Quality Writing

PSY 7103 Week 4 Assignment
Bipolar disorders (BDs) are one of the psychiatric illnesses that are quite prevalent in the
world today. Studies show that 1-5% of the world population have a chronic disease trajectory
and have a high risk of increased premature deaths (Dome et al., 2019). Suicide has been proven
to be a key contributor to the decreased life expectancy among patients with bipolar disorders
(Dome et al., 2019). Bipolar disorder has a depression-predominant course that is often
associated with a long duration of untreated bipolar. Bipolar depression is thus associated with
higher risks of suicidal behavior. The relationship between psychiatric disorders and suicide has
been an issue of importance among many researchers and mental health practitioners. According
to Pompili et al. (2018), more than 75% of suicide attempters and suicide completers have major
depressive disorders (mostly untreated) at the time they attempt the suicide act.
Further, people with major depressive disorder (MDD) and type 1 and type II bipolar, as
well as those with major affective disorders (MAD), are highly vulnerable to suicide (Pompili et
al., 2018). The male gender has been found to have a high risk for lethal suicides while their
female counterparts face a high-risk factor for attempts (Pompili et al., 2018). Suicidality as a
result of depression among bipolar patients is more frequent among patients who are single
parents, unmarried, divorced, or live in isolation from their social circles (Ferro, 2016). Apart
from gender, another sociodemographic factor is age. Bipolar patients above the age of 75 years
and those under 35 years are at an elevated risk for engaging in suicide or suicide-related
behaviors compared to their counterparts in other age brackets (Dome et al., 2019). Bipolar

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depression is related to higher risks for suicide, and the risk varies among subjects of different
age brackets.
The problem to be addressed by this study is the high prevalence of suicide risk among
bipolar patients below the age of 35 and above the age of 75 who are depressed ((Dome et al.,
2019). Age is a key sociodemographic risk factor in suicide associated with bipolar depression.
Existing studies show that pharmacotherapy is a key predictor of suicidality risk ((Jamison,
2019). After controlling other variables such as depression severity, anxiety, and diagnosis,
pharmacotherapy has been found to cause an increased risk for suicide. In 2004, U.S Food and
Drugs Administration (FDA) offered an advisory on the worsening situation relating to
suicidality and treatment of depression among bipolar patients using antidepressants (Dome et
al., 2019). The advisory pointed to an existing relationship between antidepressants and suicide
and suicide thoughts in patients of bipolar being treated for depression.
Existing literature, however, shows that antidepressants are not directly associated with
increased suicide risk. Despite this, there are incidences when it is obligatory for physicians not
to administer antidepressants to treat bipolar depression (Dome et al., 2019). There exists
evidence showing that administering antidepressants may cause patients with depression to
experience mania or even increased irritability which is a condition associated with an increased
risk for suicidality (Ferro, 2016). Conversely, when manic individuals, especially those that are
high-voltage, slow down and experience switches in their moods, they face an elevated risk for
suicide (Ferro, 2016). Aggression and impulsivity levels are essential factors for both the timing
as well as the risk of suicidality. They may help in accounting for the disparity in the
effectiveness of certain components such as lithium in reducing the risk that bipolar patients may

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face for suicide. Rresearchers agree that the correct dosage for mood-stabilizers is a key
determinant for whether a person develops a high suicide risk or not (Jamison, 2019).
Persons with bipolar depression have been said to show increased cognitive loss that has
often been associated with age. Studies have suggested that increased cortisol activity when
persons with bipolar go through episodes of depression may experience cumulative
excitotoxicity in the amygdala and associated brain regions that are linked with loss in cognitive
activity (O’Rourke et al., 2017). However, no consensus has been reached. In a recent study,
Sajatovic et al. (2017) have opposed the idea that cognition is a likely mistake that should be
reevaluated in older bipolar patients who experience depressive episodes.
Reflection
I have learnt a lot about APA formatting my going through the work I submitted as well
as the comments provided by my professor. First, I have realized that I made several mistakes in
my week 3 assignment as I omitted several citations. There are sentences that needed citations
but I failed to include that. I made two assumptions. One, since I had already cited the first
sentence, and the second sentence was related to the second, then I did not have to repeat the
same citation in two consecutive sentences. However, that was a mistake because the two
sentences, though following each other, were independent. Thus, each sentence needed its own
citation even if this means repeating the same author(s) twice in a paragraph. I have made this
assumption on several instances in my journey writing papers. This assignment has been an eye
opener and it is a mistake that I will correct moving forward as I am almost writing my
dissertation.

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The second assumption I made in the citations is that after paraphrasing a fact, I did not
necessarily have to cite it especially if it did not directly relate to the original text. For instance, I
omitted a citation in the sentence when I stated that “existing literature shows that
antidepressants are not directly associated with suicide risk”. I thought that this is my conclusion
after reading existing sources and I did not have to cite. However, I had made reference to
someone else’s work and it was necessary to acknowledge that.

Overall, I have learned quite a lot after going through this work. I noticed mistakes that I
had missed when reviewing my document earlier in week three before my submission. Also, the
comments from my professor were insightful and pointed errors that I did not even think were
errors. additionally, there are certain broad claims in my work that I should avoid in future. For
instance, writing “existing literature”. This is a very broad phrase and should instead be replaced
by the exact author or authors whose work I am making reference to in that paragraph. By taking
such issues into consideration, I have realized that when writing, it is important to make my
claims as precise and specific as possible. After all, I am not referring to all the existing literature
but rather to a specific journal article. Overall, I am proud of myself and the progress I have
made this far.

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References

Dome, P., Rihmer, Z., & Gonda, X. (2019). Suicide risk in bipolar disorder: a brief
review. Medicina, 55(8), 403.
Ferro, M. A. (2016). Major depressive disorder, suicidal behaviour, bipolar disorder, and
generalised anxiety disorder among emerging adults with and without chronic health
conditions. Epidemiology and psychiatric sciences, 25(5), 462-474.
Jamison, K. R. (2019). Suicide and bipolar disorder. The Science of Mental Health, 115-119.
O’Rourke, N., Heisel, M. J., Canham, S. L., Sixsmith, A., & BADAS Study Team. (2017).
Predictors of suicide ideation among older adults with bipolar disorder. PLoS
one, 12(11), e0187632.
Pompili, M., Innamorati, M., Raja, M., Falcone, I., Ducci, G., Angeletti, G., … & De Pisa, E.
(2018). Suicide risk in depression and bipolar disorder: Do impulsiveness-aggressiveness
and pharmacotherapy predict suicidal intent?. Neuropsychiatric disease and
treatment, 4(1), 247.
Sajatovic, M., Strejilevich, S. A., Gildengers, A. G., Dols, A., Al Jurdi, R. K., Forester, B. P., …
& Shulman, K. I. (2017). A report on older‐age bipolar disorder from the International
Society for Bipolar Disorders Task Force. Bipolar disorders, 17(7), 689-704.