Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

Chief Complainant: Medicines suppress who I am. I am looking for an evaluation for drug resistance and alternative therapies since I have had hospital stays and mood swings in the past.

History of Presenting Illness:
A 28-year-old Caucasian woman named P.P. comes in for assessment because she is having trouble taking her medicine and is looking for other options. She struggles with a complicated mental past while managing polycystic ovaries and hypothyroidism. Her history includes hospital stays for auditory hallucinations and insomnia, as well as a suicide attempt in 2017.  Assessing, Diagnosing and Treating Adults with Mood Disorders Essay Anxiety, sadness, and possible bipolar disorder diagnoses have prompted a number of drug studies (including Zoloft, Citalopram, Risperidone, and Klonopin), each with its own set of difficulties. P.P. goes through phases of extreme inventiveness interspersed with feelings of fatigue and inadequacy. Her appearance is further complicated by the fact that bipolar illness and maybe schizophrenia run in her family. Interestingly, she abstains from drinking alcohol and other narcotics and continues her daily habit of smoking nicotine. The referral is the result of an investigation into more efficacious treatment techniques prompted by discontent with pharmaceutical management. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

ORDER  HERE A PLAGIARISM-FREE PAPER HERE

Current Medications:

P.P. is now on medicine for polycystic ovarian syndrome and hypothyroidism with no defined doses and frequency. The length of time these drugs have been used to treat their corresponding ailments is unknown. During taking the patient’s history, P.P. makes no mention of any OTC or homoeopathic medicines.

Allergies: No known allergies to food and drugs. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

Reproductive history:

Although P.P. says she has regular and predictable menstrual cycles, she does not provide the date of her last menstrual period (LMP). She disputes lactating and pregnancy. P.P. takes birth control tablets to treat her polycystic ovaries; however, the brand or exact procedure is not specified. She often has safe sexual encounters. Her case makes no mention of any particular sexual problems. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

Review of Systems

GENERAL: No weight loss, chills, fever, fatigue or weakness.

HEENT:

Eyes: Denies double vision, blurred vision, or yellow sclerae.

Ears, Nose, Throat: No complaints of hearing loss, congestion, sneezing, sore throat, or runny nose.

SKIN: no rashes and itching present.

CARDIOVASCULAR: Absence of angina or chest discomfort and no palpitations.

RESPIRATORY: No reports of cough or shortness of breath.

GASTROINTESTINAL: No reports of nausea, vomiting, anorexia, or diarrhoea

GENITOURINARY: No complaints of burning on urination, hesitancy, odor, urgency, or odd urine color.

NEUROLOGICAL: No reports of dizziness, headache, numbness, or tingling in the extremities Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

MUSCULOSKELETAL: No report of back pain, joint pain, muscle pain, back pain, or stiffness.

HEMATOLOGIC: There are no signs of bleeding or anemia.

LYMPHATICS: No swollen lymph nodes felt on assessment and no splenectomy history.

ENDOCRINOLOGIC: No reports of sweating, heat or cold intolerance. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

THE DIAGNOSTIC RESULTS

Thyroid Function Tests: Given her hypothyroidism history, this test, such as measuring free thyroxine (T4), thyroid stimulating hormone (TSH), and perhaps triiodothyronine (T3), might provide important information about her present thyroid condition (Barhanovic et al., 2019). These tests measure her levels of thyroid hormone and assist in establishing if her gland is working normally or whether her thyroid medication needs to be adjusted.
Hormonal Panel: A thorough hormonal panel is helpful in determining the extent of P.P.’s polycystic ovarian syndrome (PCOS). Testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (L.H.), as well as estradiol levels are usually measured on this test. These tests assist in confirming the PCOS diagnosis as well as assess if any hormone abnormalities, such as hyperandrogenism, and irregular menstrual cycles, are causing her symptoms. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

Drug Use Screening: It is essential to do a thorough drug use screening because of her drug use history, specifically with regard to nicotine usage. Urine drug testing is usually part of this examination, which also looks for any continuing substance use that could be aggravating or contributing to her mental health issues. Planning for therapies and measures targeted at co-occurring drug use disorders are informed by the identification of substance use patterns.

Imaging Studies: Brain MRIs or C.T. scans may be necessary in some situations when structural abnormalities, as well as intracranial disease, are thought to be a factor in her mental symptoms (Zovetti et al., 2020). These imaging methods help diagnose and treat neurological disorders affecting her mental health by providing extensive anatomical information about the brain. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay
ASSESSMENT

1. P seems to be a 28-year-old woman with an unstable personality and an untidy look. She moves about in her seat a lot and avoids making long-term eye contact, giving off the impression of being guarded and irritated. Throughout the evaluation, she exhibits mood swings, going from times of muted impact to times of lively expressiveness. Her affect is unstable, which is consistent with her described mood swings, and she sometimes starts crying while talking about her background. The rate as well as volume of her speech are typical, although there are occasional tangential remarks, especially when talking about her creative interests and her experiences with medication. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

During the interview, it was noticed that P.P mental processes were sometimes circumstantial, although seeming goal-directed. She shows a great aversion to medicine, claiming that it inhibits her creativity as well as her sense of identity. She admits she had suicidal thoughts in the past and to have overdosed on medicine, but she denies having any intentions of harming herself or others. She does, however, claim to have heard voices in the past during restless nights, which she credits to her enhanced creative powers. There is little information available about her mental illness since she continues to feel that her creative abilities are hindered by her medication. Her previous experiences with medication non-adherence, as well as her unwillingness to participate in treatment modalities despite advice from medical specialists, indicate that she has poor judgment. During the evaluation, no obvious perceptual abnormalities, such as illusions or hallucinations, were noted. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

Differential Diagnosis

Bipolar Disorder, Type II, is described by recurrent depressive periods intermingled with hypomanic moments. Instead of experiencing intense manic episodes, those with Type II bipolar disorder suffer milder hypomanic states. Prolonged feelings of melancholy, despair, exhaustion, and lack of interest or enjoyment are symptoms of depressive episodes (Gitlin & Malhi, 2020). The cyclical pattern of these episodes, which can last for weeks or months and are interspersed with times of stable mood, is the distinguishing feature of Type II Bipolar Disorder. Family history, drug misuse, stress and health issues are risk factors. Typically, mood stabilizers, psychotherapy, and lifestyle changes are used in conjunction with treatment. For those with this condition, prompt assessment and therapy are crucial to improving long-term results and managing symptoms. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

Major Depressive Disorder is hallmarked by the absence of a manic history or hypomanic episodes and the occurrence of one or more major depressive episodes. Despite P.P’s depressed symptoms, Type II bipolar disorder is more likely to be the cause of her hypomanic episodes and mood cycles (Li et al., 2021). The DSM-5 criteria differentiate MDD from bipolar Disorder by stating that people with MDD do not go through manic or hypomanic episodes. P.P reported episodes of high mood and vigor during her hyperactive phases point to a Type II diagnosis of Bipolar Disorder as opposed to Major Depressive Disorder (Vandeleur et al., 2017). Since the management techniques for MDD and Bipolar Disorder are different, this distinction is essential for both treatment planning as well as prognosis. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

P.P has mood swings that are more extreme than are usually associated with Cyclothymic Disorder. Cyclothymic Disorder is defined by recurrent episodes of hypomanic and depressed symptoms which do not fit the parameters for a severe depressive and hypomanic episode, according to DSM-5 criteria (Brancati et al., 2021). But P. P distinct and intense bouts of despair and hypomania are more in line with Type II bipolar disorder. Besides the milder and fewer debilitating mood swings observed in the Cyclothymic condition, this condition features cycle patterns of mood that include hypomanic and depressed episodes. Given the intensity and distinctiveness of P.P mood swings, a Type II diagnosis of Bipolar Disorder seems more suitable than a Cyclothymic Disorder diagnosis. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

The rationale

P.P clinical presentation, which includes recurring mood swings with discrete periods of enhanced mood and vigor followed by depressed symptoms, clearly supports the main diagnosis of Type II Bipolar Disorder. Her opposition to medicine, which she justified by claiming it was restricting her creativity, is consistent with a typical trait seen in bipolar disorder sufferers. This diagnosis is further supported by P.P past experience with auditory experiences throughout restless nights, which are symptomatic of hypomanic symptoms. The prevalence of hypomanic symptoms and cyclical mood patterns unique to Bipolar Disorder, Type II, led to the exclusion of MDD as well as Cyclothymic Disorder being alternative diagnoses. Significant negatives that reinforce the specialized nature of Bipolar Disorder criteria are the lack of present suicidal or homicidal ideas, the absence of reported delusions or hallucinations in the mental state evaluation, and negative drug use screening results. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

The plan

Psychotherapy: Combining psychotherapy techniques to address adherence to medications, mood stability, and stress management coping mechanisms can be beneficial for her. In order to successfully treat mood swings, cognitive-behavioural therapy (CBT) will concentrate on recognizing and challenging negative thinking patterns linked to drug resistance as well as improving problem-solving abilities (Croatto et al., 2023). Interpersonal therapy (IPT) will also assist P.P in examining and enhancing her connections with others, addressing any stresses that could be associated with mood dysregulation. Peer support, skill development, and socializing opportunities are some benefits of group therapy programs. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

Treatment and Management: Mood stabilizers, like lithium or anticonvulsants, are started as part of pharmacologic therapy to control mood swings as well as stop them from happening again. These drugs have been shown to be effective in lowering the frequency and intensity of depressive and manic episodes as well as regulating mood. To maximize therapy results, regular monitoring of drug adherence and adverse effects will be necessary (Kalin, 2020). Complementing medication and enhancing general well-being are nonpharmacologic therapies including regular sleep patterns, regular exercise, as well as stress-reduction methods like mindfulness meditation.  Complementary as well as alternative treatments that have evidence-based proof of mood stabilization, such as yoga or herbal supplements, may be beneficial for P.P. These treatments may be used in addition to more conventional forms of therapy to help manage mood disorders and build resilience in general. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

Follow-up Parameters: Appointments for routine follow-up will be planned in order to track treatment progress, evaluate medication adherence, and handle any new issues or side effects. In order to monitor mood swings, the effects of medicine, and any factors or stressors that may contribute to mood instability, P.P will be urged to maintain a mood journal.

Health Promotion Activity: To support P. P’s general physical as well as mental well-being encourages her to partake in regular physical exercise like walking, running, or yoga. Regular physical activity is shown to promote mood stability, lessen anxiety and depressive symptoms, and improve quality of life overall. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

Patient Education Strategy: Inform P.P. and the other family members about Type II Bipolar Disorder’s causes, symptoms, available treatments, and outlook via psychoeducation. Stress that good management of the illness requires adherence to medication, frequent follow-up visits, and healthy lifestyle choices. Talk about techniques for identifying mood episode warning signs in advance and creating a customized relapse prevention strategy. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

Reflection:

Upon examining the P.P. situation, a number of significant insights become apparent. First of all, it emphasizes how complicated mood disorders may be and how important it is to conduct a comprehensive examination and use differential diagnosis to inform treatment choices. The difficulty in differentiating between Type II bipolar illness and other mood disorders, including MDD as well as cyclothymic Disorder, is brought to light by P.P presentation. Carefully assessing the patient’s medical history, signs and symptoms, as well as family history, is essential for a healthcare professional to make a precise diagnosis and create a suitable treatment plan. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

Furthermore, ethical questions about how to strike a balance between autonomy as well as beneficence are raised by P. P’s opposition to medicine because she fears it would stifle her creativity. Prioritizing the patient’s general well-being as well as making sure that treatment choices are supported by evidence and in accordance with best practices, are just as important as respecting the individual’s autonomy as well as preferences. Making joint decisions and improving treatment adherence may be facilitated by having candid and cooperative conversations with Petunia on the possible advantages and disadvantages of medicine as well as other treatment choices. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

In addition, P.P’s experiences and health outcomes are significantly shaped by her socioeconomic class, cultural background, and family history of bipolar illness and suicide attempts, among other social determinants of health. In order to provide patient-centered as well as culturally competent treatment, it is essential to acknowledge and address these aspects within the larger context of patient care. In terms of illness prevention as well as wellness promotion, P.P may be taught the value of stress reduction strategies, good lifestyle choices, and self-care routines in order to properly manage her medical condition. In addition to medication therapies, supporting her to prioritize appropriate sleep, maintain a nutritious diet, and participate in regular physical exercise may help her general well-being. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

In the future, I would stress how crucial it is to collaborate and communicate with her family, other medical professionals engaged in her care, and yourself. Through the cultivation of an integrated approach and the consideration of the many facets of P.P’s well-being and health, we can collaborate to maximize her treatment results and elevate her standard of living. Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

 References

Barhanovic, N. G., Antunovic, T., Kavaric, S., Djogo, A., & Spasojevic, V. K. (2019). Age and assay related changes of laboratory thyroid function tests in the reference female population. Journal of Medical Biochemistry, 38(1), 22. DOI: 10.2478/jomb-2018-0020

Brancati, G. E., Barbuti, M., Schiavi, E., Colombini, P., Moriconi, M., Pallucchini, A., … & Perugi, G. (2021). Comparison of emotional dysregulation features in cyclothymia and adult ADHD. Medicina, 57(5), 489. https://doi.org/10.3390/medicina57050489

Croatto, G., Vancampfort, D., Miola, A., Olivola, M., Fiedorowicz, J. G., Firth, J., … & Solmi, M. (2023). The impact of pharmacological and non-pharmacological interventions on physical health outcomes in people with mood disorders across the lifespan: An umbrella review of the evidence from randomised controlled trials. Molecular psychiatry, 28(1), 369-390. https://doi.org/10.1038/s41380-022-01770-w

Gitlin, M., & Malhi, G. S. (2020). The existential crisis of bipolar II Disorder. International Journal of Bipolar Disorders, 8(1), 5. https://doi.org/10.1186/s40345-019-0175-7

Kalin, N. H. (2020). Advances in understanding and treating mood disorders. American Journal of Psychiatry, 177(8), 647-650. https://doi.org/10.3390/medicina57050489

Li, Z., Ruan, M., Chen, J., & Fang, Y. (2021). Major depressive Disorder: advances in neuroscience research and translational applications. Neuroscience bulletin, 37, 863-880. https://doi.org/10.1007/s12264-021-00638-3

Vandeleur, C. L., Fassassi, S., Castelao, E., Glaus, J., Strippoli, M. P. F., Lasserre, A. M., … & Preisig, M. (2017). Prevalence and correlates of DSM-5 major depressive and related disorders in the community. Psychiatry research, 250, 50-58. http://dx.doi.org/10.1590/1516-4446-2020-0650

Zovetti, N., Rossetti, M. G., Perlini, C., Maggioni, E., Bontempi, P., Bellani, M., & Brambilla, P. (2020). Default mode network activity in bipolar Disorder. Epidemiology and psychiatric sciences, 29, e166. https://doi.org/10.1017/S2045796020000803 Assessing, Diagnosing and Treating Adults with Mood Disorders Essay

260209__s40345-019-0175-7_65f6a35392151 (1)