Distinguishing Bipolar and BPD Disorders
North Carolina Central University
Bipolar and Borderline Personality Disorder are mood and personality disorder respectively, that have had many challenges amongst psychiatrist in differentiation. Not only does the two disorders share several symptoms and associated impairments, there is also continuing debates in the psychiatric literature about whether the two disorders actually represent different conditions (Hatchet, 2010). The following paper compares and contrasts Bipolar and Borderline Personality Disorders and discusses implications of differential diagnosis of the disorders that can lead to long-term effects for the patient due to the fundamentally different treatment each disorder needs. Comparison of Bipolar and Borderline Personality Disorder
According to the Diagnostic and Statistics Manual of Mental Disorder, 4th edition Text Revision (DSM-IV-TR), bipolar is a recurrent mood disorder featuring one or more episodes of mania or mixed episodes of mania and depression (Antai-Otong, 2008). The bipolar disorders include, bipolar I disorder, bipolar II disorder, cyclothymic, and bipolar NOS disorders. Bipolar I disorder includes one or more manic or mixed episodes, usually with a major depressive episode. Bipolar II disorder includes one or two major depressive episodes and at least one hypomanic episode. Cyclothymic disorder includes at least 2 years of hypomanic periods that do not meet the criteria for the other disorders. Bipolar NOS, does not meet any of the other bipolar criteria.
The etiology of Bipolar disorder has been researched and documented for many years and has many theories and perspectives. Causative factors include psychodynamic, existential, cognitive behavioral and developmental and complex biologic and genetic factors (Antai-Otong, 2008). Signs and Symptoms (s/s) of Bipolar disorder varies from the type of episode they patient is experiencing. Major depressive episodes include a depressed mood or lose of interest for at least 2 weeks and five or more of the following: Significant weight loss or gain, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue, worthless feelings or inappropriate guilt, problem concentrating or recurrent thoughts of death. Manic episodes s/s includes, persistent elevated irritable mood of more than one week, increased self-esteem, decreased sleep, increased, increase talk and pressured speech, racing thoughts and ideas, distractibility, extreme goal-directed activity, excessive buying, sex and business investments (Pederson, 2012).
In order to have successful treatment of bipolar disorder, a holistic approach is the best therapy. This includes, pharmacologic and psychotherapeutic interventions. Pharmacologic include mood stabilizers, anti-depressants, anti-psychotics and electroconvulsive therapy. There has been a controversy with the use of anti-depressants for treatment due to its effect with mood stabilizers. It is not a mainstay, but is still prescribe when they are not sure if it is unipolar or bipolar, but becomes dangerous when switching from a depressive episode to a manic or hypomanic episode (Antai-Otong, 2011). Electroconvulsive therapy is the last resort if the mood stabilizers and anti-psychotics fail or when an immediate intervention is needed.
Psychotherapeutic intervention is mostly where the nursing care is used more frequently. Psychosocial and behavioral intervention, both fall under the umbrella of psychotherapeutic treatment and are important for more positive treatment outcomes. If a patient is in the acute phase, the nurses’ main focuses are safety and maintain a therapeutic milieu that facilitates resolution of symptoms and minimizes complications. The nurse also educated the client and family about medications, treatment options and other psychotherapies...
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