Bipolar Disorders Essay Sample

Posted: January 7th, 2023

Bipolar Disorders Essay Sample

Assignment 1: “Captain of the Ship” Project – Bipolar Disorders

Bipolar disorders are severe disorders of mood that include both depressive episodes and expansive, grandiose, or manic episodes. During these times, the person may engage in activities with little awareness of the consequences because of accompanying psychosis. A diagnosis of bipolar disorder includes periods of mania or hypomania and periods of depression where the mood is down, hopeless, and suicidal. The neurovegetative symptoms of bipolar depression can be incapacitating. It is also important to differentiate the psychosis of bipolar disorder from schizophrenia. Bipolar Disorders Essay Sample

In this Assignment, you will become the “captain of the ship” as you provide treatment recommendations and identify medical management, community support resources, and follow-up plans for a client with a bipolar disorder.

Learning Objectives

Students will:

• Recommend psychopharmacologic treatments based on therapeutic end points for clients with bipolar disorders
• Recommend psychotherapy based on therapeutic end points for clients with bipolar disorders
• Identify medical management needs for clients with bipolar disorders
• Identify community support resources for clients with bipolar disorders
• Recommend follow-up plans for clients with bipolar disorders

To prepare for this Assignment:

• Select an adult or older adult client with a bipolar disorder that you have seen in your practicum.

In 3-4 pages, write a treatment plan for your client. In which you do the following:

• Describe the HPI and clinical impression for the client.
• Recommend psychopharmacologic treatments and describe specific and therapeutic end points for your psychopharmacologic agent. (This should relate to HPI and clinical impression.).Bipolar Disorders Essay Sample
• Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices.
• Identify medical management needs, including primary care needs, specific to this client.
• Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.
• Recommend a plan for follow-up intensity and frequency and collaboration with other providers.

“Captain of the Ship” Project – Bipolar Disorders

HPI and Clinical Impression for the Client

Client XX a 30-year-old master’s student presented to the clinic complaining of persistent mental psychiatric symptoms for three years in spite of treatment. She reported that she was experiencing difficulties in social interactions and expressing herself. She also complained of depressive symptoms, lack of energy, crying spells, and appetite loss despite taking moclobemide 600 mg/day and lamotrigine 100 mg/day for the last 2 years. She was easily irritable, anxious, experienced concentration problems and would often walk around the house at midnight.  She reported that there were times she felt overly confident and overly sociable, very talkative, more irritable, aggressive, and would laugh uncontrollably which was not normal for her. The client reported that she started experiencing symptoms during 6^th grade where she started wearing sunglasses, felt sad, loss of appetite and sleep disturbances. The symptoms deteriorated after her undergraduate degree where she rarely interacted with others, lacked motivation, lack of energy, felt worthless and helpless and stayed in the bed all day.Bipolar Disorders Essay Sample

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The client’s diagnosis is bipolar II disorder. This is because the client experiences depressive episodes and hypomanic episodes. According to DSM-5 criteria, symptoms of depressive episodes consist of; lack of sleep, crying uncontrollably, fatigue, appetite loss, lack of interest in former activities, and suicidal thoughts (Muneer, 2016).  Hypomania symptoms include euphoria feelings, risky behaviors, increased energy, delusions, and decreased need to sleep (McCormicket al, 2016). Client XX manifested both depressive and hypomanic symptoms and hence fits the diagnosis of bipolar II disorder.Bipolar Disorders Essay Sample

Psychopharmacologic Treatments

Lithium: This medication will be prescribed as a mood stabilizer for the patient. Evidence shows that lithium is effective in managing acute episodes of polarity and preventing mania and hypomania episodes(Shah et al, 2017).  In addition, the medication has been demonstrated to be effective in suicide prevention in individuals with bipolar disorder (Shah et al, 2017).

Lurasidone: This medication will aim to treat the bipolar depressive symptoms for the client. According to Bawa&Scarff (2015),lurasidone is FDA approved for treatment of bipolar depression as monotherapy or together with lithium. In addition, lurasidone has minimal side effects such as minimal weight gain and reduced risk for cognitive deficits, and a low metabolic risk profile (Bawa&Scarff, 2015).

Psychotherapy Choices

Interpersonal and social rhythm therapy: This therapy will aim to increase the consistency of the daily routines for the client because disrupting circadian rhythms is associated with mood disorders (McCormick et al, 2015). The mood instability present in individuals with bipolar disorder is a result of circadian rhythm changes. Interpersonal and social rhythm therapy has been shown to improve medication adherence and also improve the patient’s ability to identify triggers to mood episodes and develop coping and preventative strategies (McCormick et al, 2015).Bipolar Disorders Essay Sample

Cognitive-behavioral therapy (CBT): CBT will aim to treat depressive and hypomanic episodes for the patient. CBT postulates that maladaptive and pessimistic thinking and core dysfunction beliefs are the cause of recurrent mood disorders (Geddes & David, 2013).  Therefore, CBT will aim to change the client’s maladaptive thinking patterns and feelings into more adaptive and positive thinking patterns. Evidence shows that CBT is effective in improving depressive symptoms and improving social functioning in individuals with bipolar disorder (Geddes & David, 2013).

Medical Management Needs

The client and her family will need to be educated about her condition and encourage her to adhere to the treatment regimen and adopt a healthy lifestyle. There is also a need to educate the client and the family regarding the psychosocial stressors for the maniac and depressive episodes and the likely effect on illness(Kilbourne et al, 2013). The patient should also be informed regarding the significance of maintaining regular schedules for activities of daily living including diet and sleep. The client also needs to beeducated about the side effects of the prescribed treatment. Lithium prescription needs to be monitored closely to avoid toxicity and advise the client to avoid dehydration when taking the medication (Kilbourneet al, 2013).

Community Support Resources

It will be important to refer the client to the nearest available support groups to ensure the client gets peer support from people experiencing similar mental health issues. She will also be given educative magazines and other resources that contain information about bipolar disorder and its management(Culpepper, 2014). A community social worker will also be assigned to the client to provide any support as well as monitor the client’s adherence to treatment. Finally, the client will be linked to organizations that offer psychotherapy treatments without charges because she is experiencing financial difficulties and might not be able to afford care (Culpepper, 2014).Bipolar Disorders Essay Sample

Follow-up Plan

The client will be reviewed after every 14 days. The psychiatrist will be performing assessment during each review and prescribe medications accordingly. The PMHNP will be educating the client and providing other care roles such as medication administration and monitoring the client’s progress(Culpepper, 2014).  A community social worker will monitor the client and home including her adherence to the treatment regimen.

References

Bawa R &Scarff . (2015). Lurasidone: A New Treatment Option for Bipolar Depression—A Review. InnovClin Neurosci. 12(1-2), 21–23.

Culpepper L. (2014). The Diagnosis and Treatment of Bipolar Disorder: Decision-Making in Primary Care. Prim Care Companion CNS Disord. 16(3): PCC.13r01609.

Geddes & David M. (2013).Treatment of bipolar disorder.Lancet.381(9878).

Kilbourne A, David G, Allison N & Miller C. (2013).Integrating Bipolar Disorder Management in Primary Care.Curr Psychiatry Rep. 214(6), 687–695.

McCormick U, Murray B &McNew B. (2015). Diagnosis and treatment of patients with bipolar disorder: A review for advanced practice nurses. J Am Assoc Nurse Pract. 27(9), 530–542.

Muneer A. (2016). The Neurobiology of Bipolar Disorder: An Integrated Approach. Chonnam Med J. 52(1), 18–37.

Shah N, Grover S &Rao P. (2017).Clinical Practice Guidelines for Management of Bipolar Disorder.Indian J Psychiatry.59(1), S51–S66. Bipolar Disorders Essay Sample