Case Overview
Sarah, a 22-year-old female, reports being happy all the time for the past two weeks. During this period, she has made several arbitrary decisions, such as gambling, unprotected sex, and work termination, which might lead to significant negative consequences in the future. She has had less sleep, experienced delusional episodes, and demonstrated highly unusual behavior.
Main Diagnosis
Mood disorder: Bipolar I disorder – A manic episode lasting up to three weeks.
Two Differential Diagnoses
The primary diagnosis differs from bipolar II disorder due to the evidence of a manic episode instead of hypomanic episodes (Purse, 2021). The diagnosis also differs from cyclothymia due to the highly irregular patient’s behavior and lack of consistent mood swings (Perugia et al., 2017).
Target Symptoms
- Elated affect during a psychiatric interview;
- Rapid speech;
- Poor concentration;
- Easily distracted;
- Hypersexuality;
- Risky behavior;
- Arbitrary decision-making;
- Feeling elevated all the time during the past two weeks;
- Sleeping disorder;
- Delusional.
Diagnostic Test
The diagnostic test for bipolar disorder requires the person to be in a manic episode for at least a week and sustain at least three common symptoms of the mental health problem (Purse, 2020). During the examined period, Sarah demonstrated more than five symptoms, including poor concentration, risky behavior, little sleep, hypersexuality, rapid speech, and others, confirming a manic episode of bipolar I disorder.
Treatment Plan
In the case of bipolar I disorder, the complex treatment should include medication, therapy, and lifestyle changes. The former generally concerns antipsychotics and mood stabilizers to prevent further episodes (Purse, 2020). Therapy is necessary to identify the manic episode triggers and moderate their impact (Purse, 2020). Lastly, lifestyle change is a complementary measure to improve the quality of life, sleep efficiency, and overall health (Purse, 2020). Ultimately, the complex treatment might successfully mitigate future manic episodes.
References
Perugia, G., Hantouchec, E., & Vannucchia, G. (2017). Diagnosis and treatment of cyclothymia: The “primacy” of temperament. Current Neuropharmacology, 15(3), 372-379.
Purse, M. (2020). What is a manic episode? VeryWellMind. Web.
Purse, M. (2021). Symptoms and diagnosis of bipolar disorder. VeryWellMind. Web.