Academic journal article Indian Journal of Positive Psychology

Holistic Quality of Life Intervention (HQLI) for Women Having Bipolar II Disorder: A Pilot Study

Academic journal article Indian Journal of Positive Psychology

Holistic Quality of Life Intervention (HQLI) for Women Having Bipolar II Disorder: A Pilot Study

Article excerpt

Bipolar disorder, as per the estimation of the World Health Organization (WHO), is the 6th leading cause of global disability (Miklowitz & Johnson, 2009). The life time prevalence of bipolar spectrum disorder has been reported between 2.6-7.8% (Faravelli et al., 2006) and its incidence has been increasing every year. Patients with bipolar disorder are being symptomatic during 47% of their life time, predominantly depressive symptoms (Miklowitz, 2010). The affective, cognitive and behavioral problems arise during bipolar episodes bring affliction and disruptions to sufferers' life. These affect their daily functioning and well-being and persist even after symptomatic recovery (Kongsakon, Thomyangkoon, Kanchanatawan, & Janenawasin, 2008).

Bipolar II disorder is characterized by at least one major depressive andhypomanic episodes (APA, 2013). When it comes to women, the disorder is unique in its presentation due to the impact of reproductive cycle especially postpartum, the pre-menstrual phase of menstrual cycle, and pre-menopause (Rasgon, Bauer, Glenn, Elman, & Whybrow, 2003) and challenging to treat due to greater relativity of medical and psychiatric comorbidity (Parial, 2015). Studies also show that women are more prone to have bipolar II disorder than men, with a female: male ratio 3:2 and are more likely to have depressive episodes than men do (Kupfer et al., 2002). Women who are having bipolar II disorder are carrying a greater threat of recurrence than men do (Suominen et al., 2009). Recurrence of depressive episode can cause high suicidal rate among women with bipolar II disorder (Susan, Arnold, & Altshuler, 2006). Another studies point out that the subsyndromal depressive symptoms and neurocognitive impairments account for poor psycho social functioning in bipolar II patients (Bonnin et al., 2009; MartinezAran et al., 2007). In fact, depressive symptoms are extensively connected with functional impairment in various realms such as academic or occupational functioning, duties at home, and interpersonal relationship with family members, friends, and others (Altshuler etai., 2006).

Until the past two decades, the primary goal of bipolar treatment was symptom reduction of mania and depression without much emphasis on retrieval of psycho social functioning (Rosa et al., 2013). Recently, quality oflife has been widely recognized as one of the potential alternative aim in the management of bipolar patients (Kongsakon, Thomyangkoon, Kanchanatawan, & Janenawasin, 2008; IsHak et al., 2012). According to the World Health Organization (WHO, 1996), "quality of life is the individual's perception of their position in life within the context of the culture and value systems in which they live and in relation to their goals.'Aminil and Sharifi (2012) have come up with the finding that quality oflife comprises individual satisfaction with all the aspects of life and it encompasses physical, psychological, social, and environmental well-being.

Clinical features such as symptoms of depression and anxiety mainly determine the quality oflife of the people with severe mental illness (Hansson, 2006). According to IsHak and companions (2012), quality oflife ofbipolar patients is being severely affected during depressive episode than Mania or hypomania. Social stigmatization of psychiatric patients, adversely affects the life quality of the patients and their family (Latalova et al., 2013). The World Health Organization long ago has recognized stigma as one of the greatest impediment to the treatment of the mental illness (Oral, 2007) which often brings loss of social support, occupational failure, reduced functioning, higher symptom levels and obviously lower quality oflife (Hawke, Parikh, & Michalak, 2013).

Well-informed and supportive family members have a crucial role in the recovery process and life quality maintenance of the patients. Those who have poor support, rejection and hostile attitudes from the family are more vulnerable to stress as well as depression which have an adverse effect in the recovery process and overall functioning (Elgie & Morselli, 2007). …

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