08 Oct Bipolar Disorders

Bipolar Disorders

This abstract from Nature Reviews Disease Primers (Vieta et al., 2018) offers a succinct way to think about bipolar disorders:

Bipolar disorders are chronic and recurrent disorders that affect >1% of the global population. Bipolar disorders are leading causes of disability in young people as they can lead to cognitive and functional impairment and increased mortality, particularly from suicide and cardiovascular disease. Psychiatric and nonpsychiatric medical comorbidities are common in patients and might also contribute to increased mortality. Bipolar disorders are some of the most heritable psychiatric disorders, although a model with gene–environment interactions is believed to best explain the aetiology. Early and accurate diagnosis is difficult in clinical practice as the onset of bipolar disorder is commonly characterized by nonspecific symptoms, mood lability or a depressive episode, which can be similar in presentation to unipolar depression. Moreover, patients and their families do not always understand the significance of their symptoms, especially with hypomanic or manic symptoms. As specific biomarkers for bipolar disorders are not yet available, careful clinical assessment remains the cornerstone of diagnosis. The detection of hypomanic symptoms and longitudinal clinical assessment are crucial to differentiate a bipolar disorder from other conditions. Optimal early treatment of patients with evidence-based medication (typically mood stabilizers and antipsychotics) and psychosocial strategies is necessary.

Reference: Vieta, E., Berk, M., Schulze, T. G., Carvalho, A. F., Suppes, T., Calabrese, J. R., … Grande, I. (2018). Bipolar disorders [Abstract]. Nature Reviews Disease Primers, 4. Retrieved from https://www.nature.com/articles/nrdp20188

To prepare for the Discussion:

•             Review the media pieces listed in the Learning Resources.

•             Review the expectations in the Discussion Rubric.

Consider the following scenario:

Betty came to her second session with you describing what appear to be manic and depressive episodes. You have valid questions and concerns and want to get a formal psych eval.

How would you explain to Betty that you have concerns about her symptoms and want to refer her to see a psychiatrist for evaluation? Write out a mini script showing what you, the counselor, might say to Betty.

Respond to the following prompts using a mini script.

•             Provide an explanation of why counselors refer clients to a psychiatrist for a psych eval (what is and what is not in our scope of practice).

•             Explain what collaborative behavioral healthcare is.

•             Include a description of two circumstances when a counselor would refer a client for a psych evaluation.

•             Describe two circumstances when a counselor would use the Release of Information (ROI) signed by a client.

•             Include an empathetic reflection to Betty.

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