BiPolar Week 6.docx - Running head BIPOLAR THERAPY Assessing and Treating Clients with Bipolar Disorder Assessing and Treating Clients with Bipolar

BiPolar Week 6.docx - Running head BIPOLAR THERAPY...

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Running head: BIPOLAR THERAPY Assessing and Treating Clients with Bipolar Disorder March 21, 2019 Assessing and Treating Clients with Bipolar Disorder 1
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BIPOLAR THERAPY Bipolar/Bipolar Mood Disorder or Manic Depression, are mental disorders of the brain, in which there is an extreme shift in mood, activity, and inabililty to think clearly. Bipolar disorder is not as common, as depression, and take considerable toll among other behavioral and mental disorders. Bipolar illness, usually manifest in late teens and early adulthood, 18-25, with approximately 5.4 million diagnosised (NIMH). The incidence of bipolar mood disorder is highest among ethnic groups, Native Americans, and lower among African Americans, Hispanics, and Asian/Pacific Islanders than whites (NIMH). The average age 25 with the initial onset, women are three times more likely to be affected by bipolar than men. The feelings of elation, irritability, excitability or racing thoughts, are often part of the symptomology (Teotia, 2017). There may be episodes of psychosis if the client goes untreated, which can lead to hospitalization. This paper will discuss a 26YO Korean woman, discharged from in-patient psychiatric therapy, tested positive for CYP2D6*10 allele (Nikulin et al. 2017), and her treatment plan, post-hospitalization to prevent recurring episodes of mania. My Client Alert Oriented x4 spheres, client 26yo female of Korean ancestry. Client states “they say I am bipolar” ‘quite busy,” “likes to cook,” “dance, talk and sing “distracted and “fidgety” manipulating items on the desk. Post two weeks follow up, after 21-day hospitalization for acute mania. The client is not sleeping “hate to sleep” “no fun,” and ‘fantastic mood” Client was eventually diagnosis with bipolar disorder. The client is inappropriately dressed, wearing a formal evening gown. Client speech is pressured, rapid and erratic. Client reports mood 2
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BIPOLAR THERAPY euthymic, affect is broad. Client judgment grossly intact; however, insight is impaired. All the client’s lab tests were within normal limits, and reports “good health.” the client is 5’5”, 110lbs. The client received genetic testing, as none or the previously prescribed medication “was not working.” Genetic testing revealed positive for CYP2D6*10 allele, an enzyme that metabolizes 20% of the medications (Dean, 2017). The client reported, she “stopped taking the lithium,” two weeks ago. Client denies auditory/visual/tactile hallucinations. Client denies suicidal/homicidal intent currently. The Young Mania Rating Scale (YMRS) score is 22 (Kim et al. 2018). Decision One Atypical antipsychotics or second-generation antipsychotic (SGA) (i.e., risperidone, aripiprazole, quetiapine, olanzapine)) are usually prescribed for bipolar/mania (FDA.gov). These medications differ from typical antipsychotics, due to a lessening of the extrapyramidal effects (decrease cognition, spasms, jerky movements, tremors, etc) (FDA.gov). Though, risperidone,
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