Paper Example on Culture-Bound Syndromes: Bipolar Disorder

Introduction

Culture-bound syndromes (CBS) are disorders and illnesses that encompasses distinct cognitive, affective, and behavioral manifestation in specific cultures. CBS, in this perspective, are deviant from the usual behaviors prevalent among people of particular locales. There are several CBS disorders, but this paper focuses on Bipolar. The essay critically evaluates the causes of bipolar disorder (BD), its symptoms, treatments, its prevalence in the Western societies, and different perspectives of cultural psychologists towards it. However, psychiatric-mental health practitioners should integrate cultural knowledge into the care of BD clients since culture is a personal bio-psychosocial phenomenon that varies with the society.

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Bipolar Disorder

This mental condition causes an extraordinary shift in a person's energy, mood, and brain functioning. According to the statistics of the International Bipolar Foundation (2017), more than 5.7 million people in America or 2.6% of the population have this culture-bound syndrome every year. It affects people above 18 years, particularly in their early adulthood and late adolescence among teenagers. However, some people may develop BD in their late adulthood (International Bipolar Foundation, 2017). It is not recognized as a form of illness since it cannot be correctly diagnosed and treated in the early stages of its manifestation.

Bipolar disorder is prevalent in cultures that have high degrees of inequality, individualism, and encourage long-term achievements (Johnson & Johnson, 2014). The researchers, in this case, studied the prevalence of BD in 17 countries that have different cultures. The authors used a bivariate correlation to determine the relationship between the prevalence of bipolar and cultural dimensions. Johnson and Johnson (2014) noted that BD is prevalent in performance-oriented cultures that focus on long-term orientation and individualism.

However, BD does not have a single cause but instead result from an integration of multiple factors. These components, according to Rowland and Marwaha (2018), are hormonal problems, brain-chemical imbalance, biological traits, environmental and genetic factors. The latter entails traumatic events, mental stress, and abuse, which triggers bipolar. However, it has a genetic component, and thus, the condition may be within the family. An imbalance in the neurotransmitter, in this context, is an example of a brain-chemical factor that causes BD.

The symptoms of bipolar disorder are severe changes in energy, dramatic mood swing, depression, and extreme euphoria (Satcher, 2001). However, there is no culturally-specific treatment for BP. The reason, according to Satcher, (2001), is that health and mental healthcare in developed countries has its basis on medicine and Western science. Such medical treatments depend on objective evidence and scientific inquiry. The author further argued that while, objective evidence is the basis of medical treatment in the modern world, the service system and the culture of the clinician is a critical factor in the clinical equation. The modes of BP treatment are medication, psychotherapy, and cognitive-behavioral therapy. Examples of such treatment are mood stabilizers, antidepressants, anti-anxiety, and antipsychotic treatment.

Treatment of Bipolar Patients in Different Societies

Stigma is the most serious problem among people experiencing bipolar disorder. Research shows that stigmatization is an impediment to bipolar patients and their well-being, considering the existence of prejudice, stereotypes, and misconceptions about the illness (Shamsaei et al., 2013). According to the authors, these misconceptions and stereotypes about bipolar disorder challenge both the community and family-care givers. The isolation and stigmatization of such patients, according to Shamsaei et al. (2013), has worsened their recovery. The reason is that the community gives such people poor treatment and support. Also, rejection increases their difficulty to gain community acceptance and thus worsening their treatment.

Western societies also stigmatize people with bipolar disorders. However, research shows that individuals with BD in developed countries such as the US are more depressed than their counterparts in native cultures of India and Africa (Viswanath & Chaturvedi, 2012). The reason, according to the authors, is that low acceptance of BD patients in the West triggers feelings of suicidal ideations and guilt. Also, between 25 and 50% of bipolar patients in developed societies of the west attempt suicide, where 15% of them complete the act (Jablensky et al., 2001). Therefore, bipolar patients in the west face severe stigmatization and rejection in the society and thus the reason for high levels of depression, feelings of guilt, and suicidal ideations.

Absolutist and Relativistic View of Bipolar Disorder

The relativist and absolutist researchers have opposing views towards the manifestation and association of bipolar disorder to specific cultures of the world. However, both sides agree that the mental illness causes behavioral disturbances, and shift in moods (Shiraev & Levy, 2016). The two viewpoints influence the understanding and the treatment of BD, especially in the fields of psychiatric-mental health. The absolutist cultural psychologists argued that a majority of the mental illnesses in the modern world, including the bipolar, are similar and thus are not associated with the specific cultural phenomenon (Isaac, 2013). The existence of BD universally is the basis of the absolutist argument that it is not culture-specific. Evidence from the World Health Organization shows that bipolar and other mental illnesses are universal and thus lack cultural content (Isaac, 2013).

Conversely, the relativist cultural psychologists view bipolar as a mental illness that is unique to specific cultures. The relativist researchers argued that psychopathological study of bipolar is a normal phenomenon in some cultures and vice-versa (Shiraev & Levy, 2016). This situation suggests that the mental illness, in their view, has a direct correlation with the specific cultural phenomenon. Besides bipolar, spirit possession syndromes is natural in South America and the indigenous cultures of Africa (Shiraev & Levy, 2016).

However, relativists view bipolar a culture-specific illness that has peripheral symptoms, unlike the absolutists who see it having cross-cultural signs. The absolutist perspective is that the causes and symptoms of bipolar are similar cross multiple cultures (Shiraev & Levy, 2016). Precisely, biochemical factors have identical causes of bipolar disorder that cuts across different cultures. The identical symptoms that manifest among people with bipolar cross-culturally are mood swing, changes in energy level, and depression. The relativists, on the other hand, argued that bipolar have culture-specific symptoms that are identical in specific locales. Bipolar patients in Western countries such as Canada and the US, for instance, display guilty feelings and suicidal thoughts (Shiraev & Levy, 2016). Conversely, their counterparts in Taiwan are unlikely to show behavioral disturbance, bodily pain, shame, and guilty feelings (Shiraev & Levy, 2016).

Conclusion

Bipolar disorder causes chronic stress, and mood swing, which results in behavioral disturbances. This mental illness has no culturally-acceptable means of treatment, but medication and psychotherapy help stabilize moods and depression. The causes of the disorder are imbalance in brain-chemical substances, environmental, and genetic factors. However, western medication is based on scientific inquiry and objective evidence and thus explains the lack of cultural treatments in Western countries. Bipolar patients in the West are more depressed, have feelings of guilt, and tend to develop suicidal thoughts. However, it is essential to integrate the absolutist and relativist views in the psychopathologic treatment of bipolar since none provides an accurate psychological description and the reality of the mental illness.

References

International Bipolar Foundation. (2017). About Bipolar Disorder. Retrieved July 18, 2019, from https://ibpf.org/about-bipolar-disorder/url/

Isaac, D. (2013). Culture-bound syndromes in mental health: a discussion paper. Journal of Psychiatric and Mental Health Nursing, 20(4), 355-361. doi:10.1111/jpm.12016

Jablensky, A., Johnson, R., Bunney, W., Cruz, M., Durkin, M., Familusi, J., & Kaaya, S. (2001). Neurological, Psychiatric, and Developmental Disorders: Meeting the Challenge in the Developing World. Washington, DC: Institute of Medicine, 293-5.

Johnson, K., & Johnson, S. (2014). Cross-national prevalence and cultural correlates of Bipolar I disorder. PsycEXTRA Dataset. DOI: 10.1037/e512142015-795

Rowland, T. A., & Marwaha, S. (2018). Epidemiology and risk factors for bipolar disorder. Therapeutic Advances in Psychopharmacology, 8(9), 251-269.

Satcher, D. (2001). Mental Health: Culture, Race, and Ethnicity: A Supplement to Mental Health: A Report of the Surgeon General. (2001). PsycEXTRA Dataset. D

Shamsaei, F., Kermanshahi, S. M., Vanaki, Z., Hajizadeh, E., Holtforth, M. G., & Cheragi, F. (2013). Health status assessment tool for the family member caregiver of patients with bipolar disorder: Development and psychometric testing. Asian Journal of Psychiatry, 6(3), 222-227. DOI: 10.1016/j.ajp.2012.12.013

Shiraev, E. B., & Levy, D. A. (2016). Cross-cultural psychology: Critical thinking and contemporary applications. Routledge. Retrieved 19 July 2019, from http://bookfi.net/dl/1387149/bf8170/url/

Viswanath, B., & Chaturvedi, S. (2012). Cultural Aspects of Major Mental Disorders: A Critical Review from an Indian Perspective. Indian Journal of Psychological Medicine, 34(4), 306. DOI: 10.4103/0253-7176.108193