TPC-Journal-V4-Issue3

The Professional Counselor \Volume 4, Issue 3 234 shift to anger and irritability. For more than half of individuals with bipolar I disorder, depressive episodes follow manic episodes (APA, 2013), which is especially dangerous to the individual if he or she is not in a secure treatment setting. Treatment. Roughly two-thirds of those diagnosed with bipolar I disorder receive treatment each year (Merikangas et al., 2007). The most common form of treatment is medication, including mood stabilizers, atypical antipsychotics and antidepressants (NIMH, n.d.-b). While many of these medications are effective in managing symptoms, some can have serious side effects resulting in additional medical risks such as liver or kidney issues. These risks, in addition to lack of insight into illness, preference for manic episodes, and comorbid personality or addictive disorders can lead to noncompliance (Colom et al., 2000). In treating bipolar I disorder, individual therapy and family counseling may be helpful in developing client interpersonal skills and increasing quality of life (NIMH, n.d.-b; Steinkuller & Rheineck, 2009). There is clear empirical evidence suggesting that individuals who participated in psychotherapy more frequently and for a longer duration in addition to using medication had a better prognosis than those who participated in fewer sessions over a shorter period of time (NIMH, n.d.-b.; Steinkuller & Rheineck, 2009). These individuals appeared to recover more quickly, have fewer relapses and require fewer hospitalizations. Schizophrenia About 1% of Americans have schizophrenia (NIMH, n.d.-c). Only one in five people diagnosed with the disorder return to the level of functioning they had before onset. Therefore, schizophrenia is often a pervasive and lifelong disorder that can severely impair daily functioning. Individuals with schizophrenia may have difficulty completing tasks, focusing on assignments and processing information. Because onset of schizophrenia is typically in early adulthood, a person’s ability to make educational progress and develop necessary skills to obtain a job or receive a degree may be limited (NIMH, n.d.-c). The lack of income threatens stable housing and basic needs. Therefore, individuals diagnosed with schizophrenia are likely to require financial assistance from family or public funding sources. Treatment. The most common form of treatment for schizophrenia is medication. Antipsychotic medications focus on managing symptoms by reducing the severity and frequency of hallucinations and delusions. However, not all medications work for all individuals, and many can have significant side effects such as blurred vision, tremors, drowsiness, sensitivity to sunlight and tardive dyskinesia (NIMH, n.d.-c). Because of these side effects and the cognitive impairments inherent in the disorder, medication compliance is a problem, as individuals will sometimes skip doses or discontinue medications altogether. Other forms of treatment are recommended in conjunction with medication, such as counseling and psychoeducation to teach individuals skills for daily functioning, interacting with others, self-care and employment (NIMH, n.d.-c). Person-centered approaches may be effective, as a lack of insight into the illness may cause clients to become skeptical about treatment (Kreyenbuhl, Nossel, & Dixon, 2009; NIMH, n.d.-c). In summary, roughly one in 10 Americans will experience major depressive disorder, bipolar I disorder or schizophrenia each year, and two-thirds of those will seek treatment for their conditions (Merikangas et al., 2007; SAMSHA, 2013). Counselors who provide essential services to clients may have first made the diagnosis long ago and likely are part of a treatment team. With the release of the new version of the DSM , best practice is to review and revise diagnoses for all clients to ensure accuracy. Each change to major depressive disorder, bipolar I disorder and schizophrenia is described below.