Case Study for Mental Disorder

Questions: 1. Identify and describe the following four (4) key components of the mental state, as they relate to Ellens presentation: - Mood - Thought Content - Thought form - Insight2.Identify and describe two (2) areas of risk for Ellen in relation to her current presentation. 3.Discuss four (4) nursing care priorities for Ellen and provide a nursing intervention and a rational for each intervention identified.4. Identify one (1) recovery principle (as per the National Framework for Recovery-Oriented Mental Health Services). https://www.health.gov.au/internet/main/publishing.nsf/Content/mental-pubs-n-recovfra. Answers: 1. An individual suffering from bipolar disorder or manic depression, suffer from mood swing, which includes short period of depressive feeling, followed by sudden elevated mood. According to Kiesepp et al., (2014), the patient of bipolar disorder often displays unusual behavior due to high level of variation in their mood. It is very common for Ellen to experience intense emotion and change in the sleep pattern. The swing in the mood is prime characteristic of this mental disorder and in the case of Ellen, who is suffering from chronic bipolar disorder it is very common to suffer from anxiety and schizophrenic mood. The though content can for a mentally ill patient can be defined as what the individual is thinking about. Schneck et al., (2014), believes that person like Ellen with a mood disorder can have obsessive thought and be feeling of phobia. They also have the feeling to intoxicate with the drug and alcoholic drink. The delusional thinking is also common characteristics of bipolar disorder and it is mainly responsible for the depressive feeling. The homicidal or suicidal ideas are also a prime thought content. The delusional thinking is also likely to take, which has no link with the external reality (Rovner, 2016). The thought form or process of reflection is used to explain the exact form of thinking pattern and define the characteristics of the idea of the individual suffering from bipolar disorder. Ellen will have a high level of disturbed thought process. Power et al., (2013), stated that mentally disordered individual have highly rapid thought process due to the fact they suffer from quick change in the mood. Moreover, the thought form can be extremely disorganized as it is difficult for those persons to focus on one particular goal for an extended period of time. Correll et al., (2015), believes that the study of insight regarding bipolar disorder can have significant contribution in the curing process of bipolar disorder. Many people suffering from bipolar disorder can have better insight into their illness. Nevertheless, it is common for the bipolar patient to loss the insight due to the obsessive behavior. There is a good relationship between the weak insight and the symptoms of the bipolar disorder. In case of schizophrenia, poor insight is observed. On the other hand, people having depressive mood have is able to have strong focus on the insight. Hence, Ellen will have the impaired insight which is responsible for her rapid shift of the social behavior. 2. A person suffering from bipolar disorder will have poor social life as they are unable to display normal behavior. Due to the rapid change of mood, it is difficult they often encounter the depressive mood. The major risk in the social life for Ellen is that she is alcoholic and thus can get involve in social violence. Due to over consumption of alcohol and several other drugs, she is not able to maintain the safe behavior that is essential for meeting with people of the community. She also has the risk of getting involved in all the main form of social violence. People, who are addicted to alcohol consumption often, have the tendency to ignore all the normal social protocols. As the addiction to consuming alcohol increase within Ellen, she will face the risk of spending huge money in buying liquor products and cigarettes. Hence, her family will have to face the risk of financial crisis, where they will not have the ability to purchase the basic requirements of life. Yatham et al., (2013), stated that person with mood disorder may often face the risk of facing social discrimination even from the close family members. 3. According to Paterniti Bisserbe, (2013), keeping the patient of mood disorder is a safe environment should be the top priority of the nurse. With the help of healthy environment, it is possible for the patient to maintain the normal mood without any major disturbance for the external source that can trigger alteration in the mood. The unhealthy environment can also cause negative attitude and thereby harm their social life. The PRN medications are also another requirement for bipolar mood disorder patient like Ellen. Nevertheless, the nurse should recommend medications only if the situation of the patient reaches extreme cases. Anti-depressing drugs like Sertraline, which is regular medication for Ellen will help her to control the mood swing. Nevertheless, the nurse, who is taking care of Ellen, will have to be extra careful with the dosage of the medicines as the anti-depressant drugs have high side-effects associated with them. The nurse should encourage the patient to express their inner feelings. If they are able to describe the feelings, it is possible to relieve the stress and the tension they have within their mind. This will also able the patient to control the anger and thereby maintain calm attitude. With the help of mental psychotherapy and mental exercise, it is possible to control the hormonal misbalance in the body that is primarily responsible for the mood disorder (Trnkner, Sander Schnknecht, 2013). The nurse can also recommend the physical exercise for Ellen that will help to diminish the tension and hypertension. Finally, the most important that nurse should not put any pressure on the patient and try to give simple instructions. It is also important for the nurse to avoid all types of arguments and provide treatment according to the individual need of the patient. 4. According to the National Framework for Recovery of Oriented Mental Health Service, it is important to provide mental health care with the help of the professionally trained workers. The mental health workers should need to have enough information about the mental health disease. They also need to have enough training about the ways to deal with and behave with the people with a mental health condition. They also have the capability to deal with the risks that are associated with the treatment of mental patients ("Department of Health | A National framework for recovery-oriented mental health services: policy and theory", 2016). The mental health workers should follow strict protocol to deal with patients like Ellen so that it is possible to provide treatment according to her personal needs. Reference Correll, C. U., Detraux, J., De Lepeleire, J., De Hert, M. (2015). Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder.World Psychiatry,14(2), 119-136. Department of Health | A National framework for recovery-oriented mental health services: policy and theory. (2016). Health.gov.au. Retrieved 28 September 2016, from https://www.health.gov.au/internet/main/publishing.nsf/Content/mental-pubs-n-recovpol Kiesepp, T., Partonen, T., Haukka, J., Kaprio, J., Lnnqvist, J. (2014). High concordance of bipolar I disorder in a nationwide sample of twins.American Journal of Psychiatry. Paterniti, S., Bisserbe, J. C. (2013). Pharmacotherapy for bipolar disorder and concordance with treatment guidelines: survey of a general population sample referred to a tertiary care service.BMC psychiatry,13(1), 1. Power, R. A., Kyaga, S., Uher, R., MacCabe, J. H., Lngstrm, N., Landen, M., ... Svensson, A. C. (2013). Fecundity of patients with schizophrenia, autism, bipolar disorder, depression, anorexia nervosa, or substance abuse vs their unaffected siblings.JAMA psychiatry,70(1), 22-30. Rovner, D. (2016). Mental Status Examination in Primary Care: A Review - American Family Physician. Aafp.org. Retrieved 28 September 2016, from https://www.aafp.org/afp/2009/1015/p809.html Schneck, C. D., Miklowitz, D. J., Calabrese, J. R., Allen, M. H., Thomas, M. R., Wisniewski, S. R., ... Bowden, C. L. (2014). Phenomenology of rapid-cycling bipolar disorder: data from the first 500 participants in the Systematic Treatment Enhancement Program.American Journal of Psychiatry. Trnkner, A., Sander, C., Schnknecht, P. (2013). A critical review of the recent literature and selected therapy guidelines since 2006 on the use of lamotrigine in bipolar disorder.Neuropsychiatric Disease Treatment,9. Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Beaulieu, S., Alda, M., ... Ravindran, A. (2013). Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013.Bipolar disorders,15(1), 1-44.