Describe the HPI and clinical impression for the client. Lk is 26-year old married, mother of a young child age 2, brought to the inpatient treatment center under TDO for unstable mood, erratic bizarre behavior and suicidal ideation. Additionally, she has been homicidal towards her husband. Her main complaint “ I am stressed and unable to eat or sleep ”.The clinical impression based on the diagnostic criteria of DSM-5 indicates that the patient is suffering from bipolar disorder (American Psychiatric Association, 2013)
History of present illness
Lk stated she recently moved back from Louisiana. Currently, she is home stay mother. She reports that there were some type of altercation with her husband. Her husband is reporting she has been …show more content…
Many study indicated that treatment with pharmacologic interventions alone is associated with disappointingly low rates of remission, high rates of recurrence, residual symptoms, and psychosocial impairment (Oud, Mayo-Wilson, Braidwood, Schulte, Jones, Morriss, & Kendall, 2016). Bipolar-specific therapy is increasingly recommended as an essential component of illness management. Evidence-based psychotherapies for bipolar disorder include cognitive-behavioral therapy, family-focused treatment, interpersonal and social rhythm therapy, and psychoeducation (Geller & Goldberg, 2007). I will consider interpersonal and social rhythm therapy (IPSRT) as the treatment of choice for bipolar disorder, because it can be conducted in both inpatient or outpatient setting, but it is most often used for people with bipolar disorder in outpatient office based setting. The therapy is designed to help people improve their moods by understanding and working with their biological and social rhythms. Social rhythm therapy focuses on stabilizing social rhythms such as sleeping, eating, and exercising. When these rhythms are stable, the biological rhythms that regulate mood remain stable too. Interpersonal and Social Rhythm Therapy also teaches patients skills that let them protect themselves against the development of future episodes (Goldstein, Fersch-Podrat, …show more content…
Subsequently, she will return every 4 weeks for medication management. She is also instructed to begin behavior therapy the same week as medication are initiated and to follow up weekly for therapy sessions. I will consult with the therapist weekly for updates and any concerns or questions. I will reiterate and reinforce to both the PCP and therapist the importance of monitoring for suicidal ideations as the patient is taking an antidepressant and abruptly stopping will increase risk of suicide. About one-third of patients with OCD have major depressive disorder, and suicide is a risk for all patients with OCD (Sadock, Sadock, & Ruiz, 2014).
Conclusion Bipolar disorder is a chronic disease that requires ongoing maintenance and professional treatment. The lifetime management of patients with bipolar disorder is challenging due to the dynamic, fluctuating and chronic nature of this disease. The main goal should be managing the disease itself, not just acute episodes of mania or depression. There is no consensus on the proper pharmacological management for bipolar disorder. Lithium is the mainstay of treatment for patients with bipolar disorder and in reducing manic symptoms as well as in preventing future episodes (Jann,
History of present illness
Lk stated she recently moved back from Louisiana. Currently, she is home stay mother. She reports that there were some type of altercation with her husband. Her husband is reporting she has been …show more content…
Many study indicated that treatment with pharmacologic interventions alone is associated with disappointingly low rates of remission, high rates of recurrence, residual symptoms, and psychosocial impairment (Oud, Mayo-Wilson, Braidwood, Schulte, Jones, Morriss, & Kendall, 2016). Bipolar-specific therapy is increasingly recommended as an essential component of illness management. Evidence-based psychotherapies for bipolar disorder include cognitive-behavioral therapy, family-focused treatment, interpersonal and social rhythm therapy, and psychoeducation (Geller & Goldberg, 2007). I will consider interpersonal and social rhythm therapy (IPSRT) as the treatment of choice for bipolar disorder, because it can be conducted in both inpatient or outpatient setting, but it is most often used for people with bipolar disorder in outpatient office based setting. The therapy is designed to help people improve their moods by understanding and working with their biological and social rhythms. Social rhythm therapy focuses on stabilizing social rhythms such as sleeping, eating, and exercising. When these rhythms are stable, the biological rhythms that regulate mood remain stable too. Interpersonal and Social Rhythm Therapy also teaches patients skills that let them protect themselves against the development of future episodes (Goldstein, Fersch-Podrat, …show more content…
Subsequently, she will return every 4 weeks for medication management. She is also instructed to begin behavior therapy the same week as medication are initiated and to follow up weekly for therapy sessions. I will consult with the therapist weekly for updates and any concerns or questions. I will reiterate and reinforce to both the PCP and therapist the importance of monitoring for suicidal ideations as the patient is taking an antidepressant and abruptly stopping will increase risk of suicide. About one-third of patients with OCD have major depressive disorder, and suicide is a risk for all patients with OCD (Sadock, Sadock, & Ruiz, 2014).
Conclusion Bipolar disorder is a chronic disease that requires ongoing maintenance and professional treatment. The lifetime management of patients with bipolar disorder is challenging due to the dynamic, fluctuating and chronic nature of this disease. The main goal should be managing the disease itself, not just acute episodes of mania or depression. There is no consensus on the proper pharmacological management for bipolar disorder. Lithium is the mainstay of treatment for patients with bipolar disorder and in reducing manic symptoms as well as in preventing future episodes (Jann,