Manic Case Studies

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The client presents with both depressive and manic symptoms, however the depressive episodes based on self-report are dramatically longer in duration. Ellen shares that she has been unhappy most of her life, but has had periods where she feels an elevated mood. During these times, she found herself sleeping less and felt that her thoughts were always racing. Family and friends have expressed concern for her as well, especially during these times. Based on the presenting client information, an appropriate diagnosis is F31.81 Bipolar-II Disorder, current episode depressed, moderate, with anxious distress. The client has not had a manic episode, thereby disqualifying her for Bipolar-I. The client meets the following diagnostic criterion for …show more content…
During the period of mood disturbance, the client meets three or more of the following symptoms which differ from their typical behavior (listed are the criterion the client meets only):
a. The client reports a decreased need for sleep during the periods of hypomania.
b. - The client reports being more talkative than usual.
c. - Based on client self-report, Ellen states that she had racing thoughts.
d. - The client reports “getting a lot done,” showing an increase in goal-directed activity.
C. The hypomanic episodes are uncharacteristic to the client’s typical behavior when not symptomatic.
D. The disturbance in mood and the change in functioning is reported to be observable by others.
E. The episode is not severe enough to cause severe impairment in daily functioning or necessitate hospitalization.
F. The episode is not attributed to the side effects of a medication.
Major Depressive Episode
A. The client meets the criterion for a major depressive episode during the same two week period (or more) and represent a change from previous functioning. The client meets at least more than the minimum required specifiers in this section (listed are the criterion that the client meets …show more content…
The episode is not attributed to the physiological effects of another medication or substance.
Assessment Considerations When completing a biopsychosocial assessment for this client, the familial history of parental marital strife and emotional abuse should be included. Additionally, the client self-reports her father abused alcohol. Bipolar Disorders have been found in clinical studies to develop in adolescence (Beidel, Frueh, & Hersen, 2014, pp. 218-220). There have been further correlations that stressful life events may impact an individual with bipolar disorder. Ellen’s diagnosis also has impacted her interpersonal life; romantically, socially, and vocationally. An assessment that reviews the duration and intensity of her relationships may be helpful to further understanding the impact of her diagnosis. Her extreme reactions to criticism and approval seeking behavior further support her diagnosis (Beidel, Frueh, & Hersen, 2014, p.234). Ellen also has reported that she was more often a student rather than gainfully employed. While she has multiple college degrees, she has been unable to obtain a
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