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Bipolar disorders are mental disorders characterized by extreme shifts in mood; episodes of mood swings ranging from depressive lows to manic highs (Whitbourne, 2020). The exact etiology is not known but a combination of genetic, environmental, and brain structure are key components. Bipolar disorder is categorized into Bipolar I Disorder and Bipolar II disorder. The types of bipolar disorders are differentiated by a set of symptoms but they all are marked by fluctuations in mood and activity levels. In bipolar I type, manic (feeling extraordinarily high) episodes severe and they last for at least one week. And depressive episodes (if occur) last for at least 2 weeks (Roland, 2019). On the other hand, bipolar II disorder involves hypomanicepisodes and severe depressive episodes but full-scale manic episodes are absent. A hypomanic episode is typically a period of persistent and abnormally elevated irritable mood which at least lasts for four consecutive days. All in all, the basic difference is bipolar I am marked by full manic episode whereas bipolar II is marked by hypomania. The next category is a cyclothymic disorder that is typically characterized by brief periods of hypomanic symptoms alternating with brief periods of depressive symptoms which are not intense like full hypomanic episodes. Put differently, it is a milder version of bipolar disorder (Whitbourne, 2020). However, it may often last for longer periods. Usually, an individual may experience symptoms for at least 2 years to make the proper diagnosis.

It is imperative to take into consideration biological, psychosocial, and sociocultural perspectives when providing these diagnoses. From a biological perspective, genetic factors are considered responsible for the development of bipolar disorders. However, the question arises whether bipolar disorder can be inherited? According to recent researches, first-degree relatives (parents, children, siblings) of those with major depression are more likely (nearly two to four times) to have a mood disorder than non-relatives (Whitbourne, 2020). Furthermore, twin studies signify that one of the twins has bipolar disorder then the other is 40% likely to have it (Harrison, Geddes, & Tunbridge, 2018). As per the biological perspective, these disorders are also caused due to altered serotonin functioning. Looking from this lens, the heritability is estimated at sixty percent (Harrison, Geddes, & Tunbridge, 2018). On the other hand, the psychological perspective takes defensive responses and cognitive-behavioral domains into context. These disorders may occur due to past stressful life events. Or there may be the case of excessive exposure to chronic strains. But when it’s triggers and progresses, the disorder may further develop on its own. There is also a role of dysfunctional thoughts when causes are taken into consideration (Whitbourne, 2020). Environmental triggers (such as recreational stimulant use, failing in love, lack of exercise, sleep deprivation, etc) are also responsible for some bipolar disorders. On the cognitive front, a triad perspective is considered involving a negative outlook of self, future, and the world (Whitbourne, 2017). For instance, individuals may start to over-generalize things, take excessive responsibilities, assume temporal casualty, and involve in dichotomous thinking. Insecure people are at higher risk of developing depressive disorders.

As a counselor, this counselor needs to understand the subtle differences while diagnosing these disorders so that the interventions could be tailored accordingly. Moreover, it requires short-listing probable or possible issues to refine the diagnosis. Also, these three perspectives call forth the need for this writer to carefully examine the symptoms. For example, the biological perspective sees medications such as anti-depressants as the first line of treatment, whereas the psychological perspective considers therapy as the best line of treatment (Connolly & Thase, 2011). All patients should be offered group or individual psycho-education for better results in the long run. So basically, it’s a combination of medication and psychotherapies. Clients must also be offered therapeutic drug monitoring due to its importance for safety. It is imperative to augment psychiatric care. This writer will always make sure that the client receives proper diagnosis and intervention. In this context, it is crucial to devise a proper plan of care for ensuring that the client is adhering to the prescribed treatment. Any unusual symptoms, behaviors, side effects of medicines will be further discussed with the specialized professional. This writer will optimally try to meet the client’s needs and requirements while delivering therapeutic sessions.

References

Connolly, K. R., & Thase, M. E. (2011). The clinical management of the bipolar disorder. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3219517/

Harrison, P. J., Geddes, J. R., & Tunbridge, E. M. (2018). The emerging neurobiology of bipolar disorder. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5755726/

Roland, J. (2019). Bipolar 1 Disorder and Bipolar 2 Disorder.Retrieved from https://www.healthline.com/health/bipolar-disorder/bipolar-1-vs-bipolar-2

Thomas, S. (2020). Alcohol and drug abuse statistics. Retrieved from https://americanaddictioncenters.org/rehab-guide/addiction-statistics

Whitbourne, S. K. (2020). Abnormal psychology: Clinical perspectives on psychological disorders (9th ed.). NY: McGraw-Hill Education.

Of all major health concerns throughout the 21st century that has increased, substance use disorders of drugs and alcohol are among the most devastating and insidious. According to the National Survey on Drug Use and Health reports, those aged twelve and up engage in some sort of illicit activity involving drugs or alcohol and that over 28 million people incur health risks by using psychoactive substances (Wendt & Gone, 2018). On an annual basis, illicit substance use takes the lives of over 600,000 people whereas alcohol is the third leading cause of death that is majorly preventable behind cancer and heart disease (Maddux & Winstead, 2016). Although serious challenges arise from addictions to substances and alcohol, these illicit behaviors also create devastating effects for families and the victims of violence that the behaviors of those addicted conduct.

Alcoholism and drug addiction correlate with society’s views concerning the variations of temporal, religious, and geographic contexts (Merikangas & McClair, 2012). For example, during the 1700s, drug addiction was not as problematic as it is today, therefore then, drug addiction didn’t receive much attention or bias/stigmas towards those addicted as societies have formed during the 20th and 21st centuries. In addition, according to Merikangas & McClair (2012), “the effects of cultural attitudes towards addiction and alcohol dependencies have been illustrated as values practiced by the Mormons and Muslims in the prohibition of such usage (p. 781). However, for Americans, recreational use of each is not prohibited until a certain point of the usage is met by the person. There are variations in differences among the cultures of the world concerning alcoholism and drug abuse perspectives. Some cultural groups will have comparatively lower rates than others in the consumption of drugs and alcohol gave the cultural and contextual elements that have been passed down via generations (Merikangas, K. R., & McClair, 2012). That is because of social customs and social norms having a high prevalence of substance abuse.

Maddux, J. E., & Winstead, B. A. (2016). Psychopathology: Foundations for a contemporary understanding. Routledge.

Merikangas, K. R., & McClair, V. L. (2012). Epidemiology of substance use disorders. Human genetics, 131(6), 779-789. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC44082…

Comorbidity typically implies interaction between the illnesses (Whitbourne, 2020). Many people suffering from SUD can develop other mental illnesses also and vice versa. There are several genetic factors and mental illnesses that contribute to SUDs. It is certainly challenging to maintain a therapeutic alliance with clients with comorbidities (NIDA, 2018). In such cases, it becomes challengingfor counselors to monitor and examine the status of each disorder and alerting each other to signs of relapse. People with comorbidityfrequently suffer from demoralization because of the complexity of having two problems (NCBI, 2015). This calls forth the need to inspire hope among them. Also, the distinction between beliefs and behaviors sometimes becomes difficult to interpret. Clients may exhibit a variety of behaviors, so it’s difficult to apply contingency management techniques. Clients with significant illnesses may be unsettling or threatening. Therefore, the recognition of patterns that interfere with treatment is critical. Hence, counselors need to primarily use a supportive, empathic, and culturally appropriate approach while managing counter-transference when working with clients with co-occurring disorders (NCBI, 2015).

References

Dixon, D. W. (2020). Opioid Abuse. Retrieved from https://emedicine.medscape.com/article/287790-overview#a5

Dydyk, A. M., Jain, N. K., & Gupta, M. (2020). Opioid Use Disorder.Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK553166/

NCBI. (2015). Substance abuse treatment for persons with co-occurring disorders. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK64179/

NIDA. (2018). Comorbidity: Substance use disorders and other mental illnesses. Retrieved from https://www.drugabuse.gov/publications/drugfacts/comorbidity-substance-use-disorders-other-mental-illnesses

SAMHSA. (2019). A national survey of drug use and health .Retrieved from https://www.samhsa.gov/data/release/2019-national-survey-drug-use-and-health-nsduh-releases

Thomas, S. (2020). Alcohol and drug abuse statistics. Retrieved from https://americanaddictioncenters.org/rehab-guide/addiction-statistics

Whitbourne, S. K. (2020). Abnormal psychology: Clinical perspectives on psychological disorders (9th ed.). NY: McGraw-Hill Education.

Bipolar disorder affects 4% of the American population and is a chronic disease that typically requires lifelong treatment (McCormick et al., 2015). 120 billion in US spending is the cost to treat bipolar disorder in the US annually and this cost continue to grow (McCormick et al., 2015). Treating and diagnosing these disorders have a specific criterion in the differentiation of diagnosis (McCormick et al., 2015). Cyclothymic disorder does not meet the specific criteria to meet depressive and or hypomanic disorder in Bipolar type 2 disorder (McCormick et al., 2015). However, individuals with these symptoms at a lower extent are at higher risk for the development of Bipolar type 1 and 2 (McCormick et al., 2015). The duration of symptoms is longer with cyclothymic disorder, and can assist in diagnosis (McCormick et al., 2015).

McCormick, U., Murray, B., & McNew, B. (2015). Diagnosis and treatment of patients with bipolar disorder: A review for advanced practice nurses. Journal of the American Association of Nurse Practitioners, 27(9), 530–542. https://doi.org/10.1002/2327-6924.12275

National Institute of Mental Health (NIH). (2020). Bipolar disorder. Retrieved from https://www.nimh.nih.gov/health/topics/bipolar-dis…