Mental Health Nursing Care and Intervention Assessment Answer

Introduction

Mental health issues are a significant general wellbeing concern that influences millions of people globally (Hernández-Torrano et al., 2020). Mental health nurses are basic individuals from the medical services group that give caring and evidence-based therapy to people experiencing dysfunctional behaviour. By improving their patients' overall well-being and quality of life, they aid in healing (Jurewicz, 2015). Tina, a 32-year-old woman undergoing a difficult mental health crisis, will be the focus of this article, which will examine the crucial role that mental health nurses play in providing care to individuals with mental health issues. The evidence of a manic episode in Tina's case suggests that she has bipolar disorder. Her side effects, conduct, and life conditions require an exhaustive and thoughtful methodology, and emotional well-being medical caretakers assume a significant part in conveying such therapy.

Tina needs evidence-based mental health nurse treatment while in the inpatient ward, according to the case. It will look at the different factors that contributed to Tina's condition, such as genetic predisposition and recent life events, and will explain the aetiology of bipolar disorder. Furthermore, the essay will investigate evidence-based recommendations for treating bipolar illness, which will include both pharmaceutical and non-pharmacological approaches in order to develop a thorough and successful treatment plan.

Aetiology of the Disorder

Bipolar disorder is a chronic, severe mood condition that affects 1-3% of the world's population. Its aetiology is multifaceted, with genetic, environmental, and neurological variables all playing a role.

Genetic factors

Jain & Mitra (2023) on families and twins have repeatedly revealed a major hereditary component in the development of bipolar illness. Individuals who have a first-degree relative with the illness (e.g., a parent or sibling) are at a considerably increased chance of acquiring the disorder themselves. Bipolar disease heritability is believed to be 70-80%, indicating that genetics play a significant part in its aetiology (Jain & Mitra, 2023). Several genes, notably those involved in regulating neurotransmitter systems, ion channels, and brain plasticity, have been linked to bipolar illness (Rowland & Marwaha, 2018). Although specific gene variations linked to bipolar illness have been found, it is critical to recognise that several genes with minor effects are likely to contribute to the total hereditary risk.

Neurobiological Factors

Bipolar disorder's neurological base is complicated and not fully understood. However, research has repeatedly pointed to neurotransmitter system abnormalities, including serotonin, dopamine, and norepinephrine (Goes, 2023). Dopamine activity increases during manic episodes, leading to increased arousal and pleasure-seeking behaviours. In contrast, serotonin levels are lowered during depressive episodes, adding to feelings of melancholy and exhaustion (Arnold et al., 2021). In addition, persons with bipolar illness have been found to have irregularities in the control of the body's biological cycles, such as the sleep-wake cycle and circadian rhythms. These interruptions might contribute to the cycling of mood episodes.

Environmental Factors

Environmental variables can also play a role in the development of bipolar illness, particularly in people who have a genetic predisposition (McIntyre & Calabrese, 2019). Stressful life events, such as traumatic experiences, the death of a loved one, or major life transformations, can bring off mood episodes (McIntyre & Calabrese, 2019). Substance usage, particularly of stimulants or mood-altering medications, can aggravate symptoms and increase the frequency of mood episodes in vulnerable people.

Tina's family history of mental health concerns, as well as the recent pressures of divorce and eviction, may have contributed to her present manic episode. The interaction between hereditary susceptibility and environmental triggers emphasises the significance of a comprehensive and individualised approach to bipolar illness treatment and care.

Evidence-Based Guidelines for Treatment

Pharmacological Interventions

Since, in Tina’s case, her symptoms indicate a manic episode which could be part of bipolar disorder, the treatment would focus on stabilising her mood and dealing with her presenting symptoms. Firstly, this would involve pharmacological interventions such as giving Tina mood stabilisers like Lithium and Valproate. Lithium is regarded as the primary mood stabiliser for treatment in cases that involve manic episodes and long-term prevention of such episodes in the condition of bipolar disorder (Ulrichsen et al., 2023). Lithium would help Tina by stabilising her mood, reducing her anger and irritability and improving her sleep. It would also prevent relapse. A study by Fountoulakis et al.(2022) showed the efficacy of lithium in reducing manic symptoms and preventing relapse in European adults.

In addition to this, another effective mood stabiliser that can help Tina is Sodium Valproate, like Lithium which also acts on neurotransmitter systems, including GABA and glutamate giving rise to the effect of mood stabilisation (Schäfer & Brandl, 2020).

The second type of pharmacological intervention can involve the administration of atypical antipsychotics. This would involve drugs such as Olanzapine and Quetiapine. Firstly, Olanzapine has been found to be effective for the management of acute manic symptoms of bipolar disorder. It would help Tina with the duration and intensity of the manic episodes, along with her elevated mood and impulsivity. This would result in a calming effect, and Tina would feel less restless and agitated. It would also be beneficial in regulating Tina’s sleep patterns (Shoshina et al., 2022). Secondly, Quetiapine can be administered to calm down her restlessness and result in the alleviation of symptoms such as racing thoughts and irritability (Kim et al., 2019). Other drugs which can be used for the management of manic episodes include Carbamazepine and Lamotrigine. Carbamazepine is recommended, especially for patients who are sensitive to lithium and valproate. It works by acting on sodium channels and glutamate receptors, contributing to its mood-stabilizing effects. On the other hand, Lamotrigine has been found to effectively prevent depressive episodes in bipolar disorder (Kishi et al., 2021).

Psychosocial Interventions

The first intervention in this category which can help Tina is Cognitive Behaviour Therapy (CBT). It focuses on recognising and changing harmful thought patterns and behaviours. It is a goal-oriented and evidence-based method of psychotherapy. Firstly, CBT can help Tina by increasing self-awareness regarding her thought patterns leading to exaggerated self-esteem and irrational beliefs. This can result in more balanced thinking. Secondly, this approach would provide Tina with coping skills for the management of her stress and impulsive behaviour. This will result in her learning methods to channel her energy in the right direction during such episodes (Özdel et al., 2021).

The second intervention that can be used in the case of Tina is Family Focused Therapy (FFT) which would involve her and her family members playing a role in the management of the condition. This would involve encouraging open communication among family members leading to the creation of an understanding and supportive environment. It would also involve educating her children and ex-husband about her condition, its symptoms and treatment (Martini et al., 2023). The third and final intervention involves psychoeducation and support groups. Providing psychoeducation would involve Tina gaining insight regarding her condition, developing an understanding of the importance of adherence to medication and equipping Tina with tools for the effective management of her condition. On the other hand, associating Tina with support groups would give her a sense of belonging and acceptance. In addition to this, it would enable Tina to connect with other individuals suffering from similar conditions and their strategies for coping and management (Sarkhel et al., 2020).

Role of the Mental Health Nurse

The first role of the mental health nurse is to ensure regular assessment and monitoring. This would involve conducting a comprehensive assessment of Tina’s mental health history comprising episodes of depression and mania in the past, family history and potential triggers. This should be accompanied by monitoring of Tina’s behaviour, mood and response to medications for the identification of any possible signs of relapse. The second responsibility of the nurse would be the management of medications. This would involve taking care of the medication regime and educating Tina about the importance, dosage and potential side effects of each medication (Malhi et al., 2020). The nurse would also be responsible for providing appropriate psychoeducation to Tina regarding her condition of bipolar disorder, the nature of the condition, its course and triggers that can lead to potential relapse. In addition to this, Tin would also receive education on the importance of the treatment, prompt help-seeking and identification of early warning signs (Yatham et al., 2018).

Apart from this, the nurse would help Tina by making her participate in various techniques for psychotherapy, such as CBT and FFT and IPSRT, which would enable Tina to develop coping skills accompanied by techniques for problem-solving and strategies for stress management. The nurse could also engage in regular counselling sessions. This would provide her with a safe and comfortable environment to express her thoughts and emotions without any hesitation or fear of judgement (Novick & Swartz, 2019). Another significant role played by the nurse would be collaborating with Tina to develop a plan for relapse prevention specifically tailored to Tina’s needs and concerns.

Furthermore, a mental health nurse would play a crucial role in keeping a check on Tina’s lifestyle and her habits and addressing related factors that might lead to potential relapse. This would involve helping Tina establish a stable daily routine, getting adequate sleep, engaging in regular exercise, and maintaining a balanced diet (Johansen et al., 2021). The last responsibility of the nurse would be to ensure that Tina receives care and support following the manic episode. This would involve check-ins, assessments and adjustments to medications on a regular basis; along with developing a crisis plan in case of acute relapse. This plan would include contact details of family members, local healthcare facilities, support groups and other emergency services (Goulding et al., 2021).

Strategies to Reduce Symptom Relapse

Reducing the likelihood of relapse is a critical component of the recovery-oriented approach to bipolar illness management (Krijnen-de Bruin et al., 2019). Mental health nurses play an important role in assisting Tina in implementing appropriate long-term stability and well-being measures. First, a relapse prevention strategy will be created that is specific to Tina's requirements and triggers. This strategy will entail recognising early warning indicators of both manic and depressed periods (Villaggi et al., 2015). Tina can avoid a full-fledged relapse by seeing these warning signals and taking proactive actions to get assistance and apply coping techniques. A thorough list of coping methods, such as participating in joyful hobbies, mindfulness practises, and reaching out to support networks, will be included in the plan (Robberegt et al., 2022).

Tina's development will also be monitored through frequent follow-up sessions once she is discharged from the inpatient ward. Consistent assistance and monitoring are essential for addressing any new concerns as soon as possible and adjusting her treatment plan as needed (Rice et al., 2016). Tina's follow-up meetings also allow her to openly communicate her thoughts and concerns with her mental health nurse, building a trustworthy therapeutic connection. Tina's family's engagement is critical in establishing a stable environment and lowering the danger of relapse. Engaging Tina's family, particularly her ex-husband, in her care provides a greater knowledge of her disease and contributes to the creation of a supportive and understanding home environment. Family members can also play an important role in detecting early warning signals and encouraging Tina to stick to her treatment plan (Østergaard et al., 2020).

Promoting health and self-care practices is critical in bipolar illness management and relapse prevention (Østergaard et al., 2020). Tina will be encouraged by mental health professionals to embrace good lifestyle habits such as frequent exercise, balanced eating, and adequate sleep hygiene. These techniques can assist her mood stabilise and improve her general well-being, lessening the impact of stresses on her mental health (Moriarty et al., 2020). Lastly, providing Tina with crisis management skills and emergency support contacts is critical to ensuring she has the tools she needs during times of crisis. Tina will be able to handle difficult situations more successfully and seek help when required, preventing relapses from becoming serious episodes.

Conclusion

Tina's case study emphasises the crucial role of mental health nurses in fostering recovery and well-being for those who are facing mental health crises. With its complicated aetiology encompassing genetic, neurological, and environmental variables, bipolar illness necessitates a thorough and evidence-based approach to treatment. Mental health nurses can establish successful treatment strategies, including pharmaceutical and non-pharmacological therapies, by recognising the underlying causes of the condition. Tina's successful journey towards stability and increased quality of life will be aided by the recovery-oriented framework, which encourages empowerment, resilience, and optimism.

Furthermore, implementing relapse prevention techniques, such as building a relapse prevention plan, guaranteeing frequent follow-ups, integrating her family's support, encouraging wellness practices, and giving crisis management skills, improves the chances of long-term recovery. Mental health nurses, patients, and their support networks may work together to overcome problems, build resilience, and promote a brighter future outside the constraints of mental illness via collaborative efforts. As committed advocates, mental health nurses play a critical role in enabling people like Tina to reclaim their lives and thrive despite the obstacles of bipolar disease.

References

Arnold, I., Dehning, J., Grunze, A., & Hausmann, A. (2021). Old Age Bipolar Disorder—Epidemiology, Aetiology and Treatment. Medicina , 57 (6), 587. https://doi.org/10.3390/medicina57060587

Goes, F. S. (2023). Diagnosis and management of bipolar disorders. BMJ , 381 , e073591. https://doi.org/10.1136/bmj-2022-073591

Hernández-Torrano, D., Ibrayeva, L., Sparks, J., Lim, N., Clementi, A., Almukhambetova, A., Nurtayev, Y., & Muratkyzy, A. (2020). Mental Health and Well-Being of University Students: A Bibliometric Mapping of the Literature. Frontiers in Psychology , 11 (1). https://doi.org/10.3389/fpsyg.2020.01226

Jain, A., & Mitra, P. (2023, February 20). Bipolar Disorder . PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK558998/

Jurewicz, I. (2015). Mental health in young adults and adolescents – supporting general physicians to provide holistic care. Clinical Medicine , 15 (2), 151–154. https://doi.org/10.7861/clinmedicine.15-2-151

Krijnen-de Bruin, E., Muntingh, A. D. T., Hoogendoorn, A. W., van Straten, A., Batelaan, N. M., Maarsingh, O. R., van Balkom, A. J. L. M., & van Meijel, B. (2019). The GET READY relapse prevention programme for anxiety and depression: a mixed-methods study protocol. BMC Psychiatry , 19 (1). https://doi.org/10.1186/s12888-019-2034-6

McIntyre, R. S., & Calabrese, J. R. (2019). Bipolar depression: the clinical characteristics and unmet needs of a complex disorder. Current Medical Research and Opinion , 35 (11), 1993–2005. https://doi.org/10.1080/03007995.2019.1636017

Moriarty, A. S., Castleton, J., Gilbody, S., McMillan, D., Ali, S., Riley, R. D., & Chew-Graham, C. A. (2020). Predicting and preventing relapse of depression in primary care. British Journal of General Practice , 70 (691), 54–55. https://doi.org/10.3399/bjgp20x707753

Østergaard, T., Lundgren, T., Zettle, R. D., Landrø, N. I., & Haaland, V. Ø. (2020). Psychological Flexibility in Depression Relapse Prevention: Processes of Change and Positive Mental Health in Group-Based ACT for Residual Symptoms. Frontiers in Psychology , 11 . https://doi.org/10.3389/fpsyg.2020.00528

Rice, S., Gleeson, J., Davey, C., Hetrick, S., Parker, A., Lederman, R., Wadley, G., Murray, G., Herrman, H., Chambers, R., Russon, P., Miles, C., D’Alfonso, S., Thurley, M., Chinnery, G., Gilbertson, T., Eleftheriadis, D., Barlow, E., Cagliarini, D., & Toh, J.-W. (2016). Moderated online social therapy for depression relapse prevention in young people: pilot study of a “next generation” online intervention. Early Intervention in Psychiatry , 12 (4), 613–625. https://doi.org/10.1111/eip.12354

Robberegt, S. J., Brouwer, M. E., Kooiman, B. E. A. M., Stikkelbroek, Y. A. J., Nauta, M. H., & Bockting, C. L. H. (2022). Meta-Analysis: Relapse Prevention Strategies for Depression and Anxiety in Remitted Adolescents and Young Adults. Journal of the American Academy of Child & Adolescent Psychiatry . https://doi.org/10.1016/j.jaac.2022.04.014

Rowland, T., & Marwaha, S. (2018). Epidemiology and risk factors for bipolar disorder. Therapeutic Advances in Psychopharmacology , 8 (9), 251–269. https://doi.org/10.1177/2045125318769235

Villaggi, B., Provencher, H., Coulombe, S., Meunier, S., Radziszewski, S., Hudon, C., Roberge, P., Provencher, M. D., & Houle, J. (2015). Self-Management Strategies in Recovery From Mood and Anxiety Disorders. Global Qualitative Nursing Research , 2 , 233339361560609. https://doi.org/10.1177/2333393615606092
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