Tuesday, May 28, 2013

How Does Music Therapy Relate to Bipolar Disorder?

"A mental disorder is a classified as a clinically significant behavioral or psychological syndrome that occurs and that is associated with present distress or disability or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom." (Peters, 2000). Although mental disorders may have a variety of manifestations and degrees of severity, they all are characterized by persistent, abnormal patterns of problem behaviors. These clients are sometimes described as having behavior disorders or behavioral disorders. Mental illnesses and disorders traditionally have been classified into two broad categories of neuroses and psychoses. A neurosis is a mental disorder primarily characterized by anxiety. This anxiety may be experienced directly and be the main manifestation of the disorder or it may be unconsciously controlled or modified to produce other distressing symptoms. A psychosis is a more severe mental disorder that is primarily characterized by loss of contact with reality. Individuals who have psychoses have delusions, hallucinations and an impaired ability to test reality. For many, a mental disorder can hinder a person from keeping a job, family, relationships and sanity. The psychiatric problems that occur in adults are more likely to be associated with the stresses of everyday adaptation or a more chronic reaction resulting from distress over a longer period of time. What many people don't know is that someone can in fact live a relatively normal life with the help of many therapies, such as music therapy to be specific.

"Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks." (2008). Symptoms of bipolar disorder are severe. They are different from the normal ups and downs that everyone goes through from time to time. Bipolar disorder symptoms can result in damaged relationships, poor job or school performance and even suicide. But bipolar disorder can be treated and people with this illness can lead full and productive lives. Bipolar disorder often develops in a person's late teens or early adult years. At least half of all cases start before age 25. "In the acute phases of their illness, adults who have mental or behavioral disorders often display behaviors of intense confusion, agitation, excitability, fearfulness or withdrawal. They have a need to learn and develop positive coping mechanisms to deal with the stresses and responsibility of daily life." (Peters, 2000). Some people have their first symptoms during childhood, while others may develop symptoms late in life. For example, Maria is a seventeen year old who has been suffering with bipolar disorder for two years. Her ups and down cycle average from two to three months. For the first couple of months, she is in a hypo maniac state where she goes out everyday, shops, spends excessive amounts of money, wears make up and loses a large amount of weight. The next couple of months she locks herself in her room, binge eats, gains weight, cries and completely cuts her connections with the outside world. Due to this unstable cycle, she has dropped regular school and had tried to take up homeschooling, lost all friends, unable to work for an allowance and feels worthless and hateful toward herself most of the time. Her battle with bipolar disorder has made it impossible for her to continue therapy for longer than a month at a time.

"During a depressive episode, the person has a persistent depressed mood (most of the day and nearly everyday) and several other symptoms such as diminished interest in activities that are generally enjoyable, changes in appetite or weight, changes in sleep patterns, agitation or lack of energy, feelings of worthlessness, difficulty concentrating, and thinking clearly and thoughts of suicide. Symptoms may develop at a time of personal crisis but people can also feel depressed for no apparent reason." (Davis, 1999). Most of the time, the symptoms can be nothing mysterious and can have a minimal effect on a person's life. But, overtime, the episodes can get increasingly worse for longer periods of time. In a severe state, a person can become psychotic and the episode can last for up to six months if it is left untreated.

"During a manic episode, people may have decreased need for sleep, their thoughts may race and they may be extremely talkative. They may engage in wild spending sprees or take on unrealistic tasks." (Davis, 1999). For the most part, a manic episode can be just as hurtful to a person as a depressive episode, if not more. During these times of feeling up and energized, it may seem that a person does not need their medication and that can lead to many more issues to a person with bipolar disorder. While treating these times, it can also help the person from not making poor decisions and having to deal with the repercussions later on during a depressive episode. Many of these symptoms are also present in a hypo manic episode. A hypo manic episode is similar to a manic episode, but the symptoms may be experienced to a lesser extent and do not normally affect a person in their daily life.

"Music therapy is defined as a planned, goal-directed process of interaction and evaluation of individual client's specific needs, strengths, and weaknesses, in which music or music-based experiences are specifically prescribed to be used by specifically trained personnel to influence positive changes in an individual's condition, skills, thoughts, feelings, or behaviors." (Peters, 2000). It is a process that takes place over time and involves growth, change, and development. The process of music therapy may include various musical, creative, artistic, therapeutic, developmental, educational, interpersonal, behavioral and scientific components as music therapist and client interact over time in both musical and non-musical areas. Under the direction of a trained music therapist, the music based experiences become potent therapeutic tools that can predictably and effectively influence positive changes in an individual's condition, skills, thoughts, feelings or behaviors. Once a client has been assessed, evaluated, and individual therapeutic goals have been formulated, the music therapist designs a series of specific music and rhythm-based experiences that will help the client reach these goals and objectives. Music therapists often work directly with other professionals on medical or educational treatment teams. When they work in teams, these specialists meet together and decide how to coordinate their services in a way that will best help the client meet certain therapeutic goals. Treatment for psychiatric disorders often involves a combination of approaches and interventions including a structured environment, a regime of medication, a variety of psychotherapeutic interventions and a program of activity therapies. It is important to remember that individuals with mental disorders are unique and no one treatment or combination of treatments will be right for every person in therapy. Therapists who follow a humanistic approach give unconditional acceptance to the client with genuine caring, acceptance, understanding, and respect. The therapist helps the client move beyond defenses and mental or emotional blocks to confront the basic questions of life, find meaning and move to a higher level of functioning. Therapeutic techniques are experimental, oriented to building a trusting relationship, and are designed to help the client make choices, build an internal frame of reference and take personal responsibility to find purpose and meaning in life.

There are many songs that can be beneficial for people with bipolar disorder to listen to when going through a difficult time in their life. When choosing songs in a therapy environment, it is important to look at the lyrics to see if they are sending the right message to the clients. Some songs that would be beneficial for a therapist to use in a session are Keep Breathing, Empty Bottle, and A Birds Song by Ingrid Michaelson, It's Only Life by Kate Voegel, If No One Will Listen by Keri Noble, Angel by Sarah McLaughlin, Amazing Grace, Beauty From Pain and Stand in the Rain by Superchick, Hope and Joy, On I Fight by Joy Ike, Give it Time by Jon McLaughlin, Keep Holding On by Avril Lavine, Lean on Me by Bill Withers, and Quiet Your Mind by Zac Brown Band. Each of these songs has inspiring lyrics to keep therapy enjoyable and encouraging. For relaxation purposes the songs Keep Breathing, Amazing Grace, and Angel are an excelled choice because of their simple melodies and graceful accompaniment that will enable you to focus on what is going on with you and will also enable you to do simple movement exercises. The songs Beauty From Pain, A Birds Song, Keep Holding On, On I Fight, Give It Time, If No One Will Listen, Quiet Your Mind, and It's Only Life are a good choice for encouraging clients because of the lyrics saying how things will get better and how you have to keep pushing through all of the hard times that are in a clients way. The remainder of the songs is just good to have in therapy because of the messages that they give through the lyrics.

In conclusion, bipolar disorder can have crippling effects on people's lives, but with music therapy, there can be hope. The field of adult psychiatry deals with preventing and treating mental, emotional and behavioral disorders in adults. Although psychiatric illnesses and disorders may vary greatly in severity and exact type of symptoms manifested, they all are characterized by persistent, abnormal, patterns of behavior. Music therapy is a non-invasive way to make connections with a therapist and communicate without being in an environment where it can be intimidating. With the right interventions and a good relationship with a therapist, the road of therapy can be very successful.

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