PSYCHOLOGY QUESTION!!!!! Case Study: Miss B is a 20 year old Caucasian female of
ID: 95212 • Letter: P
Question
PSYCHOLOGY QUESTION!!!!!
Case Study: Miss B is a 20 year old Caucasian female of Irish heritage who was arrested for walking along the roadway on her college campus shouting obscenities at oncoming traffic. She is agitated states"leave me alone. I am in perfect health and know my own mind." Her mother and boyfriend arrive and state that she has been taking lithium carbonate 600mg t.i.d. for Bipolar Disorder II for the past 5 years, with good results until several weeks ago. Her boyfriend states that she has been 'up all night' for the past few days and has a "harebrained scheme to become a Rhodes Scholar". Miss B's mother states that she suffers from chronic depression and that she is worried since Miss B is pregnant. She says, "I have bad genes, but is there anything that we can do to keep my grandchild from having a mental disorder?"
Education: What education needs to be done with the B family? Who else besides the B family needs education?
Medical: What health problems will the B family be prone to? What prophylaxis and health maintenance needs to be done with the B family as time goes on?
Genetic Counseling: What genetic counseling do you think should be done with the B family? What genetic counseling should be done with Miss B and her boyfriend since she is five months pregnant?
Psychosocial Issues: What are the psychosocial issues do you think the B's might have? Are there support groups in your areas of residence for Bipolar families? If so, what are they?
Explanation / Answer
Bipolar II is a mental illness which is characterised by symptoms of major episodes of depression and at least one episode of hypomania. During an episode of hypomania, the person affected feels a certain kind of high or euphoric and may also be quite irritable. Miss B, suffered from a depressive period lasting for weeks. She was having one of her hypomanic episodes when she was out on the streets and cussing at the oncoming traffic.
She having a "harebrained scheme to become a Rhodes Scholar" and being up all night for the same exhibits symptoms that a person going through a hypomaniac episode exhibits, which includes not being able to sleep all night, and still continuing to feel active and enthusiastic, being an over achiever, having ridiculous thoughts of accomplishing the unachievable.
The education required to be done with B family is to fully make them understand the intensity of the disorder that their loved one is going through. A mental illness is as severe or even more difficult to overcome physical illness, like asthma, diabetes or cancer. The B family should be a lot more supportive of Miss B as she is going through a very rough time and should not be asked to "snap out of it". It is not a personal weakness or a flaw that an individual can overcome. The family should provide her with unconditional love and offer her reassurance of everything being alright. This would just help to provide Miss B with hope that she will be able to bounce back.
The additional information required in the above case is to know for how long did Miss B's hypomaniac episode last for. There could be a possibility that if Miss B's hypomania lasted for a longer period of time then there are chances of her being diagnosed with Bipolar I. The B family then needs to be educated on the symptoms and treatment of Bipolar I which includes maniac episodes and at least one depressive episode.
However, before we arrive to that conclusion, the following criteria need to be met in accordance with The Diagnostic and Statistical Manual of Mental Disorders (DSM) which is published by the American Psychiatric Association (APA). DSM is a manual that all psychologists use to make any diagnosis as it is a standardised classification for mental disorders.
(The following criteria are from DSM-V)
Diagnostic Criteria for Bipolar Disorder-I:
1. Criteria have been met for at least one Manic or Mixed Episode.
2. The symptoms cause social/occupational distress or impairment.
3. The symptoms are not better accounted for by Schizoaffective Disorder, and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.
Diagnostic Criteria for a Manic Episode:
1. Persistent elevated, expansive, or irritable mood for at least one week
(unless hospitalization is required).
2. At least three of the following symptoms are present during mood disturbance
(four if mood is irritable):
• inflated self-esteem or grandiosity
• decreased need for sleep
• increased talkativeness
• flight of ideas or racing thoughts
• distractibility
• increase in goal-directed activity or psychomotor agitation
• increase in risky behavior
3. Symptoms don't meet criteria for a Mixed Episode.
4. Level of severity sufficient to cause social or occupational impairment, hospitalization, or psychotic features.
5. Symptoms are not due to a substance or medical condition.
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