Abnormal Psychology Research Paper Rough Draft

Introduction

Depressive and Bipolar disorders are mental disorders are complex mental disorders that affect the mood and are characterized by episodes of mania, depression, and hypomania. Common subsyndromal symptoms accompany these disorders, often presenting between these episodes. These disorders have been implicated as one of the major causes of morbidity and disability worldwide, as well as in overall reduction in quality of life and mortality (Baldassano et al., 2016). Depressive disorder, also known as major depressive disorder, is a debilitating disorder that presents with depressed mood, impairment in cognitive functions, and diminished interest. Major depressive disorder is also characterized by vegetative symptoms such as loss of appetite and sleep impairment among others.

Treatment of depressive and bipolar disorders utilizes both pharmacological and non-pharmacological interventions. Pharmacotherapy with drugs is the mainstay treatment modality that produces better clinical outcomes (Baldassano et al., 2016). However, adjunctive therapy with non-pharmacological modalities such as alternative/complementary approaches has been found to yield superior outcomes to pharmacotherapy alone. Alternative/ complementary approaches produce particular benefits in patients who develop unfavourable side effects that are linkable to these drugs, as well as those who do not comply with medications. This forms the basis of their adjunctive use in the treatment of depressive and bipolar disorders. Medications that are utilizable in the management of these disorders include olanzapine and fluoxetine, as well as atypical antipsychotics and mood stabilizers such as lithium and valproate.

Non-pharmacological interventions have also been utilized, especially in the hypomanic and depressive phases of these disorders. Therapies such as meditation and guided imagery, as well as exercise, provide considerable benefits in the alleviation of these symptoms (Strulovici, 2017). Depressive and bipolar disorders are chronic disorders that may exist lifelong. Management interventions are therefore targeted at symptomatic relief and in the prevention of sequelae that may be attributable to the pathophysiology of these disorders.

Purpose and Thesis Statement

First Main Point

Management strategies in depressive and bipolar disorders are aimed at offsetting the symptoms. Pharmacological interventions with drugs remain the cornerstone in the symptomatic management of these disorders. Examples of drugs that have been approved for the management of the depressive phase of these disorders include olanzapine/ fluoxetine combination, quetiapine, and lurasidone. Other drugs that maintain high efficacy in the alleviation of depressive symptoms include lamotrigine, antidepressants such as imipramine, paroxetine, and bupropion, as well as pramipexol, olanzapine, modafinil, and ketamine. These drugs are efficacious in relieving depressive symptoms in these disorders. The manic phase is also treatable by medications such as lithium and antipsychotic agents such as olanzapine, risperidone, haloperidol, and valproate. The use of these drugs is, however, limited by their toxicity profile, with most of them being implicated in side effects that, in some instances, warrant their withdrawal.

The side effect profile of these drugs varies. These side effects include weight gain, akathisia, metabolic dysregulation, somnolence, erectile dysfunction, and nausea, among others. These side effects form the basis of poor compliance with these medications. According to (Jawad et al., 2018), medication non-adherence to bipolar and depressive disorder medication often follows a spectrum that varies from partial nonadherence to complete no adherence. Medication adherence is dependent on several factors that border both the patient and the healthcare provider. Medication side effects remain a major cause of partial adherence. The most implicated side effect was weight gain that developed upon initiation of several bipolar medications. This side effect is considerably disturbing to younger adults and has been implicated in various instances of non-adherence to medication.

Another factor is the complexity of the medication regimen utilized in the management of these disorders. Higher pill burdens have been implicated in poor medication compliance and consequent non-adherence. This is especially disturbing in patients with comorbidities such as those with cardiovascular disorders who have to take medication to manage both their bipolar and depressive symptoms as well as their underlying cardiovascular disease. This article emphasizes medication adherence as the main determinant of improving clinical outcomes in patients with depressive and bipolar disorders. This article highlights the various causes of non-adherence and how these factors contribute to treatment failures.

Non-adherence to medication use in bipolar disorders remains to be the major cause of poor clinical outcomes and in the progression of these depressive disorders. Mago et al., 2016, reinforce this point by noting that medication non-adherence especially to mood stabilizer medications has majorly been linked to their toxicity profile. Weight gain, tremors, perceived cognitive impairment, and sedation has been reported to be the major reasons why people with bipolar disorders stop taking their medications. This article demonstrates a nexus between the commonly occurring side effects of common bipolar medications and the propensity to non-adherence. It reports that many patients will stop taking these medications upon the realization of these side effects. It also challenges prescribers to educate their patients on the anticipated side effects of these drugs as well as how they can maneuver through some of them.

Second Main Point

Bipolar and depressive disorders often present with other vegetative symptoms such as the inability to feed properly, inability to exercise, too much sleep or insomnia in others, and suicidal thoughts among others. These symptoms often contribute to the deterioration in their quality of life. The overall effect in these patients is evident in poor mental and physical states as well as in disability and morbidity states.

Overweight and obesity are common presentations in individuals with depressive and bipolar disorders. The high prevalence of obesity, overweight and metabolic disorders in these populations is linkable to the fact that bipolar disorders and these presentations appear to follow similar risk factors. Such factors as sympathetic nervous system dysregulation, behavior pattern changes, and endocrine disturbances among others have been implicated as risk factors to all of these clinical presentations.

Obesity and metabolic disorders have been implicated in increased health burden with their consequence being increased morbidity and hospitalizations. Medication use in bipolar disorders often tends to cause side effects of weight gain and metabolic dysregulation that in turn augments the clinical presentations of obesity and metabolic disorders (Fagiolini et al., 2016). The occurrence of these disorders often predisposes individuals to cardiovascular-related diseases such as hypertension and dyslipidemia. The overall effect of these comorbidities is evident in the deterioration of physical health, increased morbidity, and mortality attributable to worsening of the underlying cause. This article reinforces the need to liberate individuals with bipolar disease from vegetative symptoms such as physical inactivity and insomnia that are directly implicated in the development of obesity and overweight. Findings on the article reveal that the synergistic effects of medication and underlying symptoms of inactivity largely contribute to metabolic disorders and obesity that in turn predisposes an individual to various chronic cardiovascular disorders.

Physical activities such as exercise produce significant benefits for depressive disorders. According to Thomson et al. (2016), exercise produces dual benefits in symptomatic relief of the depressive phase of bipolar disease as well as in the prevention of obesity and overweight, which are highly prevalent in this population. Exercise will promote physical well-being and prevent diseases such as dyslipidemia and metabolic disorders, among others. This article shows the significance of exercise in the management of bipolar disorders. It exhibits how exercise can prevent the occurrence of conditions that may otherwise worsen the disease state and increase morbidity and mortality among these patients.

Third Main Point

Non-pharmacological interventions are also effective in the treatment of depressive and bipolar disorders and have been used in the adjunctive treatment of these disorders. These therapies include cognitive behavioral therapy, psychoeducation, and family-focused therapy among others (Strulovici, 2017). These interventions produce considerable efficacy in maintaining a euthymic state and alleviating the subsyndromal symptoms occurring between episodes, as well as in improving occupational and social functionality. These therapies are often used as adjuncts to conventional pharmacotherapy with drugs. These treatment modalities have been found to reduce relapse rates and have a positive impact in enhancing individual well-being and quality of life. This paper reinforces the need to consider non-pharmacological intervention in the management of depressive and bipolar disorders. Modalities such as cognitive behavioral therapy and family-focused therapies offer greater results than other forms of therapy.

Cognitive-behavioral therapy (CBT) maintains superiority over other non-pharmacological therapies in the treatment of depressive and bipolar disorders. CBT decreases the rates of relapse and improves considerably the symptoms of depression and mania (Chiang et al., 2017). This article reviews the efficacy of CBT as an adjunct to drugs in the treatment of bipolar disorders. It reveals that the clinical outcomes were better when CBT was included in therapy than when pharmacological interventions were used along. It revealed a considerable reduction in the severity of the manic and depressive phases as well as a reduction in the relapse of episodes. This shows its superiority in the management of these disorders.

Treatment of depressive and bipolar disorders utilizes pharmacological and non-pharmacological strategies. Pharmacological strategies utilize drugs. These drugs, however, produce considerable side effects that may limit their use and contribute to non-adherence. Non-pharmacological strategies have been used as adjuncts to medications. Their significance in offering better clinical outcomes when used adjunctively underpins their use.

 References

Baldassano, C., Datto, S., Littman, L., & Lipari, M. (2016). What Drugs Are Best for Bipolar Depression?. Annals Of Clinical Psychiatry, 15(3), 225-232. https://doi.org/10.3109/10401230309085692

Chiang, K., Tsai, J., Liu, D., Lin, C., Chiu, H., & Chou, K. (2017). Efficacy of cognitive-behavioral therapy in patients with bipolar disorder: A meta-analysis of randomized controlled trials. PLOS ONE, 12(5), e0176849. https://doi.org/10.1371/journal.pone.0176849

Fagiolini, A., Chengappa, K., Soreca, I., & Chang, J. (2016). Bipolar Disorder and the Metabolic Syndrome. CNS Drugs, 22(8), 655-669. https://doi.org/10.2165/00023210-200822080-00004

Jawad, I., Watson, S., Haddad, P., Talbot, P., & McAllister-Williams, R. (2018). Medication non-adherence in bipolar disorder: a narrative review. Therapeutic Advances In Psychopharmacology, 8(12), 349-363. https://doi.org/10.1177/2045125318804364

Mago, R., Borra, D., & Mahajan, R. (2016). Role of Adverse Effects in Medication Nonadherence in Bipolar Disorder. Harvard Review Of Psychiatry, 22(6), 363-366. https://doi.org/10.1097/hrp.0000000000000017

Strulovici, A. (2017). Non-pharmacological therapeutic recommendations in bipolar affective disorder. Psihiatru.Ro, 1(48). https://doi.org/10.26416/psih.48.1.2017.1006

Thomson, D., Turner, A., Lauder, S., Gigler, M., Berk, L., & Singh, A. et al. (2016). A brief review of exercise, bipolar disorder, and mechanistic pathways. Frontiers In Psychology, 6. https://doi.org/10.3389/

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For this assignment, you will use the approved subject from Topic 1. Review Topic 3 outline feedback and consider this feedback when developing your rough draft.

In 1,200-1,500 words, address the following:

Provide a comprehensive explanation of the selected subject (e.g., clinical definition, background information).
Address the societal and/or cultural implications of the chosen subject.

Abnormal Psychology Research Paper Rough Draft

Discuss how the subject is related to one or more models of abnormality, as discussed in Chapter 3 of the textbook.
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