Manic Disorder: A Comprehensive Look at Mental Health Issues - Essay Sample

Introduction

Manic disorder is mental health that causes various mental and behavioural problems. Individuals with mental health-related disorders live an unhealthy lifestyle and cannot recognize the symptoms or signs of health problems. The scope of manic disorder ranges from psychological issues to how people collectively and cannot individually interact and think with others. The manic episode problems ascribe to the biopsychological aspects like substance abuse, physical illness, and socio-economic pressure, which affect the person mentally and psychologically. These biopsychological aspects expose the person to problems that develop other mental health disorders. The common symptoms of mania mental health disorder include extreme mood swings where a person at one period is fully energized, but another during another moment they are very dull. This essay will assess the patient history and mental health state, as well as the medical, psychological, and nursing intervention methods. The essay will have three main subsections, namely history, mental state examination, and interventions.

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History Assessment

This section details the history of the patient. From the case study video, the male patient, known as John, was referred by his GP to attend an emergency clinic. He exhibits exuberance and high energy in the way he talks. The patient says that the enthusiasm has been going on and on for so many weeks.

There is no withdrawal history. The client did not mention having any withdrawal experience from any substance. Also, he does not cite any withdrawal from the family. There is no statement on psychiatric hospitalization. The client disagreed that he has been on any medical drug prescriptions. Also, there is no outpatient mental health treatment prescribed in the past.

The video did not reveal any medication history information of the patient. The client denies that he has been under any medication. He denies having any medical problems by asserting that he has been physically feeling well all along. There is no medical compliance history since there are no medication orders revealed in the video.

The client appears to come from a Christian family since he keeps mentioning the talk he has been having with God. However, there is no mention of family history in the video. When asked whether any family member has a similar experience, he says, "no, just me." He mentions that the family members see the doctor frequently, although he does not explicitly associate those appointments with psychiatric medication. In that regard, there is no family history of mental health disorders, substance abuse, or suicidal behaviors from any of his family members.

Regarding personal history, the client denies that there are days that he experiences low energy, positivity, and enthusiasm. He claims that he has never been in the hospital for any other reason other than to facilitate the cancer diagnosis and explore the solutions for cancer cure. There is no drug or alcohol history. Also, there is no legal history revealed in the video.

Concerning the occupation history, the client mentions that he is a car mechanic, and he has been earning money from the job. However, he says that he is conducting a diagnosis to find a small solution for the cure of cancer. He attributes the functioning and support to God, whom he says that he has been talking with and recommending him for a fantastic job. There is no mention of parental status, carer responsibilities, or details of dependents in the interview.

Mental State Examination

Appearance

The patient is lively, oriented, and alert. Although he is cooperative, he does not follow all commands or answer all questions during the assessment. The patient is enthusiastic and flamboyant about the idea that he thinks it will find solutions for cancer. Nierenberg (2019) notes that depressed patients take little care of their appearance, whereas clients with manic episodes are flamboyant. The client reveals its flamboyance when talking about his idea of a small cure for cancer. He says, "this week I have been working hard because you have to find out numbers," which indicates high self-esteem and flamboyance.

Behaviour

The behaviour of the patient was restless and nervous. The patient was talkative, grandiose and expressed his ideas in a very positive manner. Also, the patient revealed that he has no time to sleep. When questioned on whether he has time for rest or sleep, the patient replied "no time for sleep."

Speech

Besides, the patient talks quickly, and he is spontaneous. He looks that he is pressured to speak continuously without the need to pause or stop. He exhibits flights of ideas jumping from one logical idea to another without conclusion or consideration of the output. There is no logical coherence of his voice, which is indicative of psychomotor agitation associated with maniac people.

Affect

The patient is remarkably goal-oriented. He is so specific and keen to extend his idea of small cancer cure such that he wants to talk to the boss about the matter. Their affect shows less emotion, and it is blunted. The client says that he does not want to speak to the interviewer anymore and that he wants to talk to the boss or somebody else. This blunt attitude reveals less emotion.

Mood

Regarding the mood, the patient said that he is feeling fantastic and happy. The patient self-esteem is high and appears energetic and comfortable with high optimism. When asked whether he has been experiencing physical problems, he says, “ I’m fine, I’m fine.” According to the patient, he has been this energetic and feeling fantastic for a long time, revealing that his mood has been constant over time. However, patients effect appears to be flat or normal.

Thought Form

Concerning the thought process, the patient expresses his ideas in a very flamboyant manner. His thought process is goal-oriented characterized by extreme rapid thinking. The thoughts are not logical and lack coherent links between ideas.

Thought Content

His thoughts are obsessive or delusional false beliefs that are inconsistent with reality. The patient asserts that he will get a small cure for cancer from the data, which is indicative of bizarre ideas.

Perception

Regarding the perception of the patient, he demonstrates a lack of sensory stimuli. The patient asserts that he can be able to have a conversation with God which is indicative of auditory hallucinations. Hallucination describes the fantastic idea of cure cancer and that God commends him for the tremendous work he is doing.

Cognition

Further, the patient says he is more intelligent than his family members. Cognitively, he is alert when asked about personal questions which he recognizes and asks for concentration on the subject of discussion (Cure for cancer).

Insight and Judgement

In terms of insight, the patient lacks awareness. He denies that there is something wrong with him and his idea of a cure for cancer. He does not recognize that he has been physically unwell. When asked how he feels, he says “I feel fantastic,” indicating that he lacks insight and proper judgement regarding his health.

Risk Assessment

Regarding the risk assessment, the client cannot assess the risk he creates due to the high energy he is exhibiting. When questioned on why he wasn't approved for the work before and that being unwell is one of the reasons, he denies and claims that he has been well. He objects any question that is directed to his health and well-being, clearly indicating he cannot assess the risks around his environment.

Formulation

From the mental examination, the client exhibits flight of ideas, disinhibition, grandiose delusions, pressure of speech, punning and auditory hallucinations. His behaviour, thinking process, thought content and psychomotor actions are consistent with mania (Florida Medicaid Mental Health, 2020).

Provisional Diagnoses

According to DSM-5 criteria of bipolar disorder, manic episodes characterize the bipolar I disorder. The symptoms of manic episodes include heightened self-esteem, no need of sleep or rest, talkative, racing thoughts demonstrated by the flight of ideas, low attention span, and excessive indulgence towards achieving a goal. In that regard, the client is suffering from manic episodes associated with bipolar I and therefore should see a psychiatrist.

Interventions

Medical Intervention

Maniac disorder can prolong if not addressed by a psychiatrist. This section covers the various treatments of the disorder in line with the established clinical issues. The medical intervention aim is to reduce the periods or frequency of depressive or manic episodes as well as to reduce the intensity of the symptoms to allow the person to conduct a healthy life (Vieta, 2013).

Medical interventions of bipolar disorder mainly aim at suppressing symptoms (Vieta, 2013). Depending on the clinical issue, the interventions include medications, continued treatment, substance abuse treatment and hospitalization. The psychiatrist should consider medication to balance the moods of the affected person. Continued treatment aims at avoiding relapse while substance abuse treatment is preferable when the patient has problems with drugs such as alcohol. Also, the psychiatrist can recommend hospitalization when the patient is behaving dangerously.

Given the clinical issues identified in the previous sections, the appropriate medical intervention for the client is medications and continued treatment. The clinical issues taken into consideration include high energy, self-esteem and grandiosity. Additionally, the client has experienced more than one episode of maniac alongside lack of insight into what is happening. Therefore, medication and continued treatment will be vital to minimize the frequency of high energy moods and reduce the symptoms of manic episodes; thus helping the patient to conduct a normal life.

Due to manic episodes of high energy, the doctor should prescribe both mood stabilizers and antipsychotics medication. Among the mood stabilizers, drugs include divalproex sodium, valproic acid, lamotrigine and carbamazepine. These drugs will help reduce the frequency of manic episodes experienced by the client.

Besides, due to persisting maniac episodes, the psychiatrist should prescribe antipsychotics. Antipsychotics such as aripiprazole, asenapine, lurasidone, risperidone, ziprasidone, and olanzapine will help reduce the frequency of manic episodes (Crowe & Porter, 2020).

The side effects of medical intervention are mild and may improve with the right medication for a particular clinical issue. However, there is a caveat not to stop medication since it brings withdrawal effects. Besides, stopping the drug may worsen the symptoms of manic episodes.

Psychosocial Intervention

The psychosocial intervention aims to support the client to learn different skills, such as coping with having the mental disorder, reducing maniac or depression episodes, identifying the maniac episodes signs early to get the treatment and facilitating the client to live a healthy and quality life. Among the psychosocial treatments offered include cognitive behavioural therapy (CBT), psychoeducation, family-focused therapy, and interpersonal and social rhythm therapy (IPRST) (Crowe & Porter, 2020).

According to the assessment results, the client suffers from manic episodes and has no insights regarding the issue. Therefore, the client must understand the clinical problem by learning about manic episodes to help him understand the condition. Psychoeducation is essential psychotherapy that can be administered to the client. It aims at helping recognize mental issues and risks, as well as stick with medication and prevent relapse.

Besides, IPRST will be criti...