ESSAY: “Captain of the Ship” Project – Bipolar Disorders

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.).
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.

ANSWER

“Captain of the Ship” Project – Bipolar Disorders

Introduction

Bipolar disorder is a mental health illness characterized by severe changes in mood. Individuals diagnosed with bipolar experience extreme mood shifts such as excessive happiness, unusual energy, and enthusiasm among other mood shifts, also known as manic episodes (Grunze, 2015). Patients of bipolar may also experience periods of depression demonstrated by a lack of energy, feeling of sadness, and lack of interest in participating in activities that they normally enjoy. The disorder may show its symptoms early during adolescence and young adulthood and sometimes can extend throughout the patient’s life. Many scholars have acknowledged the fact that there are no sure causes of bipolar disorders but there is speculation that it may be due to some genetic factors, neurotransmitters imbalance, environmental stimuli, or has something to do the brain structures of some specific individuals (Tsu & Gutierrez, 2016). This paper describes HPI and clinical impressions of a client, recommends psychopharmacologic agents, psychotherapy choices, management needs, community support and offers a recommendation strategy or follow-up.

Clinical Impression and HPI

Sheila is a young female adult in her late 20s who was presented to the office in the company of her husband. Sheila re-counted that she had a difficult time expressing herself and did not interact well with others. During the session, she burst into tears and described that she was becoming irritable and intense at times without a rational reason. As the interview progressed, Sheila showed signs of being distracted and was unable to concentrate. Additionally, the patient said that she often felt restless and could not stay at home for long periods. At times she felt uneasy to return to her house. For the last three months, her husband iterated that she hardly gets any sleep and at times would wake up and walk around their house at night. The husband also said that Sheila could sometimes leave her job without her employer’s consent and walk about the streets. Sheila revealed that during her street walks, she experienced higher confidence levels and became more social and interactive with strangers which were rather unusual for her. Moreover, the husband stressed that in the last few weeks Sheila had become more aggressive, tense and irritable and sometimes she would laugh hysterically. In addition to this erratic behaviour, the husband said that her spending habits had changed and Sheila was using money on things that they did not need as a couple. Sheila added that she felt distressed and anxious especially in crowded places, lacked the energy and motivation to participate in her favourite activities and sometimes would prefer to lay in bed.

According to the diagnostic criteria in the DSM-5, the practitioner diagnosed Sheila with bipolar 2 disorder. Given the clinical impressions presented, Sheila fits in criterion A diagnosis which is characterized by unusual, heightened, irritable, and persistent mood with a constant increase in activity and energy levels (APA, 2013). Moreover, Sheila has become more talkative, her self-confidence has increased and is experiencing sleeping disorders. These symptoms satisfy the criterion B assessment of bipolar 2 disorder which portrays a shift from normal behaviour. More significantly, the depressive and manic periods along with mood disturbances have attributed to her unequivocal function change which others (her husband) can observe. The change in function, therefore, fulfils both criterions C and D assessments. On the positive side, Sheila’s episodes are not extreme enough to warrant hospital admission. Also, her episodes are not caused by abuse of substances, drugs, or other assessments in criterions E and F correspondingly (APA, 2013).

Psychopharmacological Interventions Given Sheila’s condition, it would be best to recommend antipsychotic drugs and mood stabilizers. To this effect, the best prescription for her would be 50mg of oral quetiapine daily for her manic episodes. Also, a prescription of 300mg BID lithium would be appropriate for her case as a supplementary medicine to stabilize her mood swings…