“Captain of the Ship” Project – Bipolar Disorders
The Captain of the Ship project involves Gary, a 29-year old African-American female former college student. Gary had multiple manic episodes at an interval of two every week. Pharmacological treatment of the bipolar disorder is necessary to relieve the severity of the symptoms. One of the medications is mood stabilizers which control manic episodes. The first line of treatment for the bipolar disease is Cognitive behavioral therapy (CBT) (Lopez-Munoz et al., 2018). The focus of the treatment is to alter unhealthy beliefs and behaviors and replacing them with healthy behavior. The purpose of primary treatment is to reduce the severity of the symptoms. The purpose of the project is to analyze Gary’s bipolar disorder, pharmacological and psychotherapy treatment, medical management needs, and community support.
HPI and Clinical Impression
One of the patients is interacted with in the practicum is Gary, a 29-year old African-American female former college student. Gary had multiple manic episodes at an interval of two every week. Her manic episodes which last for about an hour have mild severity. Her episodes are frequent and severe when she is stressed or around exam time. She experiences mood swings, euphoria, and loss of interest in daily activities. At home, the parents complain she sleeps fewer hours and cannot observe the discipline of eating meals on time. She has frequent mood swings when she takes alcohol at social events.
His behavior in school led to the attention of the campus police. She acknowledged pulling fire alarms without any emergency or risk of fire. She had changed her course from engineering to philosophy. Eventually, she quit her philosophy course and she is now at home with the parents. The mother accompanies her to the clinic seeking medical intervention to rescue the daughter’s condition. The symptoms and the medical history of the patient may be suffering from bipolar disorder.
Pharmacological treatment of the bipolar disorder is necessary to relieve the severity of the symptoms. One of the medications is mood stabilizers which control manic episodes (Lopez-Munoz et al., 2018). Lithium (Lithobid) is one of the best medications to prescribe to patients with manic episodes.
Antipsychotics are necessary to treat depression and manic episodes. For example, risperidone (Risperdal) is recommended for the treatment of bipolar disease (Rosenblat, 2019). The patient can combine antipsychotics with mood stabilizers.
The patient can take antidepressants to help the patient manage depression. Taking antidepressants along the antipsychotics is necessary to reduce the severity of the condition. Another medication that it’s the condition of the patient is anti-anxiety medication (Rosenblat, 2019). For example, Benzodiazepines can improve the quality of sleep and reduce anxiety. Adherence to the medication is necessary to ensure quality control of bipolar disorder.
The patient should start with one medication to avoid polypharmacy which complicates the treatment of mental diseases (Malhi et al., 2017). Gary may experience side effects of the drugs. However, it is not advisable to stop or change the medication since it can trigger withdrawal symptoms.
Psychotherapy involves counseling sessions in individual, group, or family settings. The best approach for the patient is individual and family. Individual treatment is crucial to ensure the patient can cope with life events and pursue career goals (Malhi et al., 2017). Family therapy is necessary to advise the family on how they should live with Gary. For example, psychotherapy will relieve the worries of Gary’s parents and siblings.
The first line of treatment for the bipolar disease is Cognitive behavioral therapy (CBT). The focus of the treatment is to alter unhealthy beliefs and behaviors and replacing them with healthy behaviors (Rhee et al., 2017). Gary requires CBT to learn how to cope with stressful events and manage stress. Another importance of CBT is to help Gary to identify what triggers the manic episodes.
Interpersonal and social rhythm therapy (IPSRT) is another psychotherapy that seeks to stabilize daily rhythms. For example, the patient needs to keep time and learn how to observe mealtimes, study time, sleep time, and playing (Rhee et al., 2017). A consistent approach to the treatment of bipolar improves the management of moods. Establishing a daily routine for meals, sleep, study time, and other daily activities are essential in the treatment of bipolar.
Family-focused therapy is essential in the treatment of bipolar among adults and children. A family-focused approach improves communication and family support (Sani et al., 2017). For example, Gary’s parents are critical in supporting her and encouraging her to take medication and attend counseling sessions. Another role of the family is to help identify the warning signs of the manic episodes.
Psychotherapy should include educating the patient and the family members about the condition. Psychoeducation helps the family to embrace the patient and support them in their daily activities (Rhee et al., 2017). Family members should not treat the condition as bizarre but should embrace the patient with love.
Psychotherapy treatment should involve identifying the effects of hard drugs and alcohol. For example, when the patient takes alcohol, she experiences severe manic episodes. A therapist has a responsibility of providing counseling to the patient to ensure they cease taking alcohol and other drugs (Malhi et al., 2017). Drug abuse undermines the treatment and triggers severe manic episodes.
Medical Management Needs
The primary treatment of bipolar disorder involves medication and psychotherapy. The purpose of primary treatment is to reduce the severity of the symptoms. For example, the treatment should focus on ensuring the patient can manage stress and manic episodes (Malhi et al., 2017). The outcome of the treatment should be to help Gary go back to school and maintain a normal routine for sleep and meals.
Community Support Resources
Gary is a college student who lives with the parents. She does not require support programs such as housing. The best community resource includes bipolar disorder support groups (Lopez-Munoz et al., 2018). Connecting the patient with support groups will enhance the management of the condition. Sharing the experiences during the support group meetings improves the confidence to deal with the manic episodes (Lopez-Munoz et al., 2018). It empowers the patients to avoid denial of the condition. Community support resources are crucial in the recovery process.
The case study involves Gary, a 29-year old African-American female former college student. Gary had multiple manic episodes at an interval of two every week. Bipolar disorder requires pharmacological and psychotherapeutic treatment. The purpose of primary treatment is to reduce the severity of the symptoms. Lithium (Lithobid) is one of the best medications to prescribe to patients with manic episodes. Psychotherapy should involve CBT which helps the patient to form new behavior and identify what triggers the manic episodes. Elaborate treatment plans for bipolar disorder and community support are necessary to alleviate the symptoms and improve the chances of participating in normal daily activities.
Lopez-Munoz, F., Shen, W. W., D’ocon, P., Romero, A., & Álamo, C. (2018). A history of the pharmacological treatment of bipolar disorder. International Journal of Molecular Sciences, 19(7), 2143.
Malhi, G. S., Gessler, D., & Outhred, T. (2017). The use of lithium for the treatment of bipolar disorder: recommendations from clinical practice guidelines. Journal of Affective Disorders, 217, 266-280.
Rhee, T. G., Olfson, M., Nierenberg, A. A., & Wilkinson, S. T. (2020). 20-year trends in the pharmacologic treatment of bipolar disorder by psychiatrists in outpatient care settings. American Journal of Psychiatry, 177(8), 706-715.
Rosenblat, J. D. (2019). Targeting the immune system in the treatment of bipolar disorder. Psychopharmacology, 1-13.
Sani, G., Perugi, G., & Tondo, L. (2017). Treatment of bipolar disorder in a lifetime perspective: is lithium still the best choice?. Clinical Drug Investigation, 37(8), 713-727.