Bipolar disorders intervention

Rates of smoking among patients with bipolar disorders and anxiety disorders (e.g., posttraumatic stress disorder, panic disorder) are also higher than those in the general population (Lasser et al. 2000), but there has been htde smdy of the factors associated with motivation to quit smoking or of smoking cessation interventions in these patient groups. 

There is strong evidence that bipolar disorder is associated with SUD in adolescents (Wilens et ah, 1999) and that pharmacological interventions are an effective treatment for youth with SUD and bipolar disorder. Two studies, including one randomized controlled study, have reported that mood stabilizers, specifically lithium and valproic acid (Depakote), significantly reduced substance use in bipolar youth (Donovan and Nunes, 1996 Geller et ah, 1998). In addition, these agents are considered effective agents for the treatment... 

On a slightly more positive note, combination treatments, such as combined mood stabilizers or mood stabilizer plus antidepressant, may decrease relapse rates early, aggressive intervention may shorten subsequent episodes and newer agents, such as VPA, CBZ, or lamotrigine may benefit previously resistant subgroups of bipolar disorders. It is also encouraging that patients in good remission on lithium often view themselves favorably compared with normal control subjects on life satisfaction and adjustment measures. 

Like many other psychiatric and medical disorders, bipolar disorder is not curable, but it is certainly treatable. Its clinical symptoms can be controlled, modified, and even silenced. Successful treatment must combine drug therapy, psychotherapy, and psychoeducation. More and more frequently, treatment is provided by a team that, at a minimnm, includes a physician—usually a psychiatrist—and a therapist. Whenever possible, treatment should involve the patient s immediate family (sponse, parents, and children). Although medication is the core intervention, it is widely recognized that a number of psychological variables can inflnence the course of the disorder and the patient s adherence to treatment. 

Medications are the core feature in the treatment of bipolar disorder. Without their skillful application, there is little hope for a good result. However, the illness and its course, coupled with the current imperfections of medication, make the use of psychotherapy and other psychosocial interventions essential tools. Bipolar patients are faced with myriad issues and obstacles that have a profound impact on how they perceive themselves and their future (Table 3.24). 

Clarkin, J., Carpenter, D., Hull, J., Wilnei P., Click, I. (1998). Effects of psychoeducational intervention for married patients with bipolar disorder and their spouses. Psychiatric Services, 49(4), 531-533. 

Abstract Glycogen synthase kinase 3 (GSK-3) has emerged as a prominent therapeutic target for intervention in several diseases including non-insulin-dependent diabetes mel-litus, Alzheimer s disease, stroke, bipolar disorder and affective disorders. In the present review we briefly summarise the properties of GSK-3, focusing primarily on the role of GSK-3 in Alzheimer s disease. Furthermore, we discuss the potential for therapeutic benefit of GSK-3 inhibitors. 

Soares-Weiser K, Bravo Vergel Y, Beynon S, Dunn G, Barbieri M, Duffy S, Geddes J, Gilbody S, Palmer S, Woolacott N (2007) A systematic review and economic model of the clinical effectiveness and cost-effectiveness of interventions for preventing relapse in people with bipolar disorder. Health Technol Assess 11 iii-iv, ix-206. 

Social work practitioners must understand the intricate nature of bipolar disorders as they teach clients and their families about the disorder and help the client accept intervention efforts. It is beneficial to assist the client in understanding that bipolar disorder is not an all-or-nothing mental health condition, that is, that they are either depressed or not. In fact, clients need to be helped in gaining greater understanding of the overlapping and cyclical nature of the mood states that will be experienced as well as the subsequent course of the illness. 

INTERVENTIONS WITH CLIENTS WHO HAVE BIPOLAR DISORDERS... 

In the previous section we discussed the importance of accurately assessing and diagnosing bipolar disorders and fully distinguishing between the different mood states that these clients can experience. In this section the emphasis will be on the types of treatment interventions that are available and often used successfully to manage bipolar symptoms. 

The general objectives of treating acute episodes, preventing future episodes, and restoring the client s functioning become the primary focus of treatment with clients who present with bipolar disorder symptoms. Use of medication becomes the front line of intervention with bipolar... 

In addition to medication, social work practitioners use various psychosocial interventions such as individual and group therapy in the treatment of the bipolar disorders. Of equal importance as treatment modalities are specialized addiction groups designed to also treat coexisting disorders such as substance abuse that clients with bipolar disorders experience (Weiss, Griffin, Greenfield, Najavits, Wyner, Soto, Hennen, 2000). 

Treatment interventions for bipolar clients should be structured clearly and mapped out in a plan that delineates strategies for handling the problems associated with bipolar symptoms. Social work practitioners will often encounter resistance from clients with bipolar disorders, especially those experiencing a manic episode where energy, creativity, and feelings are at an all-time high. Regardless of the resistance, it is the practitioner s responsibility to help the client and family members formulate, implement, and monitor the interventions necessary to eliminate the bipolar symptoms. 

Clients with bipolar disorders cannot be helped until they have been thoroughly assessed for appropriate medication. Once the need for medication is determined, the goal is to identify the appropriate medication and dosage. Clients with bipolar disorder, and for Aat matter any client with a serious psychiatric illness, should not be prescribed medication as the sole treatment intervention. Although major advances have been made in the field of psychotropic medication, clinical practice and the literature have always emphasized the multifaceted approach for multidimensional problems. It is important to remember that all mental illnesses impact on the biological, social, and psychological spheres of a client s life and functioning (Walsh, 1989). 

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