Exploration Care Research

Self-directed learning activity

  • Identify one area of interest or a clinical question  that you would like to explore further about psychiatric nursing practice. Consider this a point of care research topic. In daily clinical practice, it is rare to have more than 15 minutes to research a question so, keeping that in mind, spend ≤ 1 hour researching your topic.
  • Post the following to the discussion board
    • State the area of interest.
    • What did you learn?
    • Which resources were most helpful?
    • Were there any resources that you found unhelpful?SAMPLE POST

      Area of Research/ Question

      What is hypersexuality in Bipolar Disorder (manic episode)?

      What did you learn?

      Bipolar is one of the most common psychiatric illnesses. The prevalence is about 3% worldwide (Aldinger & Schulze, 2017). Many patients with Bipolar disorder and their loved ones can suffer in many ways due to the mood changes ranging from depression to mania.  A patient that is manic may present with enormous changes in mood, energy, activity, behavior, sleep, and cognition (Suppes,2019). In addition to the stated symptoms, many manic patients will have disinhibition. This can lead to things such as the patient disrobing in public or wearing bright and showy clothing. Furthermore, the patient often has a no regard for appropriateness or social boundaries.

      The elevated mood seen with mania often leads to impulsivity and poor judgement, with no concern for consequences. The disinhibition in combination with the relentless pursuit of stimulation and social activities can explain the aspect of hypersexuality in mania (Suppes,2019). Bipolar hypersexuality is a common symptom during the manic phase. The hypersexuality symptoms often present in many ways such as having increased sex within a committed relationship, having sex outside of committed relationship, or sexual encounters with multiple partners and or strangers (Marks, 2018). It is important to point out that Bipolar hypersexuality does not always mean that the patient is having sex with someone. It can be in the form of excessive masturbating or sexual fantasies that distract them from their responsibilities. According to Marks (2018), it is important to realize that hypersexuality in Bipolar is not sex addiction. When an individual with bipolar is experiencing a manic episode, the individual can have an increased appetite for many things, not just sex. When combined with the other symptoms of mania such as poor impulse control, poor insight, racing thoughts and poor judgement the result is unrefined gratification seeking(Marks, 2018).

      Bipolar hypersexuality declines as the mania declines, bringing the patient back to baseline. After the manic phase ends, people often feel guilt and regret as they realize and face the painful consequences of the decisions they made during the manic episode(Suppes,2019). For example, an individual that is very loyal to their partner, might have an affair while manic due to poor perception and judgement (Marks, 2018). In addition to the consequences the patient may have to face from the hypersexuality they may also be facing other consequences such as financial ruin, job loss, and assaulting others (Suppes,2019).  It is important to note when the patient moves into a depressive episode, the opposite behaviors usually occur such as isolation, poor confidence and decreased libido (Aldinger & Schulze, 2017).

      Practitioners can help Bipolar patients by educating patients to seek help from their provider quickly at the first sign of not needing  sleep or feelings of hypersexuality because both are early signs of mania that can progress quickly. According to Marks (2018), lack of sleep is like “lighter fluid on a fire” for Bipolar patients. If the patient seeks help early, the provider can consider medication adjustment.

      Were there any resources that you found unhelpful?

      The resource that was most unhelpful was the school library. I glanced through several studies that offer good information about Bipolar, however, I was unable to find the exact information that I needed about hypersexuality in Bipolar Disorder in a timely manner. It would probably depend on the topic, but the school library does not seem to be the best method of gathering information quickly in the practicum setting because there is too much information to sift through. Additionally, there are several steps or clicks required just to review one source of information, only to find out that it may not be what you are looking for.

      Which resources were most helpful?

      When researching hypersexuality in Bipolar Disorder, the most helpful resources were UpToDate guidelines and YouTube videos. Both references were useful for different reasons. UpToDate guidelines are very easy to use and allows the user to narrow in on any topic quickly. The results put the search terms in bold lettering making it easy to know which article is most appropriate. This allowed me to find information about the clinical features of Bipolar, including hypersexuality, within a couple minutes. I plan to utilize the UpToDate guidelines frequently as a student and a provider because the information is very accessible and typically, easy to understand. Perhaps even more important, the information on UpToDate is reliable. This can bring peace of mind to the provider by knowing they are obtaining accurate and current information that can guide treatment and properly educate patients.

      YouTube videos were extremely helpful to learn more about this topic and in my opinion, are an excellent tool for researching many other topics. The downside of YouTube is that many times, the information is not necessarily reliable. For the topic of hypersexuality in Bipolar Disorder, the most helpful information I found was a the mental health channel by a psychiatrist, Dr. Tracey Marks. I utilize this resource quite often because I have compared the information that she provides to guidelines on multiple occasions and it is always accurate information. I recommend this channel to my peers because the information Dr. Marks provides can better prepare practitioners for answering questions that patients may ask. The channel also provides information that is helpful for diagnosing by talking about how various disorders present clinically.

      Recommended Resource

      Dr. Tracey Marks, MD. Mental Health & Self Improvement. (new videos every Wednesday) Link: https://goo.gl/DFfT33

       

      References

      Aldinger, F., & Schulze, T. G. (2017). Environmental factors, life events, and trauma in the course of bipolar disorder. Psychiatry & Clinical Neurosciences, 71(1), 6–17. https://doi.org/10.1111/pcn.12433

      Marks, T., [ Dr. Tracey Marks]. (2018, October 24)., Hypersexuality in Bipolar Disorder – Why Does It Happen?

      Retrieved from https://www.youtube.com/watch?v=iYHTDn86hSo

      Suppes, T. (2019)., Bipolar disorder in adults: Clinical features., Retrieved from https://www-uptodate-com.regiscollege.idm.oclc.org/contents/bipolar-disorder-in-adults-clinical-features?search=hypersexuality%20bipolar&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

      *APA format not retained

 
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