CASE STUDY OF BIPOLAR DISORDER

CASE SENARIO

A 24 yrs. old male Single, a Student accompanied by Father. Complaints Hyperactivity,

Hallucinations, delusion Hopelessness, Suicidal Thoughts, Sadness

SHORT HISTORY –

MANAGEMENT PLAN

HISTORY

A 24yrs. old Single male, a Student

Informant – Father, reliability – good, information- adequate and consistent

Past History – No

Medical History – No

Premorbid Personality –

Interpersonal Relationship – Introvert

Family & Social Relation – Social Withdrawal

Usual Reaction to Stress – Anxiety

Mood - Fluctuating

Reasons

Constant worry throughout the day – 2 mnths

Difficulty in concentration – 4mnth

Aggressive, high palpitation, anxiety, fear and angry -6mnth

Hallucination Behaviour – Present

Eye Contact – Improper

Behaviour – Unpredictable

Speech – Spontaneous, Minimal

Mood – Unpleasureable, Depressive, Anxiety, Mood Swing

Present illness-HOPI
6mnth ago he was apparently normal than developed worry about his daily work and felt
apprehensive while carrying it out. Worry was constant and present all through the day.
His worries increased gradually and he could not concentrate on business and would do
some minor mistakes which resulted in aggressive, high palpitation, anxiety, fear and angry.
There was no significant past or family history.
General and systemic examination – normal
Mental status examination - MSE
General Appearance, Attitude and Behaviour –Patient was conscious, oriented, alert,
cooperative, rapport established, eye contact was improper.
Psychomotor activity – Normal

Speech: Spontaneous, Minimal,Tone Loud

Mood – Unpleasureable, Depressive, Anxiety, Mood Swing

Hallucination Behaviour – Present

Eye Contact – Improper

Behaviour – Unpredictable

Affect – Anxious, reactive, high range of emotion, congruent to mood in appropriate

situation, no liability, Trouble sleeping, wakefulness.
Thought:
Form of thought: the client fall comfortable & false belief occurs in his mind.
Content: Worry & Apprehension about his business.
Perception: anger
HIGHER MENTAL FUNCTIONS – HMF
Attention – Sustained
Concentration: Intact
Conciousness –Conscious, Cloudy
Memory – Immediate
Intelligence – good
HISTORY OF PRESENTING ILLNESS – Adequate
MSE – high palpitation, anxiety, fear and angry
Speech – Reaction time may be Muted
Mood/Affect –Inappropriate, Irritable.
Thought – Over Conclusion, Flight off Idea, Ignorence, Phobia
Perception - Appropriately Present.
Diagnosis – Generalised Anxiety Disorder
Differential Diagnosis –
Bipolar Disorder, Manic Depression-Mood Swings(Mania/Hypomania)
Suggestion-
Goal Setting
Impaired Social Interaction
Cognitive Behavioural Therapy (CBT)
JPMR
Deep Breathing Exercises
Mindfulness