Bipolar I Disorder

Bipolar I Disorder

Bipolar I Disorder

Milanis a 14-year-old Caucasian female brought to my office, accompanied by her mother and father. The teenager is jovial in at trendy sharp look, dressed in Women’s Loose Pattern Crop Tee, Classic Vintage Transparent Glasses, and white converse chuck Taylor sneakers with air pods plugged in her ears. The mother looks restless, and the father cool collected gentleman who does the introduction calmly. The father report that they were referred to me by their primary care provider (PCP) after seeking his advice because Milan’s behaviour at home had become wanting. At school, the teacher’s reports have been of concern since she joined the high school to the extent of asking her parents to come to school for further discussions regarding Milan’s behaviour. The PCP suggested for further evaluation by a psychiatrist to determine what the problem could be.

Her father reports that he provides everything with her daughter desires since the last time he denied her what she wanted, Milan felt sad and questioned him if she was ever part of the family or important either way to them. Milan is the firstborn, and she has a younger brother and last born sister. The family had a struggling beginning, and lately, they are doing well after moving to their new home where her younger sister was born, and she gets all the attention from the parents. The mother harshly joins the conversation angrily, shouting to Milan to be attentive and listen to me. She adds that her relationship with the younger siblings is in trouble, often hostile and quarrelsome to her brother and very irritable. She says since joining high school, her weight has gone down with inconsistent appetite.

Milan looks sad now with little attention as she reports to not havinga good bond with her mother, who isemotional, unpredictable, and changes moods vagary. She continued saying having sleep problems, no longer interested in video games anymore that was her favourite, and wanted to hurt herself and feel to want to stay away from home. She adds that her peers in school do not like her. Further interrogation, her father reports had prior discussions with Milan’s teachers regarding her conduct in school. The report indicated her being easily distracted, particularly during classwork, very short temper or seemed extremely irritable, talk fast about a lot of different things,and be sensitive when corrected or in redoing her assignment. The teacher said she sometimes had heightened energy levels of being adventures and taking part in adrenaline activities like mountain biking, which she loves. She denies suicidal attempts, no drug abuse, no bullying in school, and offers no other concerns at this time.

Diagnosis is bipolar I disorder or manic depression and anxiety disorders. According to Kowatch et al. (2009), the bipolaror manic disorder is hereditary, and from the reports, Milan’s mother has the condition that she has been brawling for long, not knowing one of her kids will have it too. Treatment will entail long term blending of medication and psychotherapy. The prescribed medication; 300 mg lithium carbonate capsules, was taken twice a day, beginning the first day and scheduling an appointment after for weeks. In regards to Macneil (2009), mood stabilizers introduced to reduce extremes in behaviour and restore the balance of neurotransmitters in the brain due to the mental effect. The state of adolescents, especially females, experience numerous and sensitive changes and therefore treated carefully.

Psychosocial therapy also an intervention by talk therapy to the girl and family-focused therapy that is lifelong. According to Johnson et al. (2005), psychological treatment is the most efficient way to deal with bipolar and anxiety disorder if well done since its positive effect on depression and anxiety. It may include using skills to enhance emotions, maintaining routines, improving social interactions, taking symptoms of suicidal or depression seriously, keep all appointments for the adolescent’s healthcare provider, and working together.

Using the DSM-5 criteria, I find Milan’s condition to be bipolar I disorder. She presents hypomanic and manic episodes occurring like easily irritable in school, wanting to hurt herself and even wanting to stay away from home. Her elevated moods are evident; even looking at how she is right now comparing how she came in is quite different. According to the American Psychiatric Association (2013), the above characteristics meet the DSM-5 criteria to justifies that Milan has a bipolar I disorder and generalized anxiety disorder.

We have several ethical and legal issues regarding the counseling of bipolar clients. They include diagnosis itself, consent to the choice of treatment, risks or side effects of treatment choice, communication with the patient goals and those of the parents, confidentiality, vulnerability, non-adherent patients, advanced statements, deprivation of liberty, and seclusion. In the opinion of Ramley et al. (2007), the legal and ethical implications are crucial for professional practice and maintaining patient rights. For instance, we may have a conflict of medication goals for the teenager and those of parents. The parents may see their daughter not behaving as expected while the daughter feels she is perfectly fine with no condition requiring medication. The conflict will arise on who to follow, making one party adversely affected.

Evidence-based literaturebacks up evidence-based practices in general practice.Many studies show how to apply the information in literature form to daily operations in examining, accessing, and practice using it. An example is the use of the DSM-5 criteria in all aspects of mental health. It provides guidelines, and minimum characteristics examined to qualify a condition to fall into mental health. According to National trends in the outpatient diagnosis and treatment of bipolar disorder in youth (2007), it provides guidelines and criteria to qualify a condition related to bipolar disorder. In line with my diagnosis, Milan’s condition meets the conditions. Also, in medication, the evidence-based literature best supports the use of lithium carbonate as a first-line treatment since her condition is mild with a start of low dosage because it is said to prevent both manic and depressive relapse. More often, decision making of an issue is made easy through identification, evaluation, and findings summarized to have baseline core factors.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

Johnson, S. L., & Leahy, R. L. (2005). Psychological treatment of a bipolar disorder. Guilford Press.

Kowatch, R. A., Fristad, M. A., Findling, R. L., & Robert M. Post. (2009). Clinical manual for the management of the bipolar disorder in children and adolescents. American Psychiatric Pub.

Macneil, C. A. (2009). Bipolar disorder in young people: A psychological intervention manual. Cambridge University Press.

National trends in the outpatient diagnosis and treatment of bipolar disorder in youth. (2007, September 1). Retrieved from https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482424

Remley, T. P., & Herlihy, B. (2007). Ethical, legal, and professional issues in counseling. Prentice-Hall.