Bipolar Disorder
The individual in this case study is being diagnosed for a bipolar mood disorder. The individual’s parents were unsure about how to go about aiding her disorder. Because of this, the individual, whose name is Madeline, underwent a 32-session program over the course of four months.
Madeline’s mother initially became concerned about her daughter’s possibility of a mood disorder when she noticed Madeline’s volatility and rage at home. It was noticed that Madeline’s anger was lashed out at her father and brother but was mainly directed toward her mother. Issues of Madeline presented by her parents included angry verbal interactions, tendency to behave like a baby, perfectionist tendencies, poor independence, and poor academic habits. It was stated that Madeline even threw objects, spat, and screamed at her parents. Clinical assessment results also showed issues relating to poor behavior, indicating signs of a bipolar mood disorder.
Certain things about Madeline, like her poor emotional and behavioral self-regulation, indicated that she had an immature nervous system, which is something babies are born with and fully matures over the first few years of life. An immature nervous system is widely in conjunction with the brain and the pathways that carry signals to it. Nervous system difficulties can affect disturbances in body rhythms because it is associated with the immune system.
It was stated in the case that Madeline’s mother considered “meaningful improvement” to be the ability to relax around her daughter and enjoy it without doing the “wrong” thing. Saying or doing the “wrong” thing around an individual with bipolar disorder can trigger an episode. The fact that Madeline’s mother dreaded the outcomes of saying or doing the “wrong” thing is another indication that Madeline likely has bipolar disorder.
Diagnosis
Bipolar disorder has many similarities to borderline personality disorder, which could have been another case in this situation. Borderline personality disorder is a mental disorder that causes difficulties in regulating emotion and it tends to be more extreme than other disorders. While borderline personality disorder may be like bipolar disorder when it comes to mood and behavior, the former deals more with sensitivity and emotion-management.
It is apparent that Madeline may have bipolar disorder because of her random outbursts, as well as the lack of outbursts. Madeline was able to tolerate certain things but was not able to tolerate others. Her emotions easily spiraled out of control, showing she has extreme irritability and a short temper.
Another possible diagnosis could have been oppositional defiant disorder, a condition in which a child shows a persistent pattern of an angry or irritable mood, as well as argumentative or vengeful behavior. Although the irritable mood and behavioral difficulties associated with oppositional defiant disorder can overlap with bipolarity, children tend to demonstrate the symptoms chronically and not episodically. Oppositional defiant disorder also does not have bipolar symptoms such as energy changes and it isn’t too difficult to tell the difference between the two.
The likelihood of Madeline having oppositional defiant disorder is low, compared to the likelihood of her having bipolar disorder. This is because she showed heavy symptoms that ODD does not even include, such as drastic mood and energy changes. A child who has oppositional defiant disorder typically shows signs of anger and irritability, but a child who has bipolar disorder typically shows it with extreme shifts in mood. Bipolar disorder is known to have “highs” and lows,” whereas oppositional defiant disorder is mostly known for the “lows.”
Treatment Modalities
There are various ways to go about treating bipolar disorder. Treatment by medicine is one course of action, taken by many. Additionally, there are various types of psychotherapy used to treat bipolar disorder, which can be seen as a more holistic alternative to medicine. Even so, many individuals use these two methods simultaneously, as psychotherapy can help them stay on their medication.
Cognitive and behavioral therapy are methods often used to treat bipolar disorder. Behavioral therapy focuses on behaviors that decrease stress, while cognitive therapy involves the modification and identification of the thinking patterns that support mood shifts. These types of psychotherapy methods offer positive results in life quality and can reduce the amount of mood episodes.
Interpersonal and social rhythm therapy are two more types of psychotherapy methods that can be used to treat bipolar disorder. Interpersonal therapy deals with relationships and focuses on reducing strains that bipolar disorder can cause. In addition, social rhythm therapy can aid in achieving more predictable daily routines by focusing on the development and maintenance of sleep schedules, aiming to keep them at normal levels. Interpersonal and social rhythm therapy work in unison to help improve mood by working with the individual’s biological and social rhythms.
Learning about bipolar disorder itself can also be a vital part of treatment. Psychoeducation can help individuals diagnosed with the disorder, as well as family members, by identifying key issues and working to prevent relapse. The biological roots of one’s own disorder can be supportive in the adherence to medicinal treatment.
In addition to other psychotherapeutic and pharmacological treatments, reliance on a support system of family and friends can be beneficial. Family-focused therapy can help one stick to their treatment plan and better work with warning signs of mood swings.
Prognosis
When it comes to bipolar disorder, the likelihood of recurrence is almost certain. Most individuals diagnosed with this have more than one episode in their lifetime. The types of episodes that are likely to occur can vary from manic to depression, or sometimes mixed. Bipolar disorder requires treatment and management throughout one’s lifetime.
Symptoms can be extreme and individuals with this disorder should be closely monitored after an acute episode. After an acute episode, a bipolar person can easily be triggered by any situation, causing negative emotions to burst out.
Although treatments for bipolar disorder can help with symptoms, it is still common to have episodes, even though the amount may be reduced. It is possible for a child’s bipolar disorder to change, and in that case, treatment needs to change as well. The extremity of a child’s moods and behaviors can better or worsen depending on the type of medication and therapy used. In many cases, it is crucial to use the proper medication for the bipolar disorder type.
There currently is no cure for bipolar disorder, but with proper attention, it can be managed. It is most often chronic, requires constant monitoring, and special care, especially for children. When treatment plans are properly followed, the outlook for a child with bipolar disorder can still be positive. As such child grows older, they will likely be able to better handle their mood disorder. Again, it is important for bipolar children to gain support and help from friends, family members, or any other loved ones.