Bipolar Disease

Essay by DRDAVEUniversity, Bachelor's September 2004

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Bipolar Disease

My client this week, I will refer to him as Mr. Smith, has returned to jail for the fifth time in 2 years. Diagnosed with bipolar disorder, Mr. Smith had recently decided to stop taking his medication because he stated that his medications were making him fat and nervous. Mr. Smith has been treated with novel antipsychotic drugs. Within five weeks of the cessation of his medications he was arrested and jailed.

Bipolar disorder is characterized by extreme mood swings, the unmistakable poles of a cycle are inconsolable misery (depression) and uncontrollable elation (mania). During the low periods, people lose all interest in life and capacity for pleasure. They find it difficult to concentrate, make decisions, or take initiative. Suicidal thoughts are common. During the manic phase, people are energetic, cheerful, talkative, and sleep little. They have unrealistic visions of wealth, power and love. They can be intrusive and domineering, may make indiscriminate sexual advances and suddenly become irritable and turn to rage.

Their thoughts may degenerate into confused fragments and incoherent agitation. They may become delusional.

What situations would prompt an individual diagnosed with bipolar disorder to suddenly stop taking their medications, which have clearly helped them to function normally within society and which have helped to stabilize their extreme mood swings?

Patients often pay a high price in side effects for the relief provided by conventional antipsychotics. "Weight gain may be the most serious drawback of the novel drugs...like the extrapyramidal symptoms caused by older drugs, weight gain is a serious side effect that portends even more serious long-term consequences, it can make people stop using the drug and relapse." (Harvard Mental Health Letter, September 2002, pg.2)

I feel that Mr. Smith needs to be counseled on the other options in medication available to him,