Bipolar disorder misdiagnosis in a teenage patient: Sarah's case

Bipolar Disorder

Case Story Bipolar Disorder

A girl suffering from Bipolar Disorder: Sarah

I was working in the community health center as an intern, when I received a call from a woman desperately looking for assistance for her 17-years-old daughter. The woman sounded tearful and anxious, as she spoke, and I immediately concluded that she was fearful and at the edge of giving up. I asked her to cool down and explain to me her problem calmly. She stated that the her daughter named Sarah, had been expelled from her school, the reason being that she was found having oral se with two boys in the school toilet. Mary, the woman's name and mother to Sarah, was a marketing executive, had not gone to work because she feared that if she left Sarah alone, the girl might flee.

Upon more information about Sarah, I leant that this was just one of the numerous crisis that Sarah had experienced, a seemingly bright girl from middle class family, brought up by a single mother. Since her teens, Sarah had appeared unable of managing her urges to abuse drugs, shoplift and involve in promiscuous and unsafe sex. She at times stole her mother's care and spent weekends away, all these frightened her mother, and she seemed unable to know how to deal with the situation. The poor lady has tried all she could, including seeking help from therapists, school counselor, her doctor, the police and even psychiatrists, yet the Sarah did not change, she only worsened.

Several psychiatrists had diagnosed Sarah with Oppositional Defiant Disorder (ODD), others with Borderline Personality Disorder, others with, Major Depressive Disorder, while others thought that she suffered from Attention Deficit Hyperactivity Disorder. Accordingly, she had been given antidepressants, benzodiazepines and even antipsychotics, but Sarah rightfully stated that all those medications did not alleviate her conditions. Indeed, she claimed that at times, these medications only worsened her symptoms.

Owing to Sarah's recurring sexual acts, one therapist had reported the mother for suspected sexual abuse, the issue was taken up by Child Protection Service, but this only worsened the situation the mother was going through, since she was innocent.

After hearing this case, I recommended that Sarah comes for therapy sessions. She did come for several sessions, and with the help of my supervisor, we discovered that she was suffering from Bipolar Disorder. This diagnosis resulted in suitable medications and therapies brought positive results, and Sarah was eventually treated.

Bipolar Disorder

Bipolar Disorder is a critical and complex mental disease, which is not common among teenagers, and this explains why it took two years for the Sarah to be correctly diagnosed. The disorder is characterized by severe changes in personality as well as mood; a person goes through a moment of mania (extreme happiness) and goes to a moment of deep depression, these episodes where the mood changes could last from weeks to months. Medications can help the victim, but psychosocial interventions are as well necessary for best treatment.

Psychosocial inventions of Bipolar Disorder

As explained by Baldessarini, et al. (2003) psychosocial inventions for treatment of Bipolar disorder comprises of pyschoeducation, individual psychotherapy, self-help as well as support groups. Accordingly, the basis of applying these therapies rests on offering the person with the necessary tools to address his/her situation while continuing to live a normal life. In some cases, social backgrounds are used as learning places, where a person can better acknowledge and manage his/her symptoms. In any selected therapy, psychiatrists, case workers, and therapist play an important and specific duty in the treatment plan of the client.

Self-help and support groups

This psychosocial intervention is made up of people suffering from bipolar disorder and any friends or family members seeking a better understanding of how the disorder impacts the normal life of a person. Belmaker (2004) asserts that self-help groups offer an environment where those with the disorder can share their experiences and learn best ways of coping with the disorder. Self-help groups and support groups offer a social background where issues concerning the disorder can be freely discussed. Owing to the fact that periods of isolation may result from this order, support groups encourages victims that some other people go through the same situation.

Pyschoeducation

These interventions are particularly meant to educate those suffering from bipolar disorder regarding the symptoms of the disorder. As noted by Belmaker (2004) when a person understand the cyclic manner of bipolar disorders, a person can have a better understanding of when mood swings occurs, and the way of dealing with them. When a person suffers a moment of mania, the person can show wild or violent behaviors varying from sexual promiscuity to dangerous escapades. Though each person will show different set of symptoms, understanding and identifying symptoms of remission can assist in preventing hospitalization. People are as well educated on the benefits of their medication in reducing and managing their disorder.

Recommendations

Though bipolar disorder seems to be a life-long and recurrent condition, there are several measures that a person can do to assist her/himself. Apart from treatment and therapies, the person can use self-help approaches to alleviate symptoms and assist the person live a normal life? Certainly, the person has to change his/her lifestyle and stop cycles of acts or behavior that can aggravate the condition. In addition, the person should accept assistance from the loved ones. For example in our case story, Sarah should accept the assistance and care from her mother. There are other steps that should be taken:

Stop drinking and abusing drugs: as noted by Parikh, et al. (1997) one of the greatest issues with bipolar disorder is the negative outcomes associated with risk taking behavior as well as drugs or alcohol misuse. It is necessary to seek professional assistance if the person is unable to stop this behavior.

Quit unhealthy relations: those suffering from bipolar disorder should look for people who can positively influence them. Those who will help them avoid unhealthy behaviors.

Do regular exercises: regular and moderate exercise assists in stabilizing the victim's mood. At the same time physical exercises allows the brain to release endorphins that makes the person to feel good and can easily sleep. However, the person should get advice from his/her doctor first (Parikh, et al., 1997)

Get plenty of sleep. Sleeping enough is an important part of managing your mood. If you have trouble sleeping, talk to your doctor or mental health provider about what you can do.

Sleep well: getting enough sleep is recommended as part of controlling a person's mood. Thus, a person should try to get enough sleep.

When these recommendations are put into consideration, a person suffering from bipolar disorder will possibly report positive results from his treatment.