Treatment for Dementia and Bipolar I Disorder

Treatment for Dementia and Bipolar I Disorder.

Abstract

The paper looks into the treatment of mental health conditions namely dementia and bipolar I disorder. The paper begins by introducing the two disorders by providing information on their causes and symptoms. Dementia is caused by damage to the brain cells, which affects communication between brain cells thus affecting the normal functioning of a person. Treatment of dementia can take the form of drug and non-drug treatment. The drugs are prescribed depending on the cause and severity of the condition. Some of the causes of dementia include Alzheimer’s dementia, vascular dementia, and front temporal dementia. In the paper, treatment of dementia using drugs such as cholinesterase inhibitors, and memantine has been put into perspective. From different studies, drug treatment remains the best form of treatment as compared to non-drug treatment. On the other hand, drug treatment has also been proven the most appropriate form of treatment for bipolar treatment. Drugs such as quetiapine lithium, paroxetine, and placebo have been found to be very effective in mood stabilization and in acting as antipsychotics. Non-drug treatments have been found to have no capacity to work as a stand-alone treatment for bipolar disorder.

Treatment for Dementia and Bipolar I Disorder

Dementia is caused by damage to brain cells, which causes the inability of the brain cells to communicate with one another (Volicer, & Hurley, 2003). Different parts of the brain are responsible for different functions. It is through coordination of those brain parts that a person functions normally. Therefore, when communication between different parts of the brain is affected, a person’s ability to function normally is affected. For instance, when the cells around hippocampus and amygdala are damaged, memory and learning are affected. Evidently, damage of brain cells around the hippocampus causes loss of memory for people with dementia. The damage of the cells is caused by the presence of high protein cells in and outside of the hippocampus causing a condition called Alzheimer.

Bipolar I disorder is a mental illness where a person experiences a manic episode in his/her life. When under manic episode, the affected person exhibits a period of elevated energy and mood, which leads to abnormal behaviors (Moller, & Nasrallah, 2003). Other than a manic episode, the person suffering from bipolar I condition experiences depression, which leads to manic depression. Some of the symptoms of bipolar I disorder includes excessive loud speech, switching from one idea to another rapidly, excited self-image, hyperactivity with the lack of sleep, and substance abuse. When under the condition, it is possible that a person will lose touch with reality and do things that are abnormal. Some of the things include excessive spending, unrealistic plans, substance abuse, sex engagement with strangers, and other types of odd behaviors. The depression phase affects a person’s mood causing loss of appetite, loss of energy, low self-esteem as result of feeling guilt and endless thoughts (Moller, & Nasrallah, 2003). It is at this stage that a person can contemplate about committing suicide.

Treatment

Both dementia and bipolar I disorder have a myriad of ways in which they can be treated. In most cases, treatment of the two conditions depends on the cause and the extent to which it has developed. For the case of dementia, there is no absolute cure for the condition, and most of the treatments are done to support the brains to function further in the backdrop cell damage (Volicer, & Hurley, 2003). The two most widely used means of treatment for the two conditions are medication and psychotherapy. In medication, drugs prescribed by a pharmacist are offered, and a medication pattern is stipulated. For both of the conditions, behavior change is a common thing. In dementia, behavior changes are witnessed in the form of anger, irritability, depression, anxiety restlessness, sleep deprivation, delusions, and hallucinations. The above conditions are also present in people with the bipolar condition. Although there is no presence of medical drugs that cure dementia disorders completely, some effects of the condition are similar to those in bipolar meaning a common treatment can help reduce or alleviate the condition.

Most of the dementia disorders are not curable other than those that are caused by thyroid and vitamin deficiencies. The drugs that are administered to treat dementia are meant for increasing for inhibiting more severe brain damage. The progression of brain damage poses a threat to life. For dementia, the most appropriate treatment is medication. Brain damage is a serious condition that needs a medical approach for it to be treated successfully. Some of the common diseases that cause dementia are Alzheimer’s dementia, dementia with Lewy bodies, vascular dementia, and frontotemporal dementia.

The dementia medication is prescribed according to the condition that one is suffering from. For Alzheimer’s dementia patients, cholinesterase inhibitors are the most appropriate means of treatment. The cholinesterase inhibitors help the patients to function slightly better than when functioning without drugs. The cholinesterase inhibitors drugs work by helping the nerve cells become receptive to communication hence improving communication between brain cells. Cholinesterase inhibitors reinforce the chemical that mediates communication between nerve cells. The reinforcement of the chemical ensures sustained communication between nerve cells for a longer period. Memantine is another drug, which works best for patients with severe Alzheimer’s disease. Memantine improves the nerve cells thus enabling the cells to receive signals and send a communication to other cells. The drug helps dementia patients to function normally for some time. The drug only works best for patients with severe Alzheimer’s condition.

For patients with vascular dementia, medication is prescribed to treat conditions that lead to this condition. Some of the conditions that lead to vascular dementia include high cholesterol, high blood pressure, type 2 diabetes, and stroke and heart problems. So far, no drugs have been prescribed for the treatment of vascular dementia and frontotemporal dementia. Physiotherapy and antidepressant drugs are recommended for vascular and frontotemporal dementias to control psychological conditions that aggravate them.

Other than medical treatment, non-drug treatments are also used to control dementia. Some of the non-drug treatments used include aromatherapy, therapeutic use of music, animal assisted therapy, massage, and multi-sensory stimulation. Most of the non-drug treatments focus on improving cognitive skills through cognitive stimulation. Those involved benefit from improved memory, thinking skills and improved quality of life. The non-drug therapy is most appropriate for those with mild dementia conditions since it can help restore the loss of memory. Antipsychotic drugs also improve conditions such as depression, anxiety, agitation, sleep deprivation, and aggression.

Between the two types of treatment, medication treatment works best for dementia. Despite the drugs having several side effects, the significance of non-drug treatment is not scientifically proven. Non-drug treatment only works best for mild dementia conditions. In severe cases, the non-drug treatment has no significant impact in restoring memory and repairing the damaged brain cells and tissues. The use of medicines such cholinesterase inhibitors and memantine improves the nerve cells enabling them to receive and send information. Consequently, use of drugs helps the nerve cells to continue functioning for protracted periods in the face of continuous brain cells damage. On the contrary, nondrug treatment does not prolong functionality of the brain cells nor does it protect them against damage. Meta-analytic studies of cognitive-behavioral therapies have proven the effectiveness of the method in treating conditions such as depression, psychotic disorders, aggression, insomnia, and anxiety but no direct impact in the treatment of dementia. Behavioral therapy interventions help to improve the quality of life for people living with dementia (Logsdon, McCurry, & Teri, 2007). Moreover, the authors argue that lowered stress therapy intervention helps to lower depression and other stressors in dementia patients. Therefore, cognitive-behavioral therapies can help to mitigate factors that can aggravate dementia but not to cure dementia. The non-drug treatment only helps to develop a routine that foster cognitive skills to improve memory and thinking. Despite the cognitive stimulation, impacts non-drug treatments have not been scientifically proven to work better than drug treatments (Hoffman, Asnaani, Vonk, Sawyer, & Fang, 2012). Behavioral symptoms are the biggest issue of concern amongst most of the caregivers in the USA. According to Volicer, & Hurler (2013), the symptoms from the biggest burden for the caregivers hence it is important to address them comprehensively. That is why non-drug therapies are also important when caring for patients with dementia (Volicer, & Hurley, 2003).

On the other hand, in Bipolar I disorder, both drug and non-drug treatments are also used. Bipolar I disorder treatment focuses on acute stabilization to help a patient with the acute manic disorder to recovery with a stable mood (Geddes, & Miklowitz, 2013). According to Geddes and Milklowitz (2013), the goal of treatment is to prevent relapse, depression, and reduction of other minor symptoms of the disorder. Medication for bipolar disorders involves antidepressants to deal with depression, mood stabilizers to alleviate negative effects of moods (manic), and antipsychotics. Some of the drugs used as antipsychotic include lithium, paroxetine, placebo, and quetiapine. In research to establish the effectiveness of the four drugs, quetiapine was established to have symptomatic improvements in patients more than the other three drugs. Use of quetiapine is also established to have reduced risks to acute-phase treatment (Geddes, & Milklowitz, 2013). Thus, patients with resistance to the protracted use of quetiapine benefit from effective treatment. Moreover, quetiapine is an antimanic and antidepressant making it more ideal for dealing with the bipolar condition. Use of drug treatment has proven to be more effective in the treatment of bipolar I disorder than the use of non-drug treatment. Drugs such as quetiapine, olanzapine, fluoxetine, placebo, lithium work to stabilize moods and psychosis. In several studies, it has been found that very few patients fail to respond to first-line treatment using most of the drugs. In long-term maintenance, lithium was found to have a 28% effectiveness in reduction of depressive relapses, 38% in reduction of manic relapses and 50% success in reduction suicide risk (Hoffman, Asnaani, Vonk, Sawyer, & Fang, 2012)

Non-drug treatment is effective in dealing with some of the conditions experienced in people with bipolar I disorders such as aggressiveness, anxiety, depression and lack of sleep (Hoffman, Asnaani, Vonk, Sawyer, & Fang, 2012). But through a study, it was found that use of non-drug treatment such as cognitive-behavioral treatment could not work in isolation in the treatment of bipolar disorders (Hoffman, Asnaani, Vonk, Sawyer, & Fang, 2012). According to the writers, non-drug treatment only works best when it used as an adjunct to pharmacotherapy (Hoffman, Asnaani, Vonk, Sawyer, & Fang, 2012). Therefore drug treatment is the most appropriate means of treatment for bipolar I disorder.

References

Geddes, J. R., & Miklowitz, D. J. (2013). Treatment of bipolar disorder. National Institute of Health, 381(9878), 1672-1682.

Hoffman, S. G., Asnaani, A., Vonk, I., Sawyer, T., & Fang, A. (2012). The efficacy of cognitive-behavioral therapy: A review of meta-analysis. National Institute of Health, 36(5), 427-440.

Logsdon, R. G., McCurry, S. M., & Teri, L. (2007). Evidence-based interventions to improve quality of life for individuals with dementia. Alzheimers Care Today, 8(4), 309-318.

Moller, H. & Nasrallah, H. (2003). Treatment of bipolar disorder. The Journal of Clinical Psychiatry, 64(6), 9-17.

Volicer, L. & Hurley, A. C. (2003). Management of behavioral symptoms in progressive degenerative dementia. The Journals of Gerontology, 58(9), 837-845.

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