Captain of the Ship” Project – Bipolar Disorders Essay

Posted: January 19th, 2023

Captain of the Ship” Project – Bipolar Disorders Essay

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. 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.Captain of the Ship” Project – Bipolar Disorders Essay.      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.

“Captain of the Ship” Project: Bipolar Disorders

Introduction

Bipolar disorders are brain disorders that lead to abnormal changes in mood, activity levels, energy, as well as the ability to perform regular activities. Individuals with bipolar disorders have events of abnormally extreme emotion, changes in sleep patterns, changes in energy levels, and abnormal behaviors. The mood episodes in bipolar disorders are classified as depressive, manic or hypomanic (American Psychiatric Association, 2013). This paper will recommend treatment and pinpoint medical management needs and other aspects for a client with type I Bipolar Disorder.

HPI and Clinical Impression

A 32-year old female presented to the clinic for assessment after attacking a stranger using an abrasive chemical. The client started having problems with peer-relationships during her high school period and her academic performance was extremely poor then. The client reported that she has experienced episodes of mania and sadness since her teenage. After she turned 20, she started having behavioral problems characterized by irritability, aggression and manic episodes with alternate episodes of depression and persecutory ideas. The mother reported that the client sometimes experiences persecutory ideas in regard to her family and delusional beliefs that her family was plotting evil against her. The client has been taking medications for her depressive symptoms (sertraline 100 mg/day and clorazepate 10 mg/day) and though irregularly. For the last four weeks, the client manifests sadness, crying spells, irritability, aggressive, lack of sleep, and increased activity. The mother reported that she also manifests psychotic episodes. According to the client symptoms, her diagnosis is type I Bipolar Disorder. According to the American Psychiatric Association (2013), bipolar 1 disorder is characterized by depressive episodes and manic episodes.  Captain of the Ship” Project – Bipolar Disorders Essay

Psychopharmacologic Treatments

Lithium: This medication will be as a mood stabilizer for this client. Lithium was chosen because it has been shown to be effective in treating both manic and depressive symptoms in patients with bipolar (Masi et al, 2018).

Risperidone:  Risperidone is an atypical antipsychotic and works by balancing serotonin and dopamine within the brain and hence improves the mood, thinking, as well as behavior (López-Muñoz et al, 2018).  Therefore, the medication will help to improve the client’s mood, thinking, and behavior and thus also treat the psychotic episodes such as persecutory ideas and delusions. Evidence shows that risperidone is effective in preventing manic episodes due to its anti-manic. The medication also prevents psychotic symptoms (López-Muñoz et al, 2018). Additionally, risperidone has been demonstrated to be safe when administered with mood stabilizers such as lithium in patients with bipolar (López-Muñoz et al, 2018).

Psychotherapy Choices

Cognitive-behavioral therapy (CBT): CBT will be used as adjunctive therapy to drugs for the client. This is because CBT has been shown to be effective in reducing depressive and manic symptoms, reduce relapse rates, and also improve psychosocial functioning in people with bipolar disorder (Swartz & Swanson, 2014). CBT will also equip the client with behavioral and cognitive skills essential to help the client in identifying triggers of mood change and manage them effectively. CBT has also been shown to be effective in improving interpersonal relationships and the quality of life for people with bipolar disorder (Chiang et al, 2017).Captain of the Ship” Project – Bipolar Disorders Essay

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Medical Management Needs

The client is delusional, experiences persecutory ideas, and psychotic episodes such as attacking the stranger. In addition, the client also manifests mania episodes. Therefore, the client will need close monitoring to ensure she does not engage in risky activities. Another medical need is to ensure the client adheres to the treatment regimen because the mania may impair her judgment (Switsers et al, 2018).

Community Support Resources

The available community resources for the client consist of a local support group that will provide the client with emotional support and motivates her to go on with the treatment. This is because the local support group has individuals undergoing similar mental health problems. The client will also be referred to a local organization that provides social services to help to monitor the client while at home. The client will be provided with internet resources and other materials that will provide more information on how to manage her condition and identify triggers to mood change (Kavitha et al, 2018).  Finally, she will be linked with an organization that can provide free treatment because she is currently unemployed without any source of income.

Follow-up Plan

The client will attend the review clinic after every four weeks. During the review, the progress, symptom improvement, medication adherence as well as any side effect of the treatment will be assessed. The multidisciplinary team that will be providing care for the client will include a psychiatrist, a PMHNP, and a social worker.Captain of the Ship” Project – Bipolar Disorders Essay

Conclusion

The client’s diagnosis is type I Bipolar Disorder as characterized by depressive episodes and manic episodes. Psychopharmacologic treatments will include lithium and risperidone. Lithium will be used as a mood stabilizer while risperidone will be used to treat and prevent mania episodes and psychotic symptoms. The psychotherapy choice for the client is CBT that will target both depressive and manic symptoms. Since the client is psychotic and delusional, the client will need close monitoring. The community support resources for this client include a local support group, agency to provide free treatment, and reading resources. Finally, the client will be reviewed after every four weeks and the multidisciplinary team handling the client will include a psychiatrist, a PMHNP, and a social worker.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.

Chiang K, Tsai J, Liu D, Lin C, Chiu H, Chou K. (2017). Efficacy of cognitive-behavioral therapy in patients with bipolar disorder: A meta-analysis of randomized controlled trials. PLoS One. 12(5), e0176849.

Kavitha R, Kamalam S & Ravi R. (2018). Functional Ability of Clients with Bipolar Disorders in Tertiary Hospital, Puducherry. Int J Community Based Nurs Midwifery. 6(1), 21–28.

López-Muñoz F, Shen W, Pilar D, Romero A & Alamo C. (2018). A History of the Pharmacological Treatment of Bipolar Disorder. Int J Mol Sci. 19(7), 2143.

Masi G, Milone A, Giulia S, Mucci M, Bruni G, Stefano B & Pisano S. (2018). Lithium treatment in bipolar adolescents: a follow-up naturalistic study. Neuropsychiatr Dis Treat. 1(14), 2749–2753.

Swartz H & Swanson J. (2014). Psychotherapy for Bipolar Disorder in Adults: A Review of the Evidence. Focus (Am Psychiatr Publ). 12(3), 251–266.

Switsers L, Dauwe A, Hilde V, Koen L & Oldenburg J. (2018). Users’ Perspectives on mHealth Self-Management of Bipolar Disorder: Qualitative Focus Group Study. JMIR Mhealth Uhealth. 6(5): e108. Captain of the Ship” Project – Bipolar Disorders Essay