Bipolar II Case Study

Symptoms and Relevant Factors

Hector is a 19-year old Hispanic boy who was suspended from university due to misconduct. The accounts given below describes the behavior of Hector in the recent past as presented by his relatives, teachers, and classmates. Hector was taken to an emergency room by the campus police of the university after a series of gross misconduct in the college in which he had been suspended some few months prior. He used to be a very disciplined and bright student in high school, but his behaviors changed when he joined campus. He had displayed significant deviation from his usual behavior before being taken to the emergency room by the campus police. He stopped seeing his friends, and most of the time he spends his time in the bed, staring at the ceiling. At times, he mumbles by himself, and he also stood on the roof of his house weirdly waving his arms.

There is a family history of madness as witnessed in his grandmother who died in a state psychiatric hospital where she lived for 15 years. Just like Hector, her diagnosis was unknown. His mother too was reported to be crazy,' and she abandoned her family when Hector was still young. According to the evaluation of the LCSW, Hector is well-groomed but very uncooperative (Schulze, n.d.). He looks inattentive, guarded and very preoccupied. He was observed to be very paranoid, grandiose and with romantic delusions. Despite his denial of hallucination, he appeared to be internally preoccupied and reported to be feeling nauseated. He was articulate in his speech, but his insight judgment seemed to be poor. Despite all these signs, he refused to undergo a cognitive test. Based on this conditions, signs, and symptoms, Hector would be diagnosed with Bipolar II Disorder which is characterized by hypomania (less-intense elevated moods) and depression (Colom, Vieta, & Scott, n.d.).

Based on the behaviors of Hector, it is clear that he might be suffering from Bipolar II disorder given the fact that the symptoms he displays almost matches with the condition. Under the hypomanic episode, Hector displays an exaggerated self-confidence. He is described to be very grandiose with romantic delusions. His lack of sleep, obsession with Janet and waving on the roof-top indicates the increased energy in him with hyperactivity with a reduced need for rest (Colom, Vieta, & Scott, n.d.). He has also experienced a rhythmic change of ideas and slight depressive episodes.

Diagnosis Ruled Out

Bipolar I was ruled out since most of the symptoms met Bipolar II with greater significance. For example, the symptoms of the disease started to show some few weeks before, and the signs displayed by Hector during the Hypomanic episode perfectly match those of Bipolar II. Substance/medication-induced Bipolar and its related disorders were also ruled out since Hector did not have any secondary substance abuse.

Treatment plan

Hector should be subjected to proper evaluation by a qualified provider to prevent self-harm or harm to other people. He should also be voluntarily admitted to an acute psychiatric stabilization unit for more assessment and proper medication. He should be assessed on a weekly basis for his mental health, medication management, and development in coping skills. Identification and development of the strengths and support of client are very integral in the further provision of the client with a conducive environment that is needed for the provision of compliance in treatment. They entail support meetings, family and group therapies and client-centered interventions using a holistic model (Berg & Sarvimaki, 2003). The treatment plan has both short and long term goals.

Short-term goals

After one week, the client should:

Fully understand how to use medicine

Make an appointment with the provider.

Be consistent in taking medication as prescribed.

Long-term goal

Based on high morbidity and mortality that relates to bipolar disorder, long-term treatment is essential in preventing recurrence and reducing the loss of productivity and increased the cost of medication.

After two months;

Hector should regularly attend mental health sessions with the provider for counseling and medication management.

Rationale for Evidenced-based Treatment

Self-empowerment and accountability play an integral role in the success of treatment of Bipolar patients. Based on the past results, educated patients can accurately take their medication, book appointments with the provider for counseling and follow instructions given by the doctors. Patients can easily avoid barriers such as lifestyle changes, stigmas that associate with mental health and affordability of medication if they understand them. Evidence-based treatment also enables patients to recognize the onset of symptoms and other illnesses related to Bipolar. Most of these patients can seek medication before they are subdued. Evidence-based treatment helps in identifying the needs of the patient, how to meet those needs and the best way to achieve the best outcome. It engages the community and all the stakeholders in the healthcare sector. It uses a patient-centered model that enables clients to participate in intervention and treatment selection (Sullivan, 2016). Evidence-based treatment ensures progress and performance of the patient. It entails education of the patient, periodic assessment of the patient and counseling. Over the recent past, VA centers started to discharge planning earlier in the admission cycle to provide clients with more extended periods of adjustment (Glass, 2009).

Biopsychosocial Factors

Failure to treat Bipolar II in time could be very detrimental to the persons affected. For instance, elevated heart rates and poor eating habits could be very consequential about the ability of the body to heal and function. Patients who do not receive medication in time could be highly dehydrated, malnourished and exhausted. The body deals typically with elevated sadness and stress which might lead to high cortisol levels in the blood. Most medical conditions affect those with mental illness hence patients with Bipolar II would be prone to numerous diseases if not treated in time. It is imperative to note that treatment of Bipolar II is always a challenge since most patients do not comply because of the side effects of the medication.

Conclusion

The symptoms that Hector displayed directly pointed to Bipolar II. Based on the treatment plan that i have established, he can quickly recover if all the necessary steps are followed. General practice and social learning theories played an integral role in helping me in developing the care plan. It helped me in identifying the needs of the client and ensuring that all the resources are available for enacting the plan. However, dealing with one client is difficult particularly when taking a micro-level perspective.

References

Berg, G. V., & Sarvimaki, A. (2003). A holistic-existential approach to health promotion. Scandinavian Journal of Caring Sciences, 17(4), 384-391. doi:10.1046/j.0283-9318.2003. 00240.x

Colom, F., Vieta, E., & Scott, J. (n.d.). Symptoms II: Depression and mixed episodes. Psychoeducation Manual for Bipolar Disorder, 85-92. doi:10.1017/cbo9780511543685.017

Glass, R. M. (2009). Diagnostic and Statistical Manual of Mental Disorders (DSM). AMA Manual of Style. doi:10.1093/jama/9780195176339.022.529

Schulze, B. (n.d.). Evaluating Programmatic Needs Concerning the Stigma of Mental Illness. Understanding the Stigma of Mental Illness, 85-124. doi: 10.1002/9780470997642.ch6

Sullivan, M. D. (2016). Patient-Centered Care or Patient-Centered Health? Oxford Medicine Online. doi:10.1093/med/9780195386585.003.0002