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Concerns for a Person with a Bipolar Disorder

Updated on July 22, 2016

Abstract

Bipolar disorder is a key public health issue; diagnosis often occurs several years after the disease has commenced in the body. Managing this disorder entails medication regimen that lasts for a lifetime. This disorder is treated with a cocktail of medication that usually consists of more than one medication. It also involves attention to psychological aspects of the patients by their friends and family. The management regimen is well established. There has been a rise of interest recently in this sector; this has spurred a lot of research on the issue. A major source of concern concerning this disorder involves the management of repeating episodes, depressive and mixed episodes. In addition to this, there has been a lot of research regarding the societal concerns for persons with this order. This paper seeks to elucidate the overall concerns for a person with bipolar disorder. This is on the finances, therapies, and socialization involved.

Bipolar disorders normally afflict the sufferer’s life from all angles. This includes; daily living, vocational objectives, physical health, interpersonal relations, among other social and spiritual affairs. It normally entails frequent relapses and may need long-term support. Recovery may be described as getting the most out of functioning and minimizing disability while promoting the overall wellbeing. Current comprehensive assessments and interventions meant to treat the disorder are useful and should reflect individual needs. These needs may include the needs of the significant others and any other involved party.

Bipolar disorder

Source

Executive Summary

Over the past ten years, bipolar disorder in both adults and children has become the focal point of media, researchers and the general public (Lofthouse and Fristad 73). Even with the increasing interest, a continuation of current research is important. Bipolar disorder has the potential to disrupt family life, normal functioning and peer to peer relations. If unattended, it may lead to an extended course, riddled with instances of relapsing and slow response to treatment (Lofthouse and Fristad 72).

This paper tackles the relevant question of the considerations to make regarding the various financial, therapeutic and social considerations to make concerning persons living with bipolar disorder. It has been drafted by an independent individual. My main aim was to review the financial, social and therapeutic concerns made concerning persons living with bipolar disorders and to propose recommendations for improvement. I attempted to detail the present comprehension of the important role of sleep in the presentation of bipolar disorder. I aim to elucidate that sleep can serve as a target of the treatment regimen and the quantification of drug response. This is because the depressive stage of bipolar disorder is characterized by disturbed sleep patterns.

I laid more emphasis on the modalities pursued in the etiology, epidemiology, evaluation and management of this condition in individuals. This condition is a complicated psychiatric disorder to manage and treat. This is even for psychiatrists. This paper shows the various considerations taken for a person with bipolar disorder. These include; socialization, financial and therapeutic aspects.

Financial concerns

The economic and financial ramifications of managing bipolar disorder are sky high (Lofthouse and Fristad 73). Bipolar disorder is considered to be the most expensive healthcare diagnosis. This is felt by both the patients and their health insurance policies. The average lifetime cost of managing bipolar disorder ranges from $11,720 per individual experiencing single manic events to approximately $624,785 for individuals with chronic or non-responsive bipolar episodes. Research has also documented that the direct costs associated with bipolar disorder totaled to $7 billion. This consisted of costs related to treatment for in-patient and out-patient care. This included expenses that were not directly related to treatment, such as the costs incurred in the criminal justice system (Quanbeck et al. 202).

In the same study, there was a total cost of $38 billion which encompassed the lost productivity of breadwinners and the principal wage earners in families. In a cost breakdown, the losses were as follows; wage earners lost $17 billion, caregivers lost $6 billion, homemakers lost $3 billion, institutionalization cost $3 billion while the productivity losses for individuals who were lost to suicide amounted to approximately $8 billion.

Insurance expenditures

This paper evaluated the various treatment rates and expenditures incurred by employers for behavioral healthcare. This also included an assessment of behavioral healthcare patients listed in large health databases storing insurance claims sponsored by employers.

The methodology used for this assessment involved scrutinizing claims filed from the year 1995 by nearly 1.7 million individuals. The average yearly charges per individual for bipolar disorder healthcare were determined. This also included the out of pocket expenses incurred by the patient and the inpatient admission rates in various hospitals. The healthcare expenditures for individuals with bipolar disorders were contrasted with the expenditures incurred by individuals with other behavioral disorders in these insurance policies.

The result was that approximately 7 percent of all individuals covered by the plan filed a behavioral healthcare claim. A significant portion of this group, amounting to over 3 percent was individuals with bipolar disorder. All in all, persons suffering from bipolar disorders accounted for approximately 13 percent of these accounted for individuals with bipolar disorders. Persons with bipolar disorders spent approximately $568 in out of pocket expenses every year. This was more than twice the $232 spent by other claimants in out of pocket expenses. The admission rate for persons with bipolar disorders was also elevated, at 39.1 percent. This was higher, compared to an admission rate of 4.5 percent for the other behavioral healthcare patients combined. In addition to this, the insurance payments made every year were higher for persons with insurance policies covering medical services for bipolar disorders. This was in comparison with diagnoses for other healthcare issues.

The costs incurred by friends and relatives of patients are mainly due to lost work hours and skipping working days as a result of looking after the patients. This can be circumvented by employing caretakers. This will ensure that the patients are properly taken care of by professionals and those around them do not skip job responsibilities which may compromise the financial standing of the family.

I concluded that bipolar disorder is the costliest of all behavioral healthcare diagnoses. This is both for individuals with bipolar disorder, including for their insurance policies. Patients suffering from bipolar disorder spent approximately $1.8 more on in patient healthcare than patients suffering from other behavioral disorders. This indicates that improved prevention and management can reduce the financial weight of bipolar disorder.

Socialization concerns

Concerns of family, caregivers and the society at large

The social effects of bipolar disorders include disability, lost work productivity, increased utilization of health services and functional impairment. The effects have been evidenced through cross-sectional evaluation, longitudinal evaluation and randomized experiments involving trials of particular treatments or treatment regimen. Persons suffering from bipolar disorders or those who have a friend or relative suffering from these disorders normally undergo considerable losses in their functional status and general quality of life. This ultimately places undue strains on personal and family relationships (Dickerson et al. 55).

The strain on personal relationships may arise from the individual facing difficulties in recapturing employment, losing productive working days and the increased probability of interacting with the criminal justice system. As stated above, this not only contributes to the cost but also to the disability connected to the disability connected to the bipolar disorder. The level of functional impairment can be heightened for individuals suffering from bipolar disorder, along with other chronic disorders such as epilepsy (Dickerson et al. 57).

A study found that more than 56 percent of individuals suffering from bipolar disorders also abused or were totally dependent on illicit drugs such as narcotics and benzodiazepines (Merikangas et al. 49). The study also found out that 44 percent of individuals suffering from bipolar disorders had or were slipping into co-morbid alcohol abuse. The pressure to provide close contact to these individuals by their family members placed a great toll on their family members and caregivers. It was also discovered that these patients had higher divorce rates or had marital issues. The family members and caregivers of these patients not only had to deal with the effects of the patient’s symptoms, but they also felt the effects of patient’s illnesses on their jobs and their leisure times (Dickerson et al. 57).

When missed work hours were combined to lower productivity as a result of stress, there was an increased financial weight on the family members and the caregivers. This effect also snowballed to the society as a whole.

Concerns of the patients

Patients suffering from bipolar disorder had difficulty in their social skills from childhood to adolescence, through to adulthood. They also had depression and other conditions which were related to mental issues.

Therapeutic concerns

Bipolar disorders exhibit an increased association with drug and substance abuse disorders; however, the pathophysiological dynamics of this disorder have not been fully investigated and documented. Stress has been found to be a major factor in the onset and resurgence of the repeated episodes of bipolar disorder. It was also responsible for the instances of substance abuse. The role of stress and other factors involved in the sensitization of bipolar disorder was reviewed to assess its relationship with mood events and the abuse of narcotics. The role of sleep in bipolar disorders has been investigated. This is to explore its possible application as a treatment objective and a way of quantifying response to the various strategies employed.

Sleep disorders have been identified as a major contributor to mania in patients suffering from bipolar disorder. In specific instances, the interference of breathing as a result of the blockage of the airways during sleep apnea leads to repeated arousals during sleep. If disturbed sleep can be used to check developing or fully developed bipolar disorder, improved sleep may be used as an indicator of improvement in individuals suffering from this disorder. Practitioners have utilized therapeutic agents who employed sleep to target bipolar disorder in individuals.

Sedation has been used to manage acute bipolar disorder from the eighteenth century. Sedating agents used include; alcohol, chloroform, opium, and bromides. Modern sedating agents include benzodiazepines and antipsychotic medication (Findling 2003).

It is evident that sleep distortions, irrespective of the cause, is imperative to the management of bipolar disorder in patients. The direct cause and effect links have not been properly documented (Findling 2003). Some practitioners have argued that to overshadow the complex behavioral tendencies and symptom relationships exhibited in bipolar disorders, it is important to reduce them into putative endophenotypes. This entails the sleep-wake phenotypes, for example, the circadian rhythm instability. Therefore, a pragmatic approach towards the management of disorders linked to sleep issues in patients with bipolar disorders should be followed. A careful evaluation of the sleep quantity and quality should be done. Considerate application of therapies involving behavioral and pharmacological approaches should be pursued. Screening for disorders linked to sleep and bipolar disorders is important to the management of the afflicted populace. It is important to channel further research into this sector since this will provide more evidence template for particular sleep linked modalities in the management of bipolar disorder. It is imperative to enable the patient to identify a network of people who will be able to provide the necessary support for them. This should be done in an effective way which will not seem to stigmatize to the patient; it should be able to stimulate the patient to seek early intervention. Following this route will ensure that patients can develop new mood episodes. The net result is that the patient will benefit from putting into place plans which will give them hope as well as direct them towards a path of attainable, realistic and tangible goals. The patients should be provided with active help to maintain and not to jeopardize important relationships with other people, financial standings and employment status. Caregivers should take seriously any concerns by the patient of the development of bipolar disorder in offspring or siblings. By providing the patient with a supportive network, the identification of early signs of a probable mood disorder can be achieved. Such approaches can enhance the patient’s co-operation towards management and enhance their sense of hope.


Conclusion

It is advisable that all the medical and psychological interventions be undertaken with considerations towards the importance of the therapeutic connection between the patient and the provider. There should be a supportive environment which will enable the patient to build up trust in the provider and his or her team. An important component of this approach is that the patient should feel free to open up about the various aspects of his or her disorder including satisfaction and displeasure with the medical regimen employed. This will ensure that continued treatment will be tailored to fit the needs of the patient and as such will be very relevant. It will also ensure that the patient’s continued participation will be meaningful and will be of great efficacy. Periodic evaluations of the treatment plan should be carried out. This assessment should include the psychosocial history done together with the patient so as to make the relevant changes. The medical practitioner should also work together with the friends and family of the patient whenever permission is obtained. The choices that are made regarding the treatment options to pursue should be made as a result of the shared process between the patient and the medical practitioner. For situations where the patient and the practitioner come from diverse cultural backgrounds, an interpreter should be availed so as to enable effective communication between the two parties.

Therapeutic approaches such as group therapy and cognitive therapy ought to be pursued. Results of the efficacy of group trials from uncontrolled experiments offer very promising results for the treatment of bipolar disorder. Cognitive therapy approaches should be employed in psycho-education intervention. The opinions of recognized medical practitioners agree that cognitive therapy is a very important approach in the management of bipolar disorder. Persons with this disorder should also be offered rehabilitation services. This should include, but should not be limited to vocational and occupational therapy. These provide environmental adaptations to build on a patient’s social and cognitive abilities to determine if an individual is ready to assume life roles and face responsibilities. Vocational rehabilitation can help the patients acquire important skills so as to enhance their skill development. This approach can enhance work behaviors and attitudes which are required for the individual to find, get and keep gainful employment.


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