Research Proposal on "Psychosocial Assessment on an Unquiet Mind by Kay Readfield Jamison"

Research Proposal 8 pages (2602 words) Sources: 3 Style: APA

[EXCERPT] . . . .

Psychosocial Assessment Of

A Person With Bipolar Disorder

psychosocial assessment of a person with bipolar disorder

"Personal accounts of mood disorders are an undervalued asset in understanding the manifestations of mental illness and in drawing attention to current issues"

Kay Redfield Jamison, Ph.D (Jamison, as cited in Evans, 2006)

One Personal Account

In the article, "Personal accounts of mood disorders often undervalued," J. Evans (2006) relates the quote introducing this study, stressing the value of personal accounts of mood disorders. Evans asserts that personal accounts significantly contribute to understanding symptoms evidenced by those experiencing mental illness. Kay Redfield Jamison, Ph.D., a prolific author on manic-depressive illness, also a professor of psychiatry at Johns Hopkins School of Medicine and, currently admits she is "afflicted (or blessed, as she sometimes feels) with manic-depressive ill-ness" (Jamison, 1996, p .91). In this study, the researcher utilizes Jamison's autobiography, An unquiet mind, to develop a psychosocial assessment of a person with bipolar disorder.

As a survivor of a manic-depressive illness, Jamison (1996) reportedly serves as the foremost authority on manic-depressive illness. Jamison's dual perspective, as a healer and one who is healed, contributes to her effectiveness. Even when pursuing her psychiatric training, Jamison regularly succumbed to "the exhilarating highs and paralyzing lows that afflicted many of her patients" (Jamison, Inside cover section). At times, due to her illness, Jamison reported she possessed boundless energy and mercurial creativity. At other times, albeit Jamison notes the disorder propelled her to engage in spending sprees, experience episodes of violence, and attempt suicide. During this paper, the researcher also utilizes information from DSM IV, and Essential Psychopathology and its treatment by Maxmen J.S. And Ward. (1995) to relate knowledge regarding Jamison's illness to her family.

In The Age of Depression, A.V. Horwitz and J.C. Wakefield (2005) relates a series of questions and answers regarding the DSM, explaining that DSM, published by the American Psychiatric Association, stands for "Diagnostic and Statistical Manual of Mental Disorders." The following section relates the DSM-IV criterion denoting Bipolar II Disorder, the mental illness Jamison (1996) experiences. Diagnostic features of Bipolar II Disorder include Jamison experiencing "one or more Major Depressive Episodes accompanied by at least one Hypomanic Episode" (DSM-IV, p. 359). Jamison regularly experienced more than five of the following symptoms; present during the same 2-week period. Her behavior(s) reflect a change from her previous functioning. More than one of the symptoms "is either (1) depressed mood or (2) loss of interest or pleasure" (Ibid.).

Jamison reports:

Feeling depressed most of the day, almost every day.

Experiencing diminished interest or pleasure in activities most of the day, nearly every day.

Although not dieting, losing a significant amount of weight in a short period of time.

Experiencing psychomotor agitation early in the day; almost every day.

Feeling fatigued; with little energy nearly every day.

Regularly feeling worthless and guilty for no obvious reason nearly every day.

Being unable to concentrate and/or think clearly almost every day.

Having recurring thoughts of death; repeated suicidal ideations, with several specific plans leading to attempting suicide.

During her manic episodes, Jamison reports she experienced:

1. Having an inflated self-esteem or grandiosity.

2. Not needing sleep, and that she feels rested after only 4 hours.

3. Talking excessively.

4. Being easily distracted.

5. Being more goal-directed at work.

6. Being excessively involved in a number of pleasurable activities with a high potential for painful consequences (DSM-IV, p. 332).

E. Urdang (2002) points out in the book, Human behavior in the social environment: interweaving the inner and outer worlds that Jamison shares snippets of her battles evolving from her mental illness in her autobiography, An Unquiet Mind. Urdang purports that even though Jamison is a person of unques-tionable strengths; her chronic illness tenaciously remains with her. Jamison describes her resistance to fighting this illness.

Even though I was a clinician and a scientist, and even though I could read the research literature and see the inevitable, bleak consequences of not taking lithium, I for many years after my initial diagnosis was reluctant to take my medication as prescribed.... Why did it take hav-ing to go through more episodes of mania followed by long suicidal depressions before I would take lithium in a medically sensible way?

Some of my reluctance, no doubt, stemmed from a fundamental denial that what I had was a real disease…Moods are such an essential part of the substance of life, of one's notions of oneself, that even psychotic extremes in mood and behavior somehow can be seen as temporary, even understandable, reactions to what life has dealt. In my case, I had a horrible sense of loss for who I had been and where I had been. It was difficult to give up the highlights of mind and mood, even though the depressions that inevitable followed nearly cost me my life. (Jamison, 1996, p. 91)

Bipolar Spectrum Diagnostic Scale

Generally, it may take an individual like Jamison, experiencing manic depression 10 years to obtain a correct diagnosis. Dr. Ronald Pies initially developed he following screening questionnaire for use by clinicians.

Instructions: Please read through the entire passage below before filling in any blanks.

1. Some individuals notice that their mood and/or energy levels shift drastically from time to time

2. These individuals notice that, at times, their mood and/or energy level is very low, and at other times, very high

3. During their "low" phases, these individuals often feel a lack of energy; a need to stay in bed or get extra sleep; and little or no motivation to do things they need to do

4. They often put on weight during these periods____.

5. During their low phases these individuals often feel "blue," sad all the time, or depressed____.

6. Sometimes during these low phases, they feel hopeless or even suicidal____.

7. Their ability to function at work or socially is impaired____.

8. Typically, these low phases last for a few weeks, but sometimes they last only a few days____.

9. Individuals with this type of pattern may experience a period of "normal" mood in between mood swings, during which their mood and energy levels feels "right" and their ability to function is not disturbed____.

10. They may then notice a marked shift or "switch" in the way they feel____.

11. Their energy increases above what is normal for them, and they often get many things done they would not ordinarily be able to do____.

12. Sometimes, during these "high" periods, these individuals feel as if they have too much energy or feel "hyper"____.

13. Some individuals, during these high periods, may feel irritable, "on edge," or aggressive____.

14. Some individuals, during these high periods, take on too many activities at once____.

15. During these high periods, some individuals may spend money in ways that cause them trouble____.

16. They may be more talkative, outgoing, or sexual during these periods____.

17. Sometimes, their behaviour during these high periods seems strange or annoying to others____.

18. Sometimes, these individuals get into difficulty with co-workers or the police, during these high periods____.

19. Sometimes they increase their alcohol or non-prescription drug use during these periods____.

Scoring: each sentence ticked is worth one point. Then, to this score add the following (depending upon which of the above 4 boxes you ticked)

Add 6 points if you ticked "fits me very well or almost perfectly"

Add 4 points if you ticked "fits me fairly well"

Add 2 points if you ticked "fits me to some degree, but not in most respects"

Add 0 points if you ticked "doesn't really describe me at all"

Total Score

Likelihood of bipolar disorder

0-6 Highly unlikely

7-12 Low probability

13-19 Moderate probability

20-25 High probability

The optimum threshold for positive diagnosis would be a score of 13 or above. The researcher may need to submit to a physical soon. Jamison scored 23 on this particular test.

From a book review of Exuberance, Jamison, reviewed by R.A. Munoz (2005), the researcher learned that at times Jamison, as some other battling mental illness, even though experiencing challenges of bipolar disorder, discovered that not everything is bad about this disorder. In addition to the depressed times, among its symptoms, this disorder sometimes includes enhanced initiative and merriment. In the article, "Aesthetic phantoms," B. Allen, (2008) purports that creativity, another sometimes constitutes another possible "side affect" of bipolar disorder. In fact, during the last few decade, much scientific research and speculation regarding the correlation between creativity and mood disorders, particularly bipolar disorder or manic-depressive illness has been researched.

This type research primarily supports the theory the two phenomena, creativity and mood disorders, are related. Two centuries ago, Lord Byron flatly stated: "We of the craft [that is, poets] are all crazy. Some are affected by gaiety, others by melancholy, but all are more or less touched" (Allen, 2008, ¶ 1). Another of Jamison's books, Touched with Fire: Manie-Depressive Illness and the Artistic Temperament having had a particularly strong impact. (Allen, 2008, ¶ 1) relates that one recent study… READ MORE

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