NR 603 Week 6 TD1 Peer Response.docx - Rameka and Class I...

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Rameka and Class, I found it hard to pick between Bipolar Disorder type 1 and bipolar disorder type 2 as I felt like she had mixed symptoms. The natural course of bipolar disorder presents with depression often leading to a diagnosis of major depressive disorder in the initial stages. This misdiagnosis often delays treatment and can contribute to worsening of symptoms due to antidepressant treatments (Fritz et al., 2017). Patients may present with symptoms or complaints that do not match that of bipolar disorder; therefore,the history is very important in making the diagnosis. As with depressive disorders, a person may presentwith vague somatic complaints during a depressive episode.Bipolar disorders can further be defined by four subtypes: bipolar I, bipolar II, cyclothymia, and bipolar disorder not otherwise specified. Bipolar I disorder involves manic or mixed episodes with or without psychosis and/or major depression. Bipolar II disorder involve hypomanic episode with major depression and no history of manic or mixed episodes. Cyclothymia involves hypomanic and depressive symptoms that do not meet criteria for bipolar II disorder with no major depressive episodes. Bipolar disorder not otherwise specified does not meet criteria for major depression, bipolar I, II,or cyclothymia (Price & Manzonni-Nissen, 2012). My top 3 differentials are listed below in order of most likely to least likely along with proposed treatment plan.Bipolar Disorder, Type I (F31.10)Bipolar disorder has two phases known as either manic or depressive. Symptoms include periods of mania, hypomania, psychosis, or depression alternating with periods of wellness. The course of bipolar disorders can vary with patients rarely experiencing a single episode. Although mania and hypomania arecommon symptoms of bipolar disorder, most will have ongoing depressive episodes contributing to disability (Wells & Kodner, 2017). Bipolar I disorder involves manic or mixed episodes with or without psychosis and/or major depression. Lisa is experiencing manifestations of mania; mania is described as a period of elevated irritable persistent mood associated with increased activity and energy daily and lasting for more than a week, flight of ideas, inflated self-esteem, increased goal directed activity such as working long hours at the big box store, rapid, tangential speech, irritability, and engaging in high risk behaviors (e.g. drinking and dabbling in drugs); making this diagnosis the most likely choice based on

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