Posted: December 8th, 2022
Bipolar Disorders Essay.
Select an adult or older adult client with a bipolar disorder that you have seen in your practicum. 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.) 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.Bipolar Disorders Essay.
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Bipolar disorders are mental disorders that causes abnormal changes in mood, energy levels, and the ability to do normal activities. People with bipolar disorders may experience abnormal emotional changes, changes in sleep patterns and energy levels, as well as abnormal behaviors. The mood changes in people with bipolar are categorized as manic, hypomanic or depressive episodes (American Psychiatric Association, 2013). This assignment presents a client with bipolar II disorders and recommend the appropriate treatment, identify the medical needs, as well as analyze other aspects for the client.Bipolar Disorders Essay.
History of Presenting Illness &Clinical Impression
Mr. P a 40-year-old man reported of a five-year history of unstable moods and depressive episodes. He reported that the depressive symptoms had worsened eight months ago after losing his job. He would feel sad all day, lacked motivation, withdrew socially, thought of suicide, felt worthless and hopelessness, lost weight, insomnia, and lost interest in so many activities. The client had attempted suicide thrice for the past 4 years. Further assessment indicated that in the past two years the client had hypomanic episodes characterized by being highly energized, risky sexual behaviors, staying awake for unusually long periods, and being overly confident. Such moods persist for about a week. His mother had a history of major depressive disorder while his father had a history of schizoid affective mood disorder. The client had been treated withfluoxetine and citalopram, without symptom remission.Bipolar Disorders Essay.
The diagnosis for the client is bipolar II disorder. The client manifests depressive symptoms such as seep problems, sadness, loss of interest in most activities, lack of energy and feeling hopelessness, and suicidal thoughts. The hypomania episodes are typified by the episode where the client would be highly energized, engage in risky sexual behaviors, and stay awake for unusually long periods (Delavenne et al, 2016).
Valproic acid, 15 mg/kg/day orally: Valproic acid will be prescribed as the mood stabilizer for the client. This is because the onset of action for the medication is fast and also the efficacy of Valproic acid in treatment of hypomania and mania in individuals with bipolar has been demonstrated in numerous studies (McCormick et al, 2015).
Quetiapine, 200 mg/day: Quetiapine is the antidepressant of choice for the client and will be utilized in treatment of depressive symptoms for the client. The medication is approved by FDA to treat maniac and depressive episodes in people with bipolar disorder. Quetiapine is also the recommended first-line medication of choice in treatment of depressive symptoms for people having bipolar disorder (Fountoulakis et al, 2017).Bipolar Disorders Essay.
Interpersonal and Social Rhythm Therapy (IPSRT): IPSRT is the recommended psychotherapy for the client. IPSRT will include interpersonal psychotherapy, social rhythm therapy (SRT), and psychoeducation.Psychoeducation will focus on the symptoms of the condition, the treatment options, triggers, and warning signs. SRT will focus on training the client to develop strategies to promote regular schedule and reduce the impact of events and behaviors that interrupt the normal life(Swartz et al, 2014). The client will be advised to maintain a regular schedule. For interpersonal psychotherapy, the client will be trained to identify the links between the problems and mood dysregulation. In interpersonal psychotherapy, the client is trained to recognize the mutual connection between interactive problems and mood dysregulation (Swartz et al, 2015).
Medical Management Needs
The medical needs for this client include the need to improve symptoms and start suitable treatment. The hypomanic mood may discourage the client from seeking treatment because one doesn’t believe they are sick and hence the primary need is to encourage the client to start the treatment (Hajda et al, 2016). The client will be monitored closely for suicidal tendencies and also for adherence to the prescribed treatment (Hajda et al, 2016).Bipolar Disorders Essay.
Community Support Resources
The client will be lined with supportive agencies like ADAA to offer treatment support as well as the local community support group so that he can get moral support. Since he does not have a job and it is a possible trigger for depressive symptoms, the client will be linked with organizations that can help in accessing employment. He will also be provided with educational resources where he can read about his condition.
The client will attend review clinic after four weeks. His treatment will involve a psychiatrist, PMHNP, and a social worker. The PMHNP will be the primary healthcare provider while the social worker will monitor the client progress and adherence to treatment while at home. The psychiatrist will provide complex consultation services
The diagnosis for the client is bipolar II disorder as indicated by hypomania and depressive episodes. The prescribed medications for the client are valproic acid and quetiapine. The prescribed psychotherapy treatment is Interpersonal and Social Rhythm Therapy (IPSRT). The medical management needs include monitoring the client for suicidal thoughts and adherence to treatment. The client will be referred to the local support group and agencies that support his treatment, and be provided with reading resources.Bipolar Disorders Essay.
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