Bipolar Disorder Research Paper

Learning Objectives

Students will:

Analyze nursing and counseling theories to guide practice in psychotherapy
Develop goals and objectives for personal practicum experiences
Create timelines for practicum activities
Develop diagnoses for clients receiving psychotherapy
Analyze legal and ethical implications of counseling clients with psychiatric disorders
Develop diagnoses for clients receiving psychotherapy
Evaluate the efficacy of cognitive behavioral therapy for clients
Analyze legal and ethical implications of counseling clients with psychiatric disorders
Week 4 Journal Entry

Select a client that you observed or counseled this week. Then, address the following in your Practicum Journal:

Describe the client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.
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SELECT A PATIENT WITH PSYCHIATRIC DIAGNOSIS OF MAJOR DEPRESSIVE DISORDER AND GENERALIZED ANXIETY DISORDER OR BIPOLAR DISORDER.

OTHER PAST MEDICAL HISTORY: DIABTES, HYPERTENSION, HYPERLIPIDEMIA, OBESITY.

Using the DSM-5, explain and justify your diagnosis for this client.
Explain whether cognitive behavioral therapy would be effective with this client. Include expected outcomes based on this therapeutic approach. Support your approach with evidence-based literature.
Explain any legal and/or ethical implications related to counseling this client. Bipolar Disorder Research Paper
Bipolar disorder is a mental condition associated with a shift in one’s moods. Common symptoms include moods elevation known as mania. Consequently, the condition can be diagnosed following depression episodes. At least 2.8 percent population of adults in the US have been diagnosed with the condition. The approximate age for adults to express the condition is 25 years although in men the diagnosis can be earlier than this. During maniac episodes, one easily expresses high desires for drug use, unprotected sex, and spending spree, whereas for depression episodes, one experiences deep sadness, energy loss suicidal thoughts and lack of interest in various activities that she used to enjoy. Women tend to experience more depressive episodes while men experience more manic episodes. DSM-5 has been used to diagnose the condition creating room for better treatment using cognitive behavior therapy guided by the possible ethical and legal implications.

27 years old married, mother of a 2 years old had the following history of disabling and recurrent headaches and depression. Various weeks before these presentations, she experienced depression and challenges in movement, her appetite dismissed and she experienced crying spells throughout the day accompanied by suicidal thoughts. She was under Prozax 20 mg a day she further stated that the medication was making her more anxious. She stated that she had initial used Wellbutrin but the agitation, insomnia and sweating episodes were bothering her. Bipolar Disorder Research Paper

Her medical history indicates that at the age of 19 she had experienced a concussion that resulted in her losing consciousness. For many years she had been experiencing mood swings, she has a history of alcohol abuse especially in the teenage years. Following the poor response she had with antidepressants, diagnosis for a depressive disorder was probable. Other past medical history indicate that the patient has been battling weight management and even at the time of presentation she appeared obese. From the age of 19, the patient has been feeling stigma for having the condition hence avoiding group activities. Some of the medications she has been using have increasingly made her hungry hence increasing her rate of consuming calories.

According to the National Institute Mental Health (NIMH) there are six possible types of bipolar disorder with response to the Diagnostic and Statistical Manual of Mental Disorder (DSM-5) (Goldstein, Liu, Schaffer, Sala & Blanco, 2013). Form Coo bipolar 1 disorder to Co5 bipolar disorder not elsewhere classified. However, the patient’s condition could be Co4 bipolar disorder associated with another medical condition. The patient is experiencing more depressive episodes than manic episodes. The patient has rapid cycling of more than four depression and mania episodes in a year. Moreover, the patient is experiencing other conditions such as anxiety, migraines, and obesity which increases her depression. She also has a history of alcohol abuse and seemingly she has relapse episodes.

Cognitive behavioral therapy (CBT) is the most effective therapeutic approach for the client. The goal of the therapy is to help the patient gain a new outlook on her situation by challenging all the possible negative fears and thoughts and teaching the patient how to control them. As a result the patient is expected to handle her stigmatization and alcohol relapse to help reduce the depression episodes. According to Wheeler (2014), the therapy requires both parties contribution to achieve results. The first step is to determine what is bothering the patient. Secondly an examination is done to her thoughts, emotions, and behaviors. In the event, negative thoughts are spotted and the therapist helps in changing the client’s reaction to these thoughts. Most important, is the ease in the patient accepting the condition and will to monitor her mood in the process of cognitive restructuring. Bipolar Disorder Research Paper

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When counseling the client there are various legal and ethical implications guiding the therapist. The law requires that although any 18 years old and above individual has the right in decision making, for bipolar patients in a case where the condition can endanger the patient the court gives room for legal guardianship (Wheeler, 2014). Ethically, the patient has the right to treatment but before this, the therapist should ensure that the patient is well informed of her condition and the possible outcomes of the treatment. Unless a legal guardian has been appointed for the patient, the information about the patient is confidential and should remain only between the therapist and the client (Bourin, 2018).

In conclusion, bipolar disorder is experienced differently in both men and women. It is hence crucial for the therapist to channel treatment on basis of gender. DSM-5 is an effective tool for carrying out a patient diagnosis to give the therapist a clear approach to the treatment process of the patient. Some prescribed drugs for the condition have a tendency of worsening the patient’s condition instead of improving it hence the need of administering cognitive behavior therapy is the best mode of controlling bipolar since it involves both the therapist and patient contribution. Moreover, the therapeutic approach is often guided by the ethical and legal guidelines.

References

Bourin, M. (2018). Treating the Cognitive Impairment in Bipolar Patients. Bipolar Disorder: Open Access, 04(01). doi: 10.4172/2472-1077.1000119

Goldstein, B., Liu, S., Schaffer, A., Sala, R., & Blanco, C. (2013). Obesity and the three-year longitudinal course of bipolar disorder. Bipolar Disorders, 15(3), 284-293. doi: 10.1111/bdi.12035

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). NY: Springer Publishing Company. Chapter 8, “cognitive Behavioral Therapy” (pp. 313-346) Bipolar Disorder Research Paper.

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