their view of themselves, this causes an uncomfortable state of dissonance that motivates a change in either attitudes or behavior (Festinger, 1957). Social comparison theory - suggests that humans gain information about themselves, and make inferences that are relevant to self-esteem, by comparison to relevant others.
Social exchange theory - is an economic social theory that assumes human relationships are based on rational choice and cost-benefit analyses. If one partners costs begin to outweigh his or her benefits, that person may leave the relationship, especially if there are good alternatives available.
Social identity theory - was developed by Henri Tajfel and examines how categorizing people (including oneself) into in-groups or out-group affects perceptions, attitudes, and behavior.
Socioemotional Selectivity Theory - posits that as people age and their perceived time left in life decreases, they shift from focusing on information seeking goals to focusing on emotional goals.
System justification theory - proposes that people have a motivation to defend and bolster the status quo, in order to continue believing that their social, political, and economic systems are legitimate and just.
Terror management theory - suggests that human mortality causes existential dread and terror, and that much of human behavior exists as a buffer against this dread (e.g., self-esteem and worldviews).
Triangular theory of love - by Sternberg, characterizes love in an interpersonal relationship on three different scales intimacy, passion, and commitment. Different stages and types of love can be categorized by different combinations of these three elements.
Like any other chronic disease, Bipolar requires a lot of careful management and effort on part of the patient, doctors, and loved ones over a lifetime (Cassano, G.B., et al 2004). The purpose of this study is to heighten and gain an in-depth understanding of Bipolar disorder and its effect on a personal, social and employment level. Only in being more aware are we able to take the necessary steps and actively work offer assistance, understanding their periodic episodes and ultimately minimize the stigma they face. For the purpose of this paper, the following case study will be used to reference specific items, pertinent concepts and perspectives.
Case Study
Christine is a healthy and vibrant 24 year old woman. She is not married, but has a two-year old daughter. Christine dropped out of school when she was in 11th grade and admits to not practicing safe sex nor does she use any form of birth control. Her mother babysits her daughter whenever she needs a sitter.
Christine was raised by her father from three years of age, her mother having left home due to domestic abuse sustained on her fathers hands. Early on her parents fought for custody over Christine and her younger sister, but due to lack of financial funds, her mother had to end the fight. Christine was old enough she tried to locate her mother, but her father informed her that her mother was dead which she never believed. When she was 11 years old, she contacted the local Department of Social Services (DSS) to ask for help in finding her mother. She told DSS of her fathers drinking and drug use, and how her father made her perform sexual acts on his friends in exchange for free drugs. Two years later, the DSS finally contacted Christines mother informing her that her daughters were in Child Protective Services custody and transportation was arranged to take the girls to their mothers home. Christines mother immediately arranged for outpatient counseling for both of her daughters due to the anticipated trauma of the entire event. Counseling continued with the girls for several months before any severe issues presented itself. But soon Christine began having nightmares she refused to go to school, and became extremely withdrawn. Christines nightmares were so severe that she tried to avoid sleeping at all. In the end, Christine admitted that the nightmares were of the sexual acts her father made her perform on his friends. Christine then became suicidal declaring over and over that she wanted to die and she wished she was dead. These statements prompted her mother to call a social worker. The social worker immediately came to her home to assessed Christine and recommended that Christine be admitted to the hospital, her mother agreed.
After three days in the hospital, Christine was released and put on Zoloft medication. Zoloft, as indicated by the doctor, would help her sleep better and keep her dreams at a minimum. But less than a week of post-hospitalization, Christine began having nightmares again. Later on the school contacted Christines mother to come to school right away. Upon arriving, Christines mother learned that Christine had been caught by a teacher stabbing herself repeatedly with a lead pencil. Christine was admitted to the adolescent psychiatric unit for a second time.
During Christines second psychiatric admission, she was given several psychological tests including the MMPI-2, although this test is still questionable in the use of children and adolescents (American Psychiatric Association, 2002). Christine was also evaluated through blood tests, EEGs and a strobe test. She was later diagnosed as having Bipolar disorder.
The doctor explained that Bipolar disorder also called manic depression, refers to severe episodes of mood disturbance ranging from depression to elation that affect a persons ability to function normally, but can be neutralized with medications and that it is very important to continue taking the medications even if the patient feels fine. Christine was put on Depekote, Zoloft, and Clonodine. After discharged, Christine continued taking her medications, but later became violent and refused to take them. She also became violent with her younger sister when she hit her on the head with an alarm clock. Her younger sister called 911, but when the police came their mother tried explaining to the officers that Christine was on new medications for her Bipolar disorder. The officers immediately arrested Christine and informed her mother that she was a risk to herself and to the public. Christine was detained under a mental hygiene warrant,
And was held in a psychiatric facility for 72 hours and would then appear before a judge to receive penalty. When it was given, Christine was ordered to be admitted for six months at Highland Springs Adolescent Psychiatric Hospital. During her stay at Highland Springs, Christines behavior worsened to the point that she was transferred to Fox Run Hospital (Safer, 2009). Fox Run Hospital is a long-term treatment hospital for children and adolescents who have mental disorders, have been sexually abused, and are declared encourageable by a court.
EFFECTS OF BIPOLAR DISORDER 11
LITERATURE REVIEW
Personal Perspective
Bipolar disorder is a mental disorder that produces episodes of mania or depression. The client suffering from this disorder does not have the ability to recognize the bizarre behavior nor do they have the ability to see that their bouts of depression are more serious than that of a normal person. The American Psychiatric Association (APA) specifies treatment for bipolar disorder depending on which form of bipolar disorder the patient suffers. Bipolar Disorder suffer from either Bipolar Disorder I, characterized by periods of depression, Bipolar II, characterized by periods of mania, and Cyclothymiacs Bipolar Disorder which is characterized by rapid cycling. Rapid cycling is often present in children and adolescents. Rapid cycling is defined by being manic one minute and then depressive the next minute. The brain is constantly on overload from either symptom of the disorder. Medications used to treat bipolar disorder vary from person to person. The classic medication used is Lithium, although this medication can be very dangerous if it is not monitored frequently through blood tests (Maj, Adiskal, Lopez, Sartorius, 2003). Too much Lithium in the blood can be toxic to the patient. Today, other medications are proving to be very effective without the harmful side effects like that of Lithium. Depekote, Cymbalta, and Serequel are just a few. These medications must still be monitored by a medical professional as they can cause other reactions such as hives, swelling of the hands, face, lips, and in some cases, they have been known to cause blood clots.
Social Perspective
With reverence to the bipolar condition as viewed in society, patients are under much scrutiny. This stereotyping contributes to many of the patients not taking their medications.
Clients are told that they have a condition they themselves cannot really see or understand. Clients who feel fine view themselves as being like everyone else. It is a hard pill to swallow to see yourself as being different or ill, especially when you feel fine. Clients have reported feeling indifferent when asked what the medication is for. Some have reported lying about what the medication is for, or even telling someone that it is for a sinus infection rather than revealing the truth that it is a mood regulator. Society has developed a stigma where psychiatric drugs are concerned (Kassin, Fein, Markus, 2008)
Bipolar Disorder generally affects more women than it does men (Burn, 1996). This correlation is also in conjunction with the number of adolescents and children who have been diagnosed with bipolar disorder as well. On average, women are diagnosed with bipolar disorder at a median age of 27.2 years of age and. men are generally diagnosed with bipolar disorder at a median age of 22.4 years of age (Maj, Akiskal, Lopez, Sartorius, 2003). Despite that latter onset of diagnosis in women, the symptoms are often present long before the diagnosis is made. This is due in large part because women experience many mood swings during pre-menstrual syndrome (PMS), pregnancy, and general reactions to stressful situations. It is charismatic of women to be more emotional than men therefore, the underlying bipolar condition may be ignored until a life threatening situation or suicidal tendencies present (Healy, 2006). Symptoms of bipolar disorder often presented by irrational displays of depression combined with intermittent periods of mania. Both men and women will verbalize suicidal ideations due to one reason or another, but those that intend on following through with the suicidal threats will ultimately not verbalize their intentions to anyone other than through a journal, letter, or suicide note (Belmaker, 2006).
Environmental Perspective
Environmental and workplace conditions play both a positive and negative part in the bipolar disorder behaviors. Environmental, workplace, and academic settings can create stressors that create bipolar disorder episode breakthroughs despite medication regimens designed to level the patients moods. Individuals in society that are unaware of ones mental status may trigger an episode by repeating rumors or by poking fun at one having been hospitalized in order to establish an episode of bipolar disorder. This pertains to the manic part of bipolar disorder in most cases. Manic episodes can cause a patient to become violent not to mention displaying behaviors that are not normally characteristic of the patients normal behavior. Patients in a
Manic episode have been known to engage in criminal behavior such as incredible spending resulting, writing bad checks, and theft (Aaronson, Wilson, Akert, 2002).
The environmental influence often intermingles with the social perspective in that peer influence is more prominent in one who is currently suffering from a manic episode of bipolar disorder. Bipolar disorder does not seem to produce erratic behaviors in one who is clinically depressed as a result of bipolar disorder. The depressive side of bipolar disorder makes the
Individual more apt to sleep or just simply not have any energy required to be active in any way. The patient may not even take note of their own personal hygiene. Certain other medical factors may interfere in the treatment of bipolar disorder. It is common for patients with bipolar disorder to be treated with mood regulators like Depekote and others, but these medications are
usually prescribed with antidepressants like Zoloft, Imipremine, Desprimine, and others however, when a patient has a medical condition like hemiplegic migraines, the treatment course of antidepressants cannot be used because these medications will produce a migraine in the patient that could become life0threatening (Personal communication, January 14, 2010). Other physical conditions like high blood pressure, cardiac conditions, diabetes, and autoimmune disorders may also alter the regimens of medications used to treat the bipolar condition in the patient. Each patients medication regimen must be altered to fit the psychological needs of the Patient, but the physical medical conditions must be taken into consideration as well (Gilbert, Fiske, Lindzey, 1998).
Other environmental factors that are rarely mentioned have to do with allergies. Certain allergies to things like dust, pollens, trees, foods, and chemicals may have a significant factor in the diagnosis of bipolar disorder. If a patient is suffering from an allergen, then their behavior and demeanor may be different during the initial assessment phase of testing and may produce a result that is inaccurate due to the variable of an allergen being present. These factors must be taken into account before an assessment is performed in order for the accuracy to be confirmed (Healy, 2006)
Discussion
Anyone who has been diagnosed with Bipolar Disorder must expect some changes to their entire life in the areas of personal life, environmental life, social life, and workplace environment. In relation to the personal life, there are adjustments that have to be made in the aspect of the patient remembering to take their medications on a regular basis. These medications are a must and a major part of treatment. Some patients may go into a period of denial and feel that they do not need the medications and will quit taking them altogether. This is a dangerous decision as some medications cannot be stopped at once, instead, they must be tapered off of the medication otherwise the physical body will go into shock from the level of medication taking such a dramatic drop (Safer, 2009). A patient may suffer convulsions, heart palpitations, irregularities in blood pressure, and possibly a stroke or death. The medications used to treat bipolar disorder are designed to synthetically replace chemicals in the brain that are not produced properly or are non-existent. Patients may also experience depressive stages where personal hygiene goes ignored for days or weeks at a time, housework becomes irrelevant, and the patient will ultimately quit a job. The depression takes over every aspect of their life.
Family intervention is the only means for seeking treatment for the patient at this stage, if family is involved in the patients life. Family members, including spouses, parents, and even adult children, will step in and take over the household chores of cleaning and doing laundry.
The patient may appear to have no appetite, refuse to take medications, or pretend to take the medications and then flush them down the toilet later. Family members functioning as caregivers often feel overwhelmed but obligated to care for their ill family member. They offer
The excuse that the patient, family member, cannot help that they are like this, or that this is just part of the illness. This behavior is consistent with attribution theory of social psychology. But situation this is only partly true. It is true that the family member cannot help having the illness, but it is the patients responsibility to do their part to combat and keep the illness under control. Caregivers often times sacrifice their own health and well-being as a result of caring for a mentally ill family member who would benefit more from a hospitalization.
The Social Perspective as it relates to bipolar disorder is equally important in a patient with bipolar disorder. A patient may have a good level of self-esteem, but through the duration of treatment, the same patient may develop a lower sense of self-esteem as they begin to see themselves as different. They may feel that there is a tattoo across their forehead reading bipolar. Their inner self-esteem and inner view of their self may change and create depressive conducive feelings related to the diagnosis of bipolar disorder. While it is natural for a patient to go through periods of understanding and coming to terms with their illness longer onsets of this depressive phase can be detrimental to their overall treatment. It is most important that a patient
Be involved with a cognitive behavioral therapy, a group therapy, or a client-entered therapy. Therapy is vital for bipolar patients. Group therapy is highly recommended for a patient with bipolar disorder as it would allow the patient to hear from others what they have experienced.
Sharing obstacles, triumphs, new medications, and good experiences may offer hopes to patients attending who have been recently diagnosed and feel caught in a fog of confusion.
Critique
Every patient deals with Bipolar Disorder in a different way. There are different levels of Bipolar Disorder. Some bipolar patients are high-functioning while others find it difficult to function at all. High functioning bipolar disorder patients take their medications regularly, go to
Work every day, have families, and no one would ever be the wiser to their mental disorder. Their periods of mania or depression are mild at best. The periods of mania are characterized by sudden bursts of energy needed to clean, mop, or do laundry. Then as soon as the work is completed, they are satisfied and continue doing other things like watching a television program or reading a book. Their periods of depression are characterized by rare episodes of crying. This may happen if something hurtful is said to them or when trying to balance a checkbook or work on yearly taxes. These episodes of mania and depression are not really out of the ordinary, but are still indicators of their form of bipolar disorder.
Not every episode is a full blown manic or depressive one. Not every person with bipolar disorder goes into mania by talking unstoppably or by irrational thoughts that run into one another. This is conclusive with bouts of depression as well. Not every depressed person lies in bed for days on end in a catatonic state, staring blankly into thin air, watching re-runs of Jerry Springer. Depression can be an internal feeling that is not outwardly expressed. Many people with bipolar disorder have learned how to develop a personality for work and one for home. At work, bipolar patients often pretend that everything is alright so that no one will suspect anything, but when the patient goes home, they let it all go and act however they feel. This is not to say that the patient has a multiple personality condition, but rather to suggest that the Work-face and the home-face are simply acts to fit the part being played at the time. In other words, it is a coping mechanism of sorts designed to protect their job. Society has attached such a stigma and stereotype with the words mental disorder, that it is often times uneasy to discuss it with peers, members of the medical profession, and most of all in the workplace. Mental illness
And mental disorders are viewed by society as a taboo. It signifies that there is something critically wrong with someones brain and creates the stigma that the patient is insane, crazy, or on the verge of a mental break down that could end up in a massive homicide. Most of this is due to made for television movies and the way that the media portrays serial killers or wanted criminals. One of the first things mentioned in the profile of these criminals is their mental conditions like schizophrenia, bipolar disorder, antisocial personality, and the like. According to Russell Spears (1997) we function on the basis of surface level similarities as if some deeper properties of the object support the decision process. When people adopt a psychological essentialistic stance (essentialist belief belief that a social category has a fixed inherent identity- defining nature), their working hypothesis is that things that look alike tend to share deeper properties (R. Spears, 1997). Thus stereotyping stems from such preconceived notions of individuals with bipolar disorder. Society has no respect for the human behind the illness, when in fact it should be the mental illness behind the person.
Parallels and Agreements
There are many commonalities between the research performed on bipolar disorder with relation to the workplace, academic settings, personal, and social life and how the individual with bipolar disorder truly functions. A person with bipolar disorder is just like anyone else except that certain chemicals are either overproduced or not produced enough. A bipolar person does not just get excited, but rather they usually get overly excited and go over the top with their emotions. The same is true for feelings of depression. A bipolar person with depression.
Become extremely depressed. Depressive episodes can last for days, weeks, and even months without intervention from a mental health professional. From a personal perspective, an
Individual wants to be treated just like everyone else and not looked at differently. This does not sound like much, but once their personal information has been revealed, they feel ostracized and feel like they are the oddball out. This feeling is normal in the fact that everyone has experienced this feeling at one point or another in their life. Some things are better left kept private unless the patient feels comfortable revealing the information. The personal and social perspectives intermingle for the most part as far as parallels are concerned. Society does offer empathy to patients with bipolar disorder in the respect that it is acknowledged that it cannot be cured. It is also understandable that there are medications and research constantly being performed to better a patients ability to cope and function within society. It is estimated that 25 of society has undiagnosed bipolar depressive conditions (Maj, Adiskal, Lopez, Sartouius, 2003). The most common diagnosis for Bipolar Disorder is Bipolar II, which is characterized by depressive moods, but it is the most difficult to treat because of its unpredictability (Safer, 2009).
The environmental perspectives are most parallel with everything stated within this paper insofar that medications are a normal regimen of treatment coupled with therapies. However, it
has been stressed repeatedly the importance of the patient continuing to take the prescribed medications on a daily basis in order to keep the synthetic chemical in the bloodstream in order to regulate the mental mood. Without the medication or with intermittent ingestion of the medication, the full effects and benefits of the medications will not be achieved and the treatment will be unsuccessful. Hospitalizations will be repeated over and over to stabilize the patients mood, but upon release, if the patient is unwilling to continue the medication regimens, the Treatment will fail again. The psychiatric nurse in a clinical setting plays an important role in the treatment of a patient with a mental disorder as he or she has the opportunity to observe the patient in a controlled environment, the hospital (Shives, 2008). He or she can offer the treating psychiatrist suggestions and explain observations that have been made in reference to behavior
Changes or aggressive behaviors observed. This information is pertinent for a doctor to know as they play a key part as to what medications should be stopped or what medications should be added in order to keep the patients mood regulated. Organic medications can have a devastating effect when used with prescription medications. Some organic medications are not meant for ingestions and can produce symptoms similar to that of bipolar disorder, but they can also produce hallucinations and aggressive behaviors. Much research is still being done on organic substances and their purpose in the psychiatric community, but so far, none have been approved for treatment of bipolar disorder.
The personal, social, and environmental perspectives all work conjunctively together to form a bio-psychosocial diagnosis of a patient with bipolar disorder. Everything must be taken into account from the physicalhealth background, the psychological background, and the social perspective past and present. This new form of diagnosing is proving to be most helpful for patients receiving any treatment, whether it is medical, psychological, or social psychology.
For someone entering the profession of a guidance counselor or a life coach, it is most important to know exactly with whom they are encountering. Their past in many perspectives plays a huge part of how they should presently be treated as it would be easier to focus on what treatments in the past have failed and why they have failed. A guidance counselor and a life coach bear the responsibilities of helping someone develop new skills for coping and making decisions in their lives. Guidance counselors should always focus on a client-centered therapy and allow the client to feel some sense of control, but this should also be coupled with the use of cognitive behavioral therapy as teaching the client how to rethink a situation or to re-evaluate why they had the feelings experienced during a specific incident may offer some insight and shed a new light on the issue. These are essential techniques to possess as a guidance counselor or a life coach in order to be successful in their craft.
Social Cognitive Emotional Impact of Bipolar Disorder
Social Impact (at work)
According to a 2007 screening study published in the Journal of Clinical Psychiatry, 42 percent of patients with bipolar disorder reported a marked affect of their symptoms on their ability to work. - In some cases the structure and routine that work provides seem to offer protection against illness. On the other hand, stress can have the opposite effect. It can be difficult to work and yet avoid stress. More often than not work related stress triggers mood episodes in a person with a genetic disposition for bipolar disorder. A life coach serves as a support system and a buffer against work related stress by helping a patient put things in perspective.
Social Impact (at home)
According to the same study published in the Journal of Clinical Psychiatry, more than 50 percent of bipolar patients reported having difficulty managing home affairs due to their condition -. It is impossible even to estimate the amount of emotional pain, stress and loss family members experience in trying to deal with, ultimately to help, a mentally ill person in the household. Having a life coach or a guidance councilor serves to minimize the stress between family members. Being the one in authority and with most knowledge about the illness, a life coach can provide objective feedback when both parties are too emotionally involved.
Cognitive Impact
Growing evidence suggests cognitive impairment among patients with bipolar disorder including mild deficits in several neuropsychological functions attention, executive processing, processing speed, working and declarative memory. This attitude applies to the cognitive dissonance theory. Cognitive therapy treatment addresses the outside influences that give a negative impact to feelings of mania that occur with an individual with disorder. Drugs can not cure such an illness, neither can any biological remedies. Seeing as how the illness is primarily ignited through external factors then it is only feasible to treat such an illness through treating the cognitive process with outside therapeutic intervention that remedies the negative thoughts and outlook built up in ones head causing this form of manic depression. Such therapy is possible with the use of Elaboration Likelihood Theory (ELM). According to them mass communication situations can be conceptualized as evoking one of two routes to attitude change, the central route and the peripheral route. The central route involves persuasion through what they call message elaboration basically, scrutinizing the content of the arguments and then changing ones attitude on the basis of the merits of the arguments. The peripheral route involves attitude change based on cues irrelevant to argument quality. (R.E. Petty J.T. Cacioppo D.O. Sears 1988)
Emotional Impact (with others)
Research in the Journal of Clinical Psychiatry shows bipolar disorder to have a negative effect on the social activities and personal relationships of patients, consequently resulting in a marked or
severe emotional impact on the individual. 26 of respondents of a recent survey by The World Federation for Mental Health (WFMH) NEVER tell people they have bipolar disorder. Fear of social stigma is a key reason why people do not share this information with others. People try to integrate individual pieces of information in order to come up with a coherent story about the target person or group in so doing they quite heavily rely on their nave theories to organize incoming information. (R. Spears 1997) But this can change when certain information are made available to people to know. People are best able to process complex arguments when they are well informed, have schematic understandings of the issue, are undistracted, and when repetition sufficiently familiarizes them with the arguments. They are motivated to do so when the issue is personally relevant, they are forewarned of the persuasion attempt, andor have a pre-dispositional need for cognitive activity. Under such conditions, according to the ELM theory, quality of arguments is the key determinant of attitude change (R.E.Petty J.T. Cacioppo 1986)
Emotional Impact (with self)
Bipolar patients are often impacted by the disquieting ambiguity over whether they have caused their own illness and how much of a role it plays in their sense of self. - Patients with bipolar disorder frequently suffer from a range of co morbid psychiatric disorders aside from substance abuse, including personality disorders, anxiety disorders, eating disorders, and attention-deficit hyperactivity disorder. Thus, adequate and individualized treatment is paramount in lessening the burden of illness experienced.
Conclusion
This paper is focused on the personal, social, and environmental perspective aspects of Bipolar disorder and how the illness affected each facet of the person. The case study mentioned in the introduction of the paper discussed a young woman named Christine, who had been
diagnosed with bipolar as a young teenage child. Through different areas of her life, she was medicated and then others where she refused to take her medications at all. In the aftermath of not being medicated, she ended up paying a very high price. She ended up pregnant by someone who wanted no part of her, her father ultimately kicked her out of the house, and she went to her mother. Immediately following the birth of the baby, the attending obstetrician had a psych consult done at the hospital since some women who give birth and are diagnosed with bipolar, have a higher tendency to develop post partum depression. Christine seemed to be okay at the time. Several days later, Christines mother took her to the local mental health facility for an evaluation due to the fact that Christine was going ballistic over the color of the nipple ring on the bottle that her mother had used. Christine insisted that on Tuesday, the blue nipple rings were suppose to be used and no other color. Christines mother feared that something else was going on and convinced Christine to go see the counselor and at least talk to them. It was determined that Christine did in fact have bipolar disorder, but that she was now dealing with obsessive compulsive disorder and generalized anxiety disorder. Christine was hospitalized for a
Period of eight months, and then transferred to a long-term care facility, all of which she was willing to go and did not have to be involuntarily committed.
The effects of the bipolar disorder illness, at least in Christines case, made school unbearable. She could not sit still in her classes and always felt that someone was talking about her. She had been engaged in more than one physical altercation with other students, suspended on several occasions, and was expelled once. Christine did not seem to care nor did she seem interested in getting her GED. From a social perspective, it was odd to observe that Christine did not seem to have the natural instinct that most mothers have with their babies. Christine treated her baby like it was just in the way.
The environmental factors, which did include medication, also included environmental influences on her life. Her only influences came from the television or her poor choices in friends. None had any goals in life other than getting drunk or staying high. Bear in mind that these behaviors were much encouraged by her father as he was an alcoholic and a drug addict himself, and misery loves company. Children apparently do learn what they live because she has fit into his shoes perfectly.
A community should take a more active role insofar as checking on one another. Mental illness affects more people than originally thought. Children and adults alike are striving to make recoveries from bipolar disorder, but without community support, it is a difficult task to be overcome. While medications and therapy are the psychiatric norm for treating bipolar disorder, it is necessary to incorporate the community as part of the recovery process. A simple phone call, dropping by for a visit, saying hello in a grocery store can do a lot more for a person than just a sixty-minute session with a therapist. A workplace is another place to offer support. Employers can discuss privately with an employee the understanding of the illness and express the companys support by offering to allow the employee days or times off for appointments if needed. Although this is just common courtesy, but an employee might be fearful to ask for time.
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