BIPOLAR DISORDER

Case Study

Sarah is a 32 year old white female who originates from Europe. She is a holder of a university degree and currently she is a middle income earner. The client is married although she does not have any children yet despite being married for 5 years. She comes from the middle income economic class of the society. Sarah comes from small religious family that attends church every Sunday. Despite the existence of the religious culture, the family is not living in peace since there are frequent quarrels.

Sarah was presented with a history of recurrent and disabling depression and headaches.  Sarah desperately wants to have children. She and her husband have been trying for a year and a half with no luck. The tests that were ran on Sarah shows little sign of infertility but with the right fertility treatment the couple would be able to conceive. With all of the bad luck Sarah has been having it has started to weigh heavily on her. She became severely depressed, had diminished appetite, had crying spells much of the day and felt suicidal. Sarah felt like she had no purpose in the world and that she was useless to her husband. Sarah feels so hopeless and helpless about her life. She has lost interest in what she used to enjoy before. She now easily gets angry or irritated and this is negatively affecting her life. Her sleeping pattern has changed as well.

Sarah’s husband insisted that she seek some guidance in hopes to have the love of his life return back to her normal self. Sarah has slowly realized that everything is changing and she needs help in order to get back on track. Sarah’s condition has caused significant impact on her relationship with others. Due to her irritability and anger, she has lost most of her close friends and this has caused her more trouble. She is also not in good terms with her husband; they rarely communicate. The inability of her to conceive has created a rift between her and her husband and keeps widening due to reduced communication between them. From her entire family it is only her sister who still stands by her side. This sibling is the only source of hope for the client because she keeps encouraging her that one day she will conceive.

Sarah agreed to meet with a professional. She was prescribed Prozac to treat her depression which is also used with Zyprexa to treat depression caused by bipolar disorder. Sarah is hoping that by seeking help and by being seen in supportive psychotherapy she will be able to return to her marriage happily and return to society living a normal life as she once had. Sarah and her husband had decided that once she was off her medication they would try again to conceive and if there was no hope then they would adopt.

To successfully complete this project, you will be expected to:

1. Assessment: Describe the methods you would use to assess and diagnose this client, based on the case study you developed. Discuss the strengths and weaknesses of these approaches to evaluate which methods would be most appropriate for your client.
2. Diagnosis: Develop a comprehensive DSM-5 diagnosis for the hypothetical client presented in the Unit 7 assignment paper. Include the principal diagnosis, medical conditions, and other conditions that may be a focus of clinical attention. Use the template provided in Resources. Provide a rationale for any choice of diagnosis you have made. Describe the advantages and limitations of using the DSM-5 to diagnose this client.
3. Treatment Planning: Develop a treatment plan for working with the client (refer to the Unit 6 discussion for an outline of a brief treatment plan). Incorporate current research and diagnostic resources used in the counseling profession to develop a treatment plan that effectively addresses this client’s presenting symptoms and issues. Describe the links you are making between the assessment process, the diagnosis, and the approach you will take with the client during therapy. Describe the following elements in your treatment plan and use specific examples to illustrate your ideas:
   1. Focus of therapy.
   2. Goals (short and long term) for the client.
   3. Specific interventions you will use to help the client reach his or her goals, based on an identified theory.
4. Evaluation of the Impact of Social Systems: Evaluate the impact of social systems on the diagnosis and treatment planning process. Explain the larger environments and social systems that would need to be considered when diagnosing this client and formulating a treatment plan. Discuss the ways in which managed care companies, the health care system, school systems, the policies within your own agency, or other social, political, or economic systems might impact the diagnosis and treatment planning process with this client.