Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for patients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) patients often present as depressive or manic but may have both; and 2) many symptoms of bipolar disorder are similar to other disorders. Misdiagnosis is common, making it essential for you to have a deep understanding of the disorder’s pathophysiology. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat patients presenting with bipolar disorder. The client is a 26-year-old woman of Korean descent who presents to her first appointment following a 21-day hospitalization for onset of acute mania. She was diagnosed with bipolar I disorder. Upon arrival in your office, she is quite “busy,” playing with things on your desk and shifting from side to side in her chair. She informs you that “they said I was bipolar, I don’t believe that, do you? I just like to talk, and dance, and sing. Did I tell you that I liked to cook?” She weights 110 lbs. and is 5’ 5” Patient reports “fantastic” mood. Reports that she sleeps about 5 hours/night to which she adds “I hate sleep, it’s no fun.” You reviewed her hospital records and find that she has been medically worked up by a physician who reported her to be in overall good health. Lab studies were all within normal limits. You find that the patient had genetic testing in the hospital (specifically GeneSight testing) as none of the medications that they were treating her with seemed to work. Genetic testing reveals that she is positive for CYP2D6*10 allele. Patient confesses that she stopped taking her lithium (which was prescribed in the hospital) since she was discharged two weeks ago.

Bipolar disorder, also known as manic-depressive illness, is a complex psychiatric disorder characterized by episodes of depression and mania. It affects approximately 2% of the population worldwide, and proper diagnosis and treatment are essential for managing the symptoms and improving the quality of life for individuals with this disorder (Merikangas et al., 2011). However, the diagnosis of bipolar disorder can be challenging due to its overlapping symptoms with other psychiatric conditions and the variability in symptom presentation among individuals. This assignment aims to explore the assessment and treatment options for patients presenting with bipolar disorder, focusing on a case study of a 26-year-old woman with bipolar I disorder.

Assessing a patient with bipolar disorder requires a comprehensive evaluation of their medical and psychiatric history, as well as a thorough examination of their current symptoms and functioning. In the case of the 26-year-old woman described in the case study, it is crucial to gather information about her past psychiatric history, including any previous episodes of depression or mania, as well as her family history of mental illness. This information can provide insights into the potential genetic factors contributing to her bipolar disorder.

In addition to the patient’s history, a clinical interview should be conducted to assess the client’s current symptoms and mood state. The woman in the case study presents with a manic episode, as evidenced by her elevated mood, decreased need for sleep, and increased energy levels. It is important to determine the duration and severity of these symptoms, as well as any associated impairment in social or occupational functioning. In this case, the patient’s 21-day hospitalization for acute mania indicates significant symptom severity and the need for intervention.

Laboratory studies and genetic testing can also be helpful in the assessment process. In the case study, the patient underwent genetic testing specifically for the CYP2D6*10 allele, which is associated with impaired metabolism of certain medications. This information is important as it can provide insight into the patient’s potential response to specific medications commonly used for bipolar disorder treatment. However, it is essential to interpret genetic testing results in conjunction with clinical judgment and consider other factors influencing treatment response.

Once a diagnosis of bipolar disorder has been established, the next step is to develop an appropriate treatment plan. Treatment for bipolar disorder typically involves a combination of pharmacotherapy and psychosocial interventions. Pharmacotherapy options include mood stabilizers, such as lithium, anticonvulsants (e.g., valproate, carbamazepine), and atypical antipsychotics. However, choosing the most suitable medication depends on factors such as the phase of the illness, the severity of symptoms, and individual patient characteristics (Grande et al., 2016).

In the case of the 26-year-old woman, her admission to the hospital and subsequent discontinuation of lithium require immediate attention. Lithium is a first-line treatment for bipolar disorder and is essential for stabilizing mood and preventing relapse. The patient’s nonadherence to medication may have contributed to her current manic episode and highlights the importance of collaborative medication management and patient education regarding the benefits and potential side effects of treatment.

In addition to medication management, psychosocial interventions are essential for long-term management of bipolar disorder. Psychoeducation, cognitive-behavioral therapy (CBT), and family-focused therapy are evidence-based psychosocial interventions that have been shown to improve treatment adherence, reduce relapse rates, and enhance overall functioning (Miklowitz et al., 2006). Engaging the patient in psychoeducation can help her understand bipolar disorder, its symptomatology, and the importance of medication adherence and lifestyle modifications. CBT can assist in identifying triggers, developing coping strategies, and managing stress. Family-focused therapy can involve the patient’s family members in treatment, enhancing their understanding and support for the patient’s recovery.

In conclusion, the accurate assessment and treatment of bipolar disorder are essential for managing the symptoms and improving the quality of life for individuals with this disorder. The case study of the 26-year-old woman highlights the importance of a comprehensive assessment, considering genetic factors, and a multidimensional treatment approach involving both pharmacotherapy and psychosocial interventions. By addressing the patient’s medication nonadherence, developing a collaborative treatment plan, and providing psychoeducation and support, healthcare professionals can help individuals with bipolar disorder achieve symptom stability and enhance their overall well-being.