Who Is The Client Meets All Criteria For Bipolar I Due?

31 y/o AA male patient seen today for psychiatric-mental health assessment. He is awake, alert and oriented x4. He is calm, cooperative and follows commands during assessment. The patient reports he is depressed, difficulty sleeping and nightmares at night. The patient explained his depression is as a result of deep thinking from a news he received two days ago from his elder brother that his mother is ill. Stressors identified by the patient include losing his job a week ago before the news about his mother; his wife is 6-months pregnant with their first child, who currently works part-time at her present job; patient relates difficulty paying monthly bills and inability to provide adequately for his family as a man. The patient denies mood swings, suicidal/homicidal thoughts and ideation. Patient reports his spouse is at work at the moment and he does not want to put stress on his wife due to her current condition. Patient denies been hospitalized for depression or psychiatric illness; and denies family history of mental illness. Patient reports he is seeking help because he does not like feeling this way using terms of “helpless and loss of worth from his spouse”. Patient reports he needs help with his depression and nightmares before his current condition get out of hands and ruined his marriage.

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,

bipolar disorder at the age of 18. client has revised care as well as many different medications to

I am diagnosing Sheen with Bipolar disorder which is categorized as an Axis I disorder, in the DSM-V. Bipolar disorder affects approximately 7.5 million people eighteen years or older in any given year (Mohr, 2013). Of the three types of bi-polar disorder, I am diagnosing him with type I bipolar disorder, which is characterized by alternating depressive episodes and one or more manic episodes. “Manic episodes are periods of abnormally and persistently elevated, expansive or irritable mood” (Mohr, 2013). During mania someone exhibits extreme mood swings with irritability and sudden outbursts of misplaced rage, work output is decreased, and they may go on spending sprees or engage in promiscuity (Mohr, 2013). He must exhibit at least three of the following symptoms in order to be correctly diagnosed with the disorder. The symptoms for type I bipolar disorder are: decreased need for sleep, inflated self-esteem or grandiosity, distractibility, more talkative than usual, increase in goal

During this period there must also be three or more of the following symptoms present: (1) inflated self-esteem or grandiosity; (2) decreased need for sleep; (3) more talkative than usual or pressure to keep talking; (4) flight of ideas or subjective experience that thoughts are racing; (5) distractibility; (6) increase in goal-directed activity; (7) excessive involvement in activities that have a high potential for painful consequences. In addition to the presence of at least three of these seven symptoms, the criteria for bipolar 1 disorder require that the mood disturbance is severe enough to cause marked social or occupational dysfunction or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. Lastly, the manic episode cannot be attributable to the effects of a substance of abuse, medication, or another medical condition (American Psychiatric Association, 2013, p. 124).

First, I would directly ask about both sides of the bipolar spectrum – mania and depression. During my interaction with the patient, I primarily focused on the depressive side of mania, as that is the side of the bipolar disorder that the patient was currently exhibiting. The patient did not exhibit any signs of mania, and had not exhibited mania since being in the facility, so I did not focus my attention on this topic. To gain a comprehensive assessment on the patient, it would have been beneficially to at least bring up mania signs and symptoms with the patient. As stated in class, not all bipolar patients will admit to the mania symptoms, as patients tend to enjoy the increased energy and productivity levels. If I would have discussed this information with the patient, he may have noted that these symptoms directly correlate to his diagnosis. Second, after completing my assessment, I would work toward acquiring a support system for the patient, outside of the hospital. Through the conversation, I did acquire the knowledge that the patient does not have family or children nearby, but I did not gather information on support systems beyond the family. Various support systems I could look at for this patient include: Veterans, sexual abuse victims, gay men, and elders without family. Outside of the VA hospital, a veteran’s success relates to the amount of

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

Mood swings are an active factor in Bipolar disorder. When one thinks of this disorder the manic highs and depressive lows are the go to symptoms. These moods include anger, nervousness, loss of intrigue, elation, fear, blame, sadness, general discontent, or loss of pleasure or interest in exercises. Behaviorally a person with disorder may become irritable, hostile, experience hyperactivity, work off impulse, cry, or have a high need for reckless sex. Cognitively they can have unwanted/unhealthy thoughts, delusion, hallucinations, or false belief predominance. There may be issues with falling asleep and their whole body may feel fatigue. Depending on the person 's eating habits, they might gain or lose excessive weight.

Using a symptom checklist the client is currently experiencing sad moods (3 times weekly), bouts with(several times throughout the day daily), difficulty sitting still (9-10 times daily), difficulty staying focused (9-10 times daily) bad dreams (nightly), blames self for trauma (nightly), negative feelings about self (3-4 times weekly) and physically fight others (once a week). The client denies any current suicidal or homicidal thoughts.

Client meets the criteria for 296.21 Major Depressive Disorder. The patient has symptoms of depression, being worried, hopelessness, suicidal, and sad.

As I stated earlier, bipolar disorder consists of shifts in mood, energy, and activity levels. This can mean someone can seem very sad and depressed for a long period of time and then a period of extreme happiness. These can be shown in mood or behavioral changes and can be shown in how well they are able to concentrate, how much sleep they are getting, or even if they have thoughts of suicide (NIMH). Although the easiest way to spot bipolar is through extreme mood swings, it can still be present when such mood swings are less noticeable. It is important to look out for even the smallest mood swings because if they are frequent enough it can be a sign of one having bipolar disorder.

296.32 (F33.1) Major Depressive Disorder, recurrent episode, moderate severity, with anxious distress. Ms. Client meets eight of the nine diagnostic criteria for Major Depressive Disorder (MDD). Specifically, during several periods of time she experienced depressed mood, diminished interest in things she enjoyed to do, hypersomnia, psychomotor agitation, fatigue, feelings of worthlessness, decreased concentration, and suicidal thoughts without intent. Additionally, as Ms. Client expressed, these symptoms are source of continuing distress and interfere with her academics and social functioning. Also, her symptoms started four years prior to the psychological assessment and persisted intermittently since then, lasting for several weeks to several months, with the most recent period of extended length (enduring two weeks) approximately one year ago. Since the last episode she has experienced these symptoms for two to three days at a time. Although the last episode that met the criterion of two weeks duration occurred approximately a year ago, the symptoms have not disappeared, but they occur periodically since then and when they do, they cause considerable distress and impairment in functioning. Thus, the disorder cannot be coded as ‘in partial or full remission’. The specifier ‘with anxious distress’ was given, because Ms. Client reports feelings of difficulty in concentration because of worry and restlessness.

Before I truly understood Bipolar disorder, it was still a fairly common word in my vocabulary. Anytime I thought someone was being moody or fluctuating between emotions, I joked by claiming that person to be bipolar. Several incidents of this involved one of my roommates who seemed to be happy one day, and quite the polar opposite the next. However, it was not until my clinical experience on the psychiatric unit that I realized what true bipolar disorder was, and that she did not fit the criteria. Even though I always thought my roommate was bipolar, I quickly found after being exposed to a diagnosed bipolar patient that my roommate was instead just moody. I decided to write this paper on bipolar disorder, not because I have struggle with it or know a friend or family member with this disease, but because I had several misconceptions about what it entailed.