Introduction
Bipolar disorder, also called “manic”, is the most costly mental disorder. Bipolar disorder is a brain illness classified by psychiatrists as a mood disorder. Popularly known as manic-depressive illness, this “mental illness” has such symptoms as unusual shifts in activity levels, moods and energy in people. Studies on the possible causes of bipolar disorder show that a number of factors, among them genetics, environmental factors and the brain structure, are likely to cause the illness.
This paper aims at presenting findings made during the interview process with a patient demonstrating bipolar disorder. This paper will use a primary research method that involves a 45 minute interview with one bipolar patient and the information recorded. The interview questionnaire will cover components of the clinical interview framework. By the end of this assignment, the difficulties, unusual behaviors and challenges experienced by bipolar patients will be discussed.
Clinical Interview and Evaluation of Mental Status
Bipolar Problems
Jane is a 22 year-old student studying journalism. She is in her second year at the university. She is from a nuclear family, both her parents are alive, and she also has two brothers and three sisters. She is the second child in the family. When talking to her, it seems that she looks normal and remains in a good psychological condition.
Nonetheless, she has extreme mood ups and downs, and gets agitated by things and people around her. When she is happy, she climbs on top of the world, her social life is at its peak. Surprisingly, she has extreme cases of depression and thoughts of committing suicide and made one suicidal attempt.
History of Illness
Jane began experiencing mood disorders in adolescence. She experienced cases of unexplained depression and would withdraw from the rest of the family and friends. Jane admitted that she was a victim of rape. The problem gets worse when there are family gatherings and events where she runs into the opposite gender.
This has made her problem deteriorate because she had to mingle with the opposite gender, particularly in the university where she has to study with male students. The situation is beneficial for her while at home as she locks herself in her room and enjoys being alone
Jane gets aggressive when approached by her male counterparts and throws insults to them. Her relationship with her father is also difficult. She has suicidal tendencies and at times takes an overdose of sleeping pills hoping to die. Physically, she is not harming herself. She has mixed feelings about the future. At times, she has high hopes to achieve some objectives while other times she is hopeless.
Symptomatic Evaluation
When approached by the opposite gender, Jane gets aggressive. She feels insecure around men and has feelings of hatred. She avoids male dominated places and gets verbally aggressive when meets female friends
Developmental History
Since childhood, Jane was a healthy one brought up in a middle class family. She did not experience developmental difficulties. She had a normal birth delivery and had good care.
Psychiatric History
Three years ago, Jane was hospitalized with post traumatic stress disorder (PTSD). Medical records indicate the cause of PTSD being a rape. She has had several psychiatric visits. While in her middle school years, Jane attempted suicide by poisoning herself. She also developed variations in her moods and had aggressive behaviors. Today, she suffers from Bipolar disorder.
History of Alcohol and Substance use
Jane has a history of alcohol abuse since her middle school years. Presently, she takes alcohol in isolation and believes it makes her forget her troubles. She mostly takes alcohol when alone in the comfort of her room, mostly after school. She has not gone through any previous treatment for alcoholism. She has no problem with taking alcohol and has no intention of quitting. She does not have a history with other drugs.
Medical History
Jane has stomach ulcers, and that has seen her hospitalized twice. This is a problem that developed during her adolescence five years ago. She takes tablets when she is in pain. She also complains about frequent headaches and insomnia, but has never been hospitalized. All this health complications result from stress and depression encountered due to her bipolar condition.
Family Medical and Psychiatric History
Jane comes from a nuclear family composed of her mother, father, two brothers and three sisters. She is the second born and lives with the rest of her siblings in her parents’ house. She has no close relationship with her extended family. Her aunts and uncles live in her neighborhood, and all her grandparents died. She rarely attends family gatherings and parties.
Past Family Structure
After birth, Jane and her elder sister were raised by their paternal grandparents. Her parents had gone abroad and, their grandparents took the role of their parents. Although parents used to send them financial support, Jane felt that her grandparents were better than her parents. She was close to her grandmother and her death affected a girl severely. She says that she lost her pillar in life.
Present Family Structure
Jane’s both parents work, but her father is the primary caregiver. Her elder sister is married, and they have a nanny who helps with all the work around the house.
She isolates herself from her younger siblings and has little or no time to play with them. Her family celebrates Christmas and other religious holidays together with the extended family composed of her aunts and uncles, who live nearby. Jane does not have a strong relationship with her family members and she is never happy with family gatherings. She passively participates in family gatherings and tries to avoid attendance.
Educational and Vocational History
Educational history
From her childhood, she was a bright girl and topped at her studies. However, this changed during her middle school years and her interest in studies started getting depressed. Although she got grades that allowed her go for university studies, she believed that she could have done better if she had not had mood variations and the lack of focus. She has had no learning disabilities, but had behavioral and emotional problems that her teachers could not manage.
Vocational history
After completing her secondary level, Jane worked as an administrative assistant for one year. She was good at her work and was a performer, but her moods would affect her output and relationship with workmates. She did not like the job because she had to interact with a lot of people daily. Currently, she is merely a student confused about the future. She seems hopeless, but at times, she thinks about being very successful in life.
History of Crime / Legal involvement
Jane has never spent a night in prison. She has sued her uncle for raping her. This legal involvement is a doom to her daily life as she feels that everybody around knows about her rape. This has widened the relationship gap between her and some of her relatives.
Social History
Jane does not have a secure social network. She has withdrawal symptoms and has few female friends. She does not keep close ties with her friends and has difficulties in explaining herself to them. She displays qualities of an introvert and enjoys her loneliness. She displays anti-social behaviors to her male counterparts and has never been in a relationship with any man and has no hopes of being with the one.
Psychosexual History
Jane is not sexually active and is not in any romantic relationship. She is sexually normal, but refuses to involve herself in any sexual and romantic relationships. She uses masturbation as a solution for dealing with her sexual feelings and desires. She is a victim of assault and rape. Her paternal uncle assaulted her sexually uncountable times as a teenager.
Evaluation of Culture
Jane identifies herself as an African-American and she has been living in Sydney since her birth. She has no issue with mixing with other races and has no particular cultural beliefs. She does not feel any impact of the multicultural society. She is also a strong Christian and attends church every Sunday.
Evaluation of Mental Status
Jane is self-composed and well-groomed. Jane is not friendly, and she only responds to those questions that are asked. Communication between us has no barriers, and her level of understanding is okay. She uses simple language to express herself and has mode and tone variations. She has depressive, anxious and suicidal thoughts and she is too aggressive towards others. Her level of concentration is normal, and she is good in decision-making process.
Summary
Jane has a mental problem. She is suffering from Bipolar disorder that makes patients have manic and depressive episodes caused by trauma. My main concern is that even despite visits to psychiatrists, Jane’s psychological, emotional and social life has effects caused by past trauma. Her present and future seem dark, and she is hopeless. This has also seen her as a socially self-affected, withdrawn person and she has few or no words. My concern is also about her suicidal feelings and hopelessness for the future at such a young age.
To address the concerns, Jane needs to seek a permanent solution. Her bipolar situation is not acute and manageable through psychosocial support. The use of psychotherapy would help her realize episode triggers, reduce negative expressions and end depression. This would be accomplished through frequent psychiatric visits as a long-term solution. Further, a support from family and close friends would also help Jane in dealing with the illness. She needs psychosocial support to get back to her normal life.
Bipolar disorder is a mental problem treated both medically and socially. Even though the condition is disruptive and long-term, it is possible for patients to watch over their moods by following treatment plans provided by psychiatrists. However, patients suffering from chronic bipolar disorder need permanent solutions to live normal lives in the society. This can be achieved through medication and psychological counseling.