Psy 249 discussion

Respond to 2 peers:

Peer 1: (Madison W)

There are seven bipolar disorders listed and explained in the DSM 5 criteria. The list includes:

· Bipolar I disorder

· Bipolar II disorder

· Cyclothymic disorder

· Substance/medication induced bipolar and related disorder

· Bipolar and related disorder to do another medical condition

· Other specified bipolar and related disorder

· Unspecified bipolar and related disorder

Bipolar I disorder criteria is the “modern understanding of the classic manic-depressive disorder”. (American Psychiatric Association, 2013, pg. 123). At least one lifetime Manic episode is needed to diagnose Bipolar I disorder. There could also be Hypomanic episodes, and Major Depressive episodes. “The essential feature of a manic episode is a distinct period during which there is an abnormally, persistently elevated, expansive, or irritable mood and persistently increased activity or energy that is present for most of the day, nearly every day, for a period of at least 1 week (or any duration if hospitalization is necessary)” (APA, 2013, pg. 127). This must be accompanied with three additional symptoms listed in criterion B on page 124 of DSM-5.

The symptoms include,

· “Inflated self-esteem

· decreased need for sleep

· more talkative

·  racing thoughts

· increase goal-directed activity

· psychomotor agitation

· Distractibility

· Excessive involvement in activities that have negative consequences

(APA, 2013, pg. 124).

Bipolar II disorder criterion requires a current or past hypomanic episode AND a current or past major depressive episode. (APA, 2013, pg. 132). There must never have been a manic episode for a person to have Bipolar II. Any hypomanic episodes or major depressive episode cannot be explained due to another issue like schizophrenia. (APA, 2013, pg. 134). Lastly, the not knowing and unpredictability of expecting an episode causes extreme distress or impacts social life.

Cyclothymic Disorder is like an early onset variation of bipolar II. If the patient starts with many hypomanic symptoms and hyper depressive symptoms for at least two years in adults that do not meet criteria for major depressive episode. If a major depressive episode occurs after 2 years of cyclothymic disorder, they will be additionally diagnosed with Bipolar II. (APA, 2013, pg. 138).

Substance/medication induced bipolar and related disorder can be diagnosed with evidence of symptoms of bipolar occurring “during or soon after substance intoxication or withdrawal or after exposure to medication.” (APA, 2013, pg.142). The symptoms must not be explained by a diagnosis of bipolar or related disorder that is not medically induced. The disturbance must not be during delirium or impair social, occupational, or other important areas of functioning. (APA, 2013, pg. 142).

Bipolar and Related Disorder Due to Another Medical Condition is a “prominent and persistent period of abnormally elevated, expansive, or irritable mood and abnormally increased activity or energy that predominates in the clinical picture” (APA, 2013, pg. 145). There much be medical evidence that the symptoms are from a direct pathophysiological consequence of another mental disorder. The disturbance must not be explained by another mental disorder, causes social and all-around distress. (APA, 2013, pg. 145).

Other Specified Bipolar and Related Disorder applies to any symptoms that are related to bipolar disorders but do not meet full criteria to diagnose.

 Unspecified Bipolar and Related Disorder applies to the same as above but the clinician “chooses not to specify the reason the criteria are not met for specific bipolar.” (APA, 2013, pg. 149).

The difference between bipolar and depression are the manic episodes. They both have major depressive episodes, but depression lacks the manic.

Medication can be extremely helpful for depression when used properly and in conjunction to therapy. SSRI’s help the brain produce more serotonin and can help with a lot of the depression symptoms. Unfortunately, with medication also comes with side-effects like possible suicide ideations (a side effect of depression without medication as well), feeling like a zombie, low libido, and other side effects depending on the medication. For bipolar disorder, mood stabilizers are a good medication to start with to help stabilize the up and downs. One common medication for mood stabilizers is Lithium. With any medication comes the possible difficulty of addiction, withdrawal and more.

Resources

American Psychiatric Association, 2013.   https://cdn.website-editor.net/30f11123991548a0af708722d458e476/files/uploaded/DSM%2520V.pdf

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Peer 2:

(Brooklyn Garcia)

Some maintain that the suicide rate for the elderly is higher among white Americans than among Native Americans because of the way the two groups value (or don't value) the elderly. Discuss at least three distinct differences in the way the two groups treat the elderly that might legitimately be related to the suicide risk.

1. Native Americans value the elderly more since they view them as the ones with wisdom and advice to give or share with the community. (Comer, Pg 228) This would off set the risk of suicide since the elderly in this group are seen as valuable among the community. In contrast White Americans despite respecting our elderly do not rely on the wisdom they have to share and often view it as just story telling. The elderly in this group are respected but not valued and in turn would be more prone to risk suicide.

2. White Americans also feel a very strong sense of self, by this I mean that often when our elderly get older they grow sick and rely on the children to help care for them with so many of us working jobs, running households, etc adding this onto our list sometimes becomes overwhelming leaving us to send our elderly to homes. In turn by doing this the elderly can then grow lonely and no longer feel included in the family as apposed to Native Americans who are very family orientated. (Comer, Pg 228) This feeling of loneliness or abandonment may eventually lead to suicide attempts.

3. I also believe another big difference is for white Americans we value the young more than the elderly. We see the young as still having a full life to live while we view the older generations as already having lived their life hence they are in a sense "disposable" if you had to choose to save an older lady from getting hit by a car or a 7 year old boy more often then not the little boy would be saved. This depends largely on the culture you grew up in as well native Americans have a large history and the things that can be passed down are seen as very valuable tools or information to this culture. Since this is a big difference in the two groups I believe its important to note that while neither group volunteers their elderly to die or encourages it as white Americans we also do not actively try to prevent it. This leads into the fact elderly also have more do not resuscitate orders since they have nearly the same mindset of having lived their life already when entering older ages. (Comer Pg 228)

The main distinct difference I believe is what the two groups value in their cultures more. In a previous class for ethics I read about the Inuit tribes and how they favored male children more than females because in their culture the males were the protectors. The Inuit would kill female babies to help control population and because for their culture it was difficult to have multiple children who needed care with constant travel this also extended to the elderly. So as with white Americans and native Americans I believe the main difference is where we place our values and what we deem as important to our culture. Native Americans value the history and lessons taught by the elderly while White Americans value more the youth and what they can bring to the future.