2. Hstory of the Present illness Patient I.R.

, 56 years old is diagnosed with bipolar affective disorder, manic depression with psychotic symptoms. When he was a child un his school age, he actively participates in school activities and can also mingle with classmates. As he grows up, he learned to become more sociable and meet more friends and people of different walks of life . And most likely his common friends are girls to whom he is comfortable with. He learns also to become independent and firm but with the moral a financial support of his loving family. He is able to finish his degree and come to and becoming mechanical engineering. He decides to work abroad o work his own mney. Until such time that he met his lawfully beloved wife who happens to work in Saudi. He is blessed with one child. Furthermore, in order to sustain the needs of the family one must sacrifice, so as the bread winner he is the one who wrks abroad After how many years, they decided that his wife will go abroad also to searchfor greener pasture leaving teir son with him. In their marriage life, it ismerely a long distance relationship and according to him it is so difficult to deal with but it is a kmust to do. So, there way of communication is really hard because it is through etter. Sometimes letters is being received one week or more after osting it . His wife has only uality life for them if she comes home for vacation. When his wife is at home during visits, he is realy happy as if he owns the whole workld. According the patient, thr most traumatic experience he had is the death of his sister. That is the time he feels very sad because he claimed that the relationship they had is really strng nd close. To is other siblings, he visits them occasionally and whenever theres a problem with one of the member of the fsmily he and the others lend their hands and intervene to any problem to resolve it. He has misunderstanding to his neighbor but not identified, every noe and then they are almost having an argument. In the case of the patient, there is no mental illness in the family. There is no past edical historyof any knowndisese, no known history of any known hospitalizations, accidents, trauma and operation. However he is just only diagnosed with hypertension when he was admitted at the psychiatric hospital ward. The time that he is firstly observed when manifestations aof the disorder was the patient was involved in the treasure hunting which he started when she met an old women dictating him to do and where to haunt. He s being manipulated by the old woman. Since then, the patient always dig around their backyard and preoccupied in doing unnecessary things, but depite this, the patient still chores and acts inaccordingly. He maybe helpful in dong house chores but observe that he loves his social life. His friends are not visiting him anymore. Afterwards,the patient s haunting activites and also stop seeing the old woman. He was observed happy during those times. The patient s wife went back again to Saudi, and after sometime; the patient resumes his usual activites digging around the house. But perhaps the cheerful, optimistic, happy, full of energy. This tim the atients starts tomumble and walks from the house to and fro and sometimes utters icoherent words. Despite this the patient does not regularly takes a bath. As the days goes by, 5 day prior to admission, the patient feels abnormally good , high, excited, hyper and irritable. Hese can be so extreme that the sufferer loses contact with the reality and starts to believe in strange things, have ppor judgment, and behaves in embarrassing manner, harmful, or event dangerous ways. These maybe accompanied by; an elvated mood, overwhelming sense of well beng and self importance; increase energy and over activity, increase speech, often rapid and louder

praying on the road. admission. .. which may difficult for others to follow.Sino ka? Peter Finder (their neighborhood whom he had a misunderstanding). Afterwards. Sino ka. kissing the ground saying I am the savior . the patient develop psychotic symptoms of delusion and hallucinations. the patient comes to him saying. Because patient keeps on saying Smith Berto. the patient was brought to their relative to Balatk Mines to show him how mning is done.. One day prior to admission. So . during the night when his son was watching tv. a very grand. He was captured and brought to the institution hence. The [atient also has bag with stones and books and saying he would go to Zamboanga leaving a treasure tohis son. Afte went to Balatok mines. over optimistic ideas and plans may be expressed. patients relatives who works in mining company. the patient went to his room shouting and shouting over and over again. The content of this is usually in keeping with the euphoric mood and unrealistic sense of self importance.than usual. The patient was seen half naked. Out of fear. the son introduce himself. the son called their relatives and asked help at nearby police station to capture the patient.

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