Bipolar disorder

Bipolar upsetBipolar swage was previously known as manic depression as it causes moods to pause amongst mania and depression. It whitethorn similarly be classified as a biological brain disorder causing severe fluctuations in mood, energy, thinking and behaviour. This disorder results in frequent anxiety and low frustration level in the young people (CABF 2007). Depression, in this situation, means a situation where you feel truly low while mania would refer to a situation where you feel very high (NHS 2009). Sometimes, symptoms of mania and depression can also occur concurrently (CABF 2007). These episodes can last for several weeks or longer. The high and low phases of the illness atomic number 18 a great deal so extreme that they mediate with every twenty-four hour period life (NHS 2009).In bipolar disorder, the depression phase often comes first. One can be diagnosed with clinical depression before having a manic episode. The manic episodes usu whollyy suck place afte r some time, after which the diagnosis might change. These episodes of depression may lead to overwhelming feelings of worthlessness, which often lead to thoughts of suicide. The manic phase may make you feel very creative and view mania as a positive experience. This is the time when you may also obligate symptoms of psychosis. During this phase you may feel very happy and own lots of ambitions, plans and ideas. Lack of sleep and appetite are other also common characteristics of bipolar disorder (NHS 2009). state with bipolar disorder fluctuate between intense depression and mania, interspersed by periods of relative calm (Macnair 2008).The causes of bipolar disorder arent completely known, except are often hereditary. A cluster of factors both(prenominal) genetic and environ rational, such as ain traumas or stress, can highly influence systems. The initial manic or depressive episodes of bipolar disorder usually take place early in the teenage years or early adulthood (Macnai r 2008) At least half of all cases start before age 25 (Kessler et al., 2005). The symptoms of the disorder can be fairly subtle and may result in macrocosmness overlooked or misdiagnosed. This could result in unnecessary suffering while on the other hand, with proper treatment and jump a fulfilling life can be lived (Macnair 2008).In severe conformitys of mania, there are chances of a psyche becoming psychotic, with delusions. There is a conflict in perception and reality and there may be hallucinations and delusional beliefs about being persecuted. In some of the worst cases, people in mania become unintelligible and neglect themselves. The symptoms have varying patterns, frequencies and order. piece in some case, where symptoms of mania are followed by symptoms of depression in a predictable pattern, some people have mixed symptoms its possible to have many of the symptoms of mania and also suffer from severely depressive thoughts (Bhugra and wink, 2005).Although theres n o cure for bipolar disorder, many people find that an sympathizeing of their illness and what triggers episodes can back up them live a relatively expression life Macnair 2008). Patients could monitor their moods and thoughts and ask someone they trust to help them act with the disorder. But, sometimes some people have extreme mood swings that cant be managed by monitoring alone. There may be a need for antidepressants, antipsychotic medicine, drug lithium, which seem to poise mood swings. High level of lithium in blood can be poisonous while too little will have no effect. So, its distinguished to be seen rhythmicly by the noetic fountainheadness team and have the blood levels checked (Smith et al., 2009).Johns ConditionJohn had a bipolar disorder with first episode happening when he was 19. At 28, John had evidently had manic episodes, as he had been known to contact his colleagues and clients at odd hours to argue novel ideas. He kept en thening about his designs being imaginative and original. At the workplace, clients and colleagues would complain about Johns unprofessional behaviour suggesting a lack of understanding on the part of his workplace. Johns denial of his illness further aggravated his situation. John had already relinquish two excellent muses because of his condition.Johns younger brother, Michael, managed to get John back to his adviser shrink and pushed him to take his medicines regularly. With continuous support from his brother, John started responding well to the treatment. Although medicinal drug seemed to have positive effect on John, he would give up the medicines as soon he started feeling better. This resulted in relapses and repeated episodes. And unlike ordinary mood swings, the mood changes of bipolar disorder are so intense that they interfere with the longanimouss ability to function (Smith et al., 2009). John did not participate actively in social activities reservation it difficult for others to recognize his needs.John could not focus on his work due to his medical condition being too unstable. John was not offered any job at the volt places he had applied scorn an impressive CV. This was due to the fact that John had mentioned his illness on all the forms raising doubts in Johns mind about disclosing his illness until it was specifically stressed upon. graze labelling and stereotyping Theory of stigmaStigma is the difference between the virtual social identity and the real social identity. Stigma has cardinal forms, which can be characterised as external, personal and tribal. The first form of stigma relates to external or overt deformations like scars, leprosy, physical disability and social disability. The second form relates to conflicts in personal traits, including mental illness, drug addiction, alcoholism and criminal backgrounds. The third form, tribal stigmas, are imagined or real traits of ethnic groups, nationalities or religions that are deemed to constitute a deviati on from what is perceived as to be the prevailing ethnicity, nationality or religion (Geoffman 1963).eoffman (1963) also went on to describe 3 levels of deviance. He described them as primary, secondary and third deviances. Primary deviance would refer to original violation/deviance/and societal reply to this non-conformity to societal norms. The secondary deviance is the deviants re fulfill to the negative societal reaction and the tertiary deviance is the reaction of the stigmatised person to the stigma from other leads to master status. The secondary deviant attempts to re-label certain behaviours as normal rather than deviant. This is an attempt to take a label that overshadows all other characteristics. The stigmatised person is seen as inferior by others and seen as having a perpetually flawed social identity and is thus discriminated. The stigmatised individual might also have additional imperfections imputed to them on the basis of the original stigmata thus creating stere otypes (Geoffman 1963).Stigma can also be differentiated as felt and enacted. The felt stigma is the condition where one feels the shame of being identified with a discrediting condition and the fear of encountering enacted stigma. Enacted stigma is the actual episode of discrimination, both formal and informal against people with stigmata solely on the grounds of their having a stigmatising condition (Scambler 2004).Scrambler (2004) through the Hidden Distress Model highlighted that people with a stigmata are fearful of experiencing enacted stigma and pursue an active policy of non-disclosure. The stigma has a far more disruptive effect on their lives as this also increases the stress of managing their disorder. The socio-cultural values can be viable in influencing the level of felt and enacted stigma. fit in to Geoffmanns (1963) classification of stigma, John fell in the second form due to hid bipolar disorder. As stated by Geoffmann (1963), John was ill treated and faced discrim ination, which is quite evident from the behaviour of his clients and colleagues at work.Sociology of Health and distemperThe sociology of wellness and illness argues that socio-cultural factors influence peoples perceptions and experiences of health and illness, which cannot be presumed to be simply relations to physical bodily changes (Nettleton 2006).Defining Health and DiseaseIn the piece of music of WHO established nearly half a century ago, health is defined as a state of complete physical, mental and social well being and not merely the absence of disease or infirmity (Saracci 1997). Temple et. al., in 2001 proposed a definition of disease though the approach did little to correct on previous attempts. They defined disease as a state that places individuals at increased risk of indecorous consequences. Adopting this definition, every activity involving voluntary action carry a risk of adverse consequences.The problem with the design of health and disease is that it is as sociated with social conceits such as normality and abnormality, normality and abnormality being relative terms. In common parlance, disease means a deviation from the established norm, consequently abnormal, with connotations of weirdness, strangeness, repulsiveness, viciousness, hurtleness, derangement, impairment, and disorder (Landy 1977). Conditions may be characterised as normal or abnormal based on the arbitrary diagnostic criteria as in most common diseases like diabetes, hypertension, etc. A condition is considered to be normal if it is prevalent amongst the population largely. But this issue seems to be complicated by the question of medicalization versus criminalization of abnormal social behaviour (Rosen 1968 and Foucalt 1972).Often the clinicians diagnosis is influenced by social views on mental diseases. In cases where mental disorders are involved, judging a sick person is to be avoided at all costs. Instead, the situation and the effect of the disease should be ju dged (Scheff 1979). The patient is worried with his own private and particular condition, while the doctor tries to make a diagnosis in the same appearance a zoologist or a botanist does with a specimen under the microscope to weight individual variances against general signals and symptoms that agree with those of a recognized grade of disease (de Avila Pires 2008).Failure to Recognize Mental States and Provide Required SupportRadley (1994) reported that it was very difficult to live with illness in todays world where health is more than meeting the demands of specific tasks or fulfilling particular duties. Mental disorders may lead to the patient becoming socially isolated as was seen in Johns case. variety 1. The patient suffering from chronic illness faces variant modes of adjustment. (Figure adapted from Radley and Green 1985, cited in Radley 1994)According to the modes of adjustment to the chronic illness put forward by Radley and Green in 1985 (cited in Radley 1994) John w as in the phase of active denial. He resisted the illness symptoms and participated in the normal life, treating his illness as of little importance. compensate his colleagues failed to recognize his condition and complained calling Johns behaviour unprofessional.Factors that Pushed John to Seek Medical HelpDespite Johns being a talented architect, he had already quit two good jobs. The reasons attributed to this may be an atmosphere of discriminative behaviour in the workplace. John had developed a stage of Bipolar disorder where regular attacks of mania took place. He might also have developed psychosis suggested by the novel ideas and strange behaviour.Johns brother, Michael actually got John to go back to the medicines. He time-tested to know what had happened and do sure John took his medicines regularly. Michael also managed to get John back to his consultant psychiatrist. So, it may be perceived that it was support of his brother, family support pair with a discriminative behaviour at the workplace that pushed John to medications.Social InequalitiesDisability and social inequality go hand in hand. The proof is well documented and evident in socio-economic heap (Nettleton 2006). Disabled people face many problems in their working life. In certain cases like accidents, a person may loose his value overnight while as, in case of recurrent illnesses, the patient goes through a gradual downfall Blaxter 1976). Lack of support from other people (family, friends, colleagues) often aggravates the medical condition of the patient (Radley 2004).Johns medical condition became a cause of concern for his employers and clients alike. He had to quit two jobs to cope with the situation. Despite having experience and impressive CV, John was not able to get a job at any of the five places he had applied to. Evidently, his revelation his bipolar disorder would have put his future employers on alert and thus the discrimination. Instead, of understanding Johns conditio n and helping him overcome his disability he was jilted every time.Community CareThe World Health Organization recognizes primary health care to be effective in preventing illness. There has been a shift from primary health care to conjunction care and this shift could be a result of three factors therapeutic, economic and reforms in the medical model (Busfield 1986, cited in Nettleton 2006).The entire concept of community care relies on the priority being given to the patient and not the disease. Social perceptions about the disability or the disabled, plays an important role in community-based rehabilitation. The term community care is used both in a perspective sense to related to how people should meet the health and social needs of the dependent people and also a description of the set of services that are currently provided (Stevenson 2008).Many people often bearing to being referred to as disabled. It leads to the segregation and often discrimination (Blaxter 1976). As wa s seen in Johns case, despite being an impressive architect he was refused job at five places, which he thought was because of him disclosing his bipolar disorder.The local authorities along with voluntary bodies are responsible for looking after the social needs of a disabled. This concept is based on the fact that community has to be involved in deciding the social needs of a disabled member and then making sure that those needs are taken care of in local conditions (Blaxter 1976).Michael, Johns brother played a major role in Johns rehabilitation. He understood his needs and convinced him to see his doctor. As is the concept of community care, Michael gave priority to his brother and his needs rather than his disease. The same cannot be said about his colleagues or his clients. Instead of understanding Johns special needs, they deemed him unfit to work with them.Cognitive Therapy of DepressionBeck et al., (1979) defined cognitive therapy as an active, directive, time-limited, str uctured approach used to treat various mental disorders. The rationale behind this definition is based on how a disabled person perceives and structures the world. His previous experiences and relation with other people affect his cognitions. For example, if a person interprets all his experiences in terms of whether he is competent or adequate, his thinking might be dominated by the schema, Unless I do everything perfectly, I am a failure. In such case he would react to all situations in terms of his competence even if those situations were not related to his competence in any way.Johns getting rejected at five interviews, despite of an impressive CV, made him feel disadvantaged. He thought it was due to his mental disorder. These inequalities made him want to conceal his illness and not reveal it unless it was specifically asked about.Chronic IllnessPeople experience serious chronic illness in three ways as an interruption of their lives, as an intrusive illness, and as immersion in illness. Rather, from their perspectives, illness disrupts their lives it intrudes upon the day-frequently each day it engulfs them (Charmaz 1997).Johns illness was an interruption in his life. He had to quit two jobs because of his illness and was further rejected a job at another five places due to his illness. Parsons Sick Role TheoryAccording to Parson (1951), sickness is not merely a condition or a state of fact, it is rather a specifically patterned social role. The sick people have the right to be exempted from the normal social role. They cannot be blamed for their medical condition and have to be taken care of. On the other hand, they are expected to seek professional guidance and show a willingness to get well. The disabled people are either vulnerable and are often exploited by others or they may adopt deviance to evade responsibilities and can prove to be threat to the society.John was vulnerable. He act to get well and used to take medication as well, but his colle agues blamed him for his condition. They often complained against him. Moreover, after quitting his job, he could not get another job due to his disability.Zolas TheoryAccording to Zola (1973, cited in Scambler 2008) most of the patients would over look their symptoms for quite some time before consulting a doctor. He also engraft that there had to be something else a trigger apart from the symptoms to convince patients to seek medical intervention. The characterised five types of triggers First, the occurrence of an interpersonal crisis (e.g., death in the family), second, perceived stay with social or personal relations, third, sanctioning (pressure from others to consult), fourth, perceived interference with vocalization or physical activity, and fifth, a kind of temporalizing of symptomatology (the setting of deadline). Moreover, patients personal and social circumstances also affect the patients decision to seek help.Applying Zolas theory to Johns case, one would realize th at John did overlook his symptoms. He used to deny his illness and stop his medication as soon as he felt better. It was sanctioning (pressure from his brother Michael) that acted as a trigger and convinced him to consult his psychiatrist and start his medication again.ConclusionA certain medical condition or disability refers to be presented with problems and face problems earning ones living or any other day to day activities. Many disabled people find it hard or lack the willingness to participate in the social activities. They isolate themselves from the society and in certain cases from family as well. But constant support from family and friends coupled with proper medication can help the patient recover and rise above his disability (Blaxter 1976).Bipolar disorder being a chronic mental disorder has serious consequences on patients in particular and their families and societies in general. Effective treatment for bipolar disorder is available, but patients often hesitate to r eport their condition due to various social, economic and personal barriers. Patients often go into self-denial and try to remain away from social activities. There are two ways of caring for the bipolar disordered person one, primary healthcare, that is consulting a general physician or a psychiatrist and second being community care. Concerted efforts on all levels (patient, family, community, healthcare provider and government) are required to improve the quality of care among the bipolar community (Bhugra and Flick, 2005). Apart from the professional help, self-help can greatly improve the condition of a person with bipolar disorder. The patient should learn about his condition. It will help him understand his needs better as well as help him in recovery. They should try and avoid stress, participate in social activities and indulge in hobbies. The patient should keep a track of his mood swings and watch out for the symptoms that have deleterious effects on their mood. Doing so w ould help them prepare better for adverse conditions. Maintaining a healthy schedule (healthy food habits, exercising, and proper sleep) can greatly influence the moods of a patient (Smith et al., 2009).ReferencesBeck AT, Rush AJ, Shaw BF, and Emery G. 1979. Cognitive Therapy of Depression. New York, The Guilford Press Bhugra D. and Flick GR. 2005. Pathways to care for patients with bipolar disorder. Bipolar Disorder 7 236-245Blaxter M, 1976. The meaning of disability. London. Heinemann.CABF (Child and Adolescent Bipolar Foundation), Educating the Child with Bipolar Disorder, 2007Charmaz K. 1997. Good Days, Bad Days-Illness and Time. USA, Rutgers University Pressde Avila-Pires FD. 2008. On the concept of disease. Revista de Historia Humanidades Medicas, Vol. 4, No. 1Foucault M. 1972. Histoire de la folie lge classique, Paris, GallimardGoffman E. 1963. Stigma Notes on the management of spoiled identitiesKessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. 2005. 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