Case Background
Mental health-related issues impact human beings in various ways. Psychological issues cause behavioral change that is hard to comprehend. In Sabrina’s case, the client has bipolar disorder. Bipolar disorders are a common condition that is disabling and can be life-threatening. Bipolar disorder involves interchanging episodes of depression, mania, hypomania, or a combination. However, many clinicians face diagnostic and therapeutic challenges related to bipolar disorders (Myczkowski et al., 2018). The psychological field is essential as it focuses on achieving prevention and treatment strategies to reduce distress. Therefore, for proper treatment, a professional therapist must follow the psychiatric diagnostic criteria for the disorder. Hence, the DSM-5 is a fundamental and reliable criterion for accurately diagnosing mental health conditions.
Presented Problem
Depression and mania, or a combination of the two, are hallmarks of bipolar disorder, a serious, long-term psychiatric condition. The first step to accurately diagnosing bipolar I or II disorder is identifying current or previous manic, hypomanic, or depressive episodes. This type of mood episode has specific diagnostic criteria and clinical probes for identifying key symptoms. Bipolar disorder subtypes Bipolar-I and Bipolar-II and cyclothymic disorder, intermediate phenotypes of the disorder frequently encountered in clinical practice, can be diagnosed using the DSM-5 criteria.
Manic Episode
The client was experiencing a distinct period of abnormally elevated, irritable mood, lasting for at least one week (Mohammadi et al., 2018). The client has mood swings most of the day, taking 10 to 15 minutes to cry in the bathroom nearly daily.
The patient experienced the following symptoms during the period of mood disturbances and also presented a significant level of behavioral change:
- The client declined invitations by co-workers to happy hours and social events; hence, an indication of social isolation due to low self-esteem
- The client has a decreased need for sleep as she spends most evening times watching television
- The disorder makes the client have subjective experiences
- The client is overwhelmed with sadness, distracted, and faces psychomotor agitation
- The mood disturbance is severe to cause marked impairment in social functioning
- The client’s episode is not attributed to substance psychological effects or medical condition
Client Resources/ Competencies
- The client is educated as she has recently graduated with a degree in civil engineering
- The client has employment in an engineering firm in Manhattan
- The client is financially-able and can make positive decisions about her life. She plans to move to New York after getting the job
- The client has a loving and caring family, workmates, and friends, who support her achievements and are concerned about her social life
Goals and Objectives/Measurable Outcomes
The client will demonstrate a reduction of subjective experiences and sadness by 80% within six months:
- Monitor the mood by improving the sleeping period to five hours every night
- Develop a schedule. Routine is vital in keeping your mood consistent. Organize a timetable and attempt to keep to it regardless of the mood to maintain consistency.
- Limit stress by having reduced pressures in life
- Build an excellent support network. Allow family and friends to assist in managing your day-to-day symptoms by offering an outsider’s viewpoint on your mood.
- Engage in physical exercise 2 to 3 times a day for 30 minutes since exercise is effective as a technique to help control mood.
Treatment/Intervention Frequency and Duration
Family-Focused Treatment
Family-focused treatment is based on the widely reproduced relationship between criticism and anger in caregivers and an increased chance of relapse in mood disorders. Family-focused therapy involves the patient and caregivers in up to 21 sessions of psychoeducation, communication skills training, and problem-solving skills training (Miklowitz et al., 2020). The intervention should take 2-3 times a week, including family meetings, to improve the client’s social interaction.
Cognitive-Behavioral Treatment
Cognitive-behavioral treatment presumes that recurrences of mood illness are governed by pessimistic thinking in reaction to life events and basic dysfunctional beliefs about the self, the environment, and the future. Cognitive-behavioral treatment to treat depression has been developed for individuals with bipolar illness, with the knowledge that manic periods are typically linked with overly positive thoughts (Furukawa et al., 2021). CBT is an evidence-based treatment that involves 12 to 16 weekly sessions depending on the degree of the manic episode. CBT has greater efficacy for all mental diseases than psychoanalysis and person-centered treatment. Hence, it will help recognize unhealthy, negative ideas and habits and replace them with healthy, constructive ones. CBT can assist in discovering what triggers bipolar episodes and useful techniques to control stress and cope with stressful events.
Evaluation
Cognitive stimulation therapy (Furukawa et al., 2021):
- CST enhances patients’ quality of life as it provides favorable effects on cognition improvement
- The technique exhibits more notable cognitive gain in females than males and elderly persons than the younger age group.
- CST enhances patients’ attention, and alertness boosts willingness to engage in conversation or socialize and improves memory.
- The treatment technique is cost-effective
- The problem with CST is that it is only influential on particular cultures.
- The strategy displays efficacy in household situations. Older patients prefer a customized therapy method versus group-based therapy.
References
Furukawa, T. A., Suganuma, A., Ostinelli, E. G., Andersson, G., Beevers, C. G., Shumake, J.,… & Cuijpers, P. (2021). Dismantling, optimising, and personalising internet cognitive behavioural therapy for depression: a systematic review and component network meta-analysis using individual participant data. The Lancet Psychiatry, 8(6), 500-511.
Miklowitz, D. J., Schneck, C. D., Walshaw, P. D., Singh, M. K., Sullivan, A. E., Suddath, R. L.,… & Chang, K. D. (2020). Effects of family-focused therapy vs enhanced usual care for symptomatic youths at high risk for bipolar disorder: a randomized clinical trial. JAMA psychiatry, 77(5), 455-463.
Mohammadi, Z., Pourshahbaz, A., Poshtmashhadi, M., Dolatshahi, B., Barati, F., & Zarei, M. (2018). Psychometric properties of the young mania rating scale as a mania severity measure in patients with bipolar I disorder. Practice in Clinical Psychology, 6(3), 175-182.
Myczkowski, M. L., Fernandes, A., Moreno, M., Valiengo, L., Lafer, B., Moreno, R. A.,… & Brunoni, A. R. (2018). Cognitive outcomes of TMS treatment in bipolar depression: safety data from a randomized controlled trial. Journal of affective disorders, 235, 20-26.