Bipolar II: A Case Study

Helen is a non drug user that repetitively goes through several week periods of racing thoughts, abnormal energetic disposition, lack of normal eating or sleeping, talking quickly, and putting herself in potential dangerous situations. This period can be described as a Manic or Hypomanic episode. Later, she enters to what qualifies as a Major Depressive Episode. She describes it as a period that may last

Bipolar Disorder is a brain disorder that is characterized by abnormal changes in mood, energy and activity levels (“National Institute of Mental Health”). Manic-depressive illness is also another name that bipolar disorder is commonly referred to as (“National Institute of Mental Health”). This disorder has four basic types including, bipolar I, bipolar II, cyclothymic, and any other which do not perfectly fit the first three. All four of the types have episodes of extreme highs, manic periods, and extreme lows, depressive periods. Symptoms can range greatly and depend on what type of episode the affected is having. Manic episodes can include, but are not limited to: having extraordinarily high amounts of energy, activity,

People with bipolar I disorder have full manic and major depressive episodes. Most of them experience an alternation of the episodes; for example, weeks of mania may be followed by a period of wellness, followed, in turn, by an episode of depression. Some, however, have mixed episodes, in which they display both manic and depressive symptoms within the same episode—for example, having racing thoughts amidst feelings of extreme sadness. In bipolar II disorder, hypomanic—that is, mildy manic—episodes alternate with major depressive episodes over the course of time. When a person experiences numerous periods of hypomanic symptoms and mild depressive symptoms, but not full-blown episodes, DSM-5 assigns a diagnosis of cyclothymic disorder. The symptoms of this milder form of bipolar disorder continue for two or more years, interrupted occasionally by normal moods that may last for only days or weeks.

The client is a 35 year old African American female who presented as open and anxious during the assessment. In 2011, the client was diagnosed with Bipolar and Anxiety. In 2015, the client was hospitalized for 7 days at Richmond Behavioral Health Authority. The client was admitted due to symptoms of irritability, lost track of time and blacked out. The client was prescribed Seroquel and Topamax.

This source gives the readers an in-depth overview of Bipolar Disorder and the causes of having the mental health issue. There’s a great distinction between the ups and downs people experience and bipolar disorder. Due to the ups and downs teens and children experience, bipolar disorder is hard to diagnose during those early years. The National Center of Biotechnology Information’s research program is run by Senior Investigators, Tenure Track Investigators, Staff Scientists, and Postdoctoral Fellows which makes the source credible. The source contained

The symptoms for manic episodes are an elevated self-esteem, need for sleep drastically decreases, talkative, feel the need to keep talking, racing thoughts, attention span decreasing making it hard to focus on important things, excessive involvement in activities with bad consequences, such as bad financial investments, shopping sprees, impulsive, unprotected sex, deeply driven at work or school, and may become agitated.

Ellen Waters meets criteria for a diagnosis of Bipolar II Disorder (296.89), current episode depressed with atypical features, mild severity. There are several things in her case that make this diagnosis clear. She reports chronic depression throughout her life, but she also describes “highs” consisting of elevated mood lasting for several months at a time during which she functions on little sleep and gets a lot done, runs up high telephones bills talking to people, and experiences racing thoughts. Additionally, she reports that her friends have obviously concerned about her abrupt changes of behavior from her depressive norm, and would often tell her that she needed to slow down or calm down. All of these are consistent with hypomania and she lacks some of the hallmarks of mania—she is still able to function at work and socially for the most part, she has not needed to be hospitalized as a result of her “highs” and she has not experienced any psychosis—thus ruling out a Bipolar I diagnosis. She is currently experiencing a depressed mood and panic attacks, which is the reason why she has been referred for treatment. She states that she was depressed for most of the month prior to this visit.

Rationale: Jennifer has been presenting with symptoms for unspecified amount of time. Jennifer meets six of the criteria for symptoms being present during the same 2-week period and represents a change from previous functioning. Jennifer is depressed most of the day, nearly every day, has diminished interest in all or almost all activities most of the days, nearly every day, has fatigue or loss of energy nearly every day, feelings of worthlessness, and diminished ability to think or concentrate, is having recurrent thoughts of death, recurrent suicidal ideation without a specific plan. The symptoms have cause clinically significant distress or impairment in social, occupational, and other functioning areas. There is no know substance or medical condition and occurrence is not better explained by Schizophrenia Spectrum or Psychotic Disorders. Jennifer has never had a manic episode or a hypomanic episode. Possible family history of depression - mother.

The two major types of Bipolar Disorder (BPD) set out in this paper are Bipolar 1 and 2. Bipolar 1 is diagnosed as guide lined by the DSM5. As the occurrence of a least one maniac episode preceding or post an episode of hypomania and/or Major depression. The DSM 5 highlights that Bipolar 2 is diagnosed by one major depressive episode in occurrence with one hypomanic episode with an absence of Mania. (Association:, 2013) Mania as defined by DSM5: “A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day.” Hypomania being: “A distinct period of abnormally and

When a patient is in a manic episode they are very excited, energetic, and hyper. A manic episode can cause a patient to make impulsive, irrational decisions such as, partaking in high risk behaviors, spending large amounts of money they cannot afford, having sexual indiscretions even when they’re in a committed relationship or driving at dangerous speeds. There is a lesser state of mania called hypomania, it is in very close relation to a manic episode, the patient is not as hyper but it is still considered a abnormal state of high emotion. When a patient is in a depression episode it consists of sadness and hopelessness. The patient can become more tired, irritable, or have a change in their eating habits. In this episode thoughts of suicide can occur, losing interest in things they have previously enjoyed. These are just a few examples of the actions a patient makes when in a manic or depressed episode. There are multiple bipolar disorders, bipolar I and bipolar II are better known. The reader has been diagnosed with bipolar two at the age of twenty two. This disorder has been a problem since the age of ten, after learning more about the disorder over the years it’s been a process learning how to cope and continue everyday life. The lives of patients who have been diagnosed with this disorder are affected

Bipolar Disorder or manic-depressive disorder is a disorder characterized by highs, manias, and lows, depressions, and can therefore be easily distinguished from unipolar depression, a major depressive disorder in DSM-5, by the presence of manic or hypomanic episodes (Miklowitz & Gitlin, 2014). Bipolar disorder is generally an episodic, lifelong illness with a variable course (American Psychiatric Association, 2010). There are two classifications of bipolar disorder; bipolar I disorder and bipolar II disorder. If the episodes are primarily manic but there has been at least one depressive episode, the diagnosis is bipolar I disorder (Early, 2009). If the episodes are primarily depressed but there has been at least one episode of hypomania, increased mood that is more euphoric than normal but not quite manic, the diagnosis is bipolar II disorder (Early, 2009).

Bipolar I is our modern understanding of the 19th Century manic-depressive disorder or affective psychosis, however, it differs in that neither psychosis nor a lifetime experience of a major depressive episode is required. It requires one or more extreme manic episode, or symptoms of both a mania and a depression. It may be preceded by, or followed by, hypomanic or major depressive episodes. Mania symptoms cause significant impairment in life and may require hospitalization or trigger psychosis. In contrast, bipolar II is defined by the lifetime experience of at least one hypomanic episode and at least one major depressive episode. Criteria for hypomania are like those of mania, but in a milder form. Instead of impairment, hypomania is marked by a distinct change in functioning. (APA, 2013)

Lori Schiller met all of the criterion for a Schizoaffective Disorder, bipolar type, with multiple acute episodes. Her symptoms either appeared during the same two week time period or lasted for longer than two weeks (American Psychiatric Association, 2013, p. 105.), (Schiller and Bennett).

Hypomanic episode is period of abnormally and persistently elevated mood and abnormally and persistently increased energy present most of the day, nearly every day for 4 consecutive days. “The change in functioning and disturbance in mood are observable by others. The episode is not due to physiological effects of a substance. It is not severe enough to cause impairment in occupational or social functioning or to necessitate hospitalization. But if there are psychotic features, then it is labeled manic. The episode is associated with unequivocal change in functioning that is uncharacteristic of individual when not symptomatic” (American Psychiatric Association, 2013). And finally the last criteria is, during the period of increased energy and mood disturbance, three or more of the following symptoms must persist: inflated self-esteem, increase in

There is no indication she has had a manic or hypomanic episode. Her depression may be complicated by grief due to her father’s death one year ago. Her symptoms seem to get worse after his passing.