Acute Mania Case Study 2022

Running Head: ACUTE MANIA 1
Acute Mania
Name of Student
Name of Professor
Institution Affiliation
Date

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Acute mania (bipolar disorder)
Mania episode cannot be termed as a disorder itself, but it is regarded as part of a
condition known as bipolar disorder. The symptoms of mania include decreased need for sleep,
extreme involvement in pleasurable activities, racing thoughts, inflated self-esteem, elevated
moods, problems maintaining attention, and elevated mood (Zorkin, Golts & Fernandes, 2017).
An individual encountering acute mania may feel good about his/her condition. In some
instances, acute mania may incorporate psychotic or psychosis symptoms. Common psychotic
symptoms are delusions (strong, false beliefs held by someone that are not based on logical
reasoning and typical cultural concepts) and hallucinations (seeing, hearing or otherwise sensing
of items that are not there) (Lazzari, Shoka, Papanna & Rabottini, 2018). In the case scenario,
Justin is experiencing acute mania condition. This is evident from the symptoms he portrayed.
He was not able to maintain concentration will be doing some tasks; for instance, he would start
organizing one part of the house and leave the task incomplete and start another work. Other
symptoms he portrayed include elevated moods, extreme involvement in his various hobbies,
decreased need for sleep as he used to walk around at night, lost weight, and he has an alleviated
blood pressure (McEvoy et al., 2018). The atieology of mania incorporates a combination of
psychological, genetic, and social factors. The atieology and contributing factors that can be
linked to the mental health condition for Justin include;
Gene is one of the factor that may be causing acute mania in Justin. Even if genes are not
the only factor that contributes to the occurrence of acute mania, studies have shown that
individuals with a close relative having acute mania have approximately 10%-25% likelihood of
developing the disorder. But in cases of an identical twin, the risk rises to 40% to 70% since they

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have the same genes (Greenwood, 2020). Genes might be contributing to Justin's condition since
his identical twin sibling Ivan was recently diagnosed with a type of mood disorder.
Stress is another factor that can cause acute mania. Highly stressful circumstances like
experiencing a death in the family, moving to a new place, and losing a job can significantly
trigger the occurrence of acute manic. Stressful circumstances in a combination of gene
vulnerability combine together to cause acute mania (García et al., 2019). Genes and stress may
be triggering the occurrence of acute mania in Justin. Justin has a history of being stressed; as
indicated like in the periods of final exams, he used to be stressed. Justin may be experiencing
stress since he has been retrenched from work, and he has been unemployed for two months.
Also, being unemployed and having three months old twins maybe overwhelming him
financially and hence resulting in stress.
Substance abuse can also trigger the occurrence of acute mania. Individuals who abuse
alcohol or drugs are at an increased risk of experiencing acute mania. Substance abuse is known
to trigger psychosis; an individual should detox from the use of substances before being
diagnosed with acute mania. Substance abuse makes the moods experienced during acute mania
to be worse and also hasten the onset of symptoms. In the case scenario, Justin has been a social
smoker, but in the last three weeks, he has been taking 30 to 35 cigarettes in a day; this could
have triggered the occurrence of acute mania. Also, Justin takes a lot of caffeinated drinks like 'v'
and "Red Bull." The use of caffeinated drinks and smoking increase the occurrence of psychotic
symptoms (ter Meulen, van Zaane, Draisma, Beekman & Kupka, 2017).
High blood pressure is another condition that can result in acute mania. Hypertension is
known to excrete a hormone called norepinephrine, which influences the reaction of the brain to
stress (Rihmer, Gonda & Dome, 2017). In the case scenario, the diagnosis conducted on Justin

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portrays that his blood pressure was alleviated since it was 172/120 mmHg, which could be
contributing to the occurrence of acute mania.
Sleep is also a factor the can contribute to the occurrence of acute mania. Researchers
have indicated that loss of sleep can trigger the occurrence of acute mania (Lewis et al., 2018).
In the case scenario, it is evident that Justin had problems since he has been prescribed
Temazepam 20mg tablet at night. He was also reported to be recruiting neighbors for charity
volunteers at 3 am.
Care management plan
The main goal of management of the condition of Justin is to help him return to normal
psychosocial functioning and alleviate the symptoms he is experiencing. Achieving a quick
containment of impulsivity, aggression, and agitation is particularly essential to support in
enhancing the patients' safety and those around them and to enable the establishment of a
therapeutic alliance. The multidisciplinary team has several functions to conduct during the
management of acute mania. It should comprise psychologists, general practitioners,
psychiatrists, and mental health nurses. In the initial evaluation, a multidisciplinary team will
work together in establishing the possible multiaxial diagnosis, listing the problems, and
determining the modalities of treatment. Also, a multidisciplinary team is necessary in the case
scenario for the provision of education regarding the condition, encouraging positive lifestyle
changes to Justin and his family, and identifying and managing comorbidities (Samalin,
Honciuc, Boyer, de Chazeron, Blanc, Abbar & Llorca, 2018).
Immediate intervention

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The immediate intervention plan for Justin should focus on stabilizing his moods. The
immediate intervention should mainly involve pharmacological intervention that acts as a mood
stabilizer. The available mood stabilizers include topiramate, lithium, lamotrigine, valproate, and
oxcarbazepine/carbamazepine. Lithium is the commonly used drug used as a mood stabilizer. I
would administer lithium since it helps in reducing or preventing the severity of episodes (Duffy,
Patten, Goodday, Weir, Heffer & Cipriani, 2017). Antipsychotic medications like aripiprazole,
olanzapine, and risperidone should also be administered since they can help in reducing the
delusional thoughts that Justin is experiencing and also decrease erratic moods. In the case
scenario, Sodium Valproate was prescribed. Sodium Valproate helps in producing a quick
antipsychotic and antimanic response with fewer side effects. Medications that address physical
symptoms like blood pressure should also be administered, for example, angiotensin-converting
enzyme inhibitors (Kleimann et al., 2016).
Short-term intervention
The main focus of short-term intervention is to enhance treatment and medication
adherence, handling stress, and educating the patients about their conditions. Psychoeducation
for family and patient is one of the short term intervention that I can administer. The aim will be
to educate Justin and his family regarding the illness he is experiencing. They should be provided
with simple and clear explanations regarding treatment options, nature of the illness, length of
treatment, and effects of medications. Carers should strive to provide family and patient with
knowledge regarding treatment, symptoms, and aetiology. Psychoeducation ought to be tailored
to the needs of the patient and family to enable them to fully understand about the illness (Malhi,
Fritz, Elangovan & Irwin, 2019). For instance, in the case scenario, Justin is provided
psychoeducation to enable him to understand why he needs to take the medicines.

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Long term intervention
The main focus of long term intervention should be to help Justin prevent any occurrence
of acute mania, and in case it occurs, he should be able to manage it. Some of the interventions
that can support this include;
Interpersonal and social rhythm therapy. This therapy will help in regulating the
routine or social rhythms of Justin and improving his interpersonal relationships so that he can
get more satisfaction in his social role. The main aim of this therapy is to help Justin understand
how he can prevent the development of new episodes of acute mania. Justin should be taught that
new episodes may be precipitated by stressful events, poor adherence to medication, and
disruption of social rhythms (García et al., 2019). The carer should provide Justin with skills on
how he can address interpersonal issues and problems in social roles. The carer also ought to
advise Justin on how he can maintain a day to day routine while paying attention to stressors. He
should avoid stressors that can affect his day to day routine (Goracci et al., 2016). For instance,
he should stabilize his daily routines and sleep/wake cycles. This will help to avoid being
preoccupied with various roles.
Guiding on Lifestyle modification. The carer and other healthcare professionals need to
provide Justin with a guide on how and why he should modify his lifestyle. Substance abuse,
like smoking and caffeine consumption complicates the illness, contributes to poor health
outcomes, and promotes mixed states. Justin needs to stop smoking, and also he should limit the
use of caffeine. This is because smoking and the use of caffeine interfere with mood, sleep, and
prescribed medicines for treating acute mania (Dols, Chan & Shulman, 2017). The family and
carers should provide Justin with support so that he can be able to adjust his lifestyle easily. This

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is because smoking and the use of caffeine can help him get through the manic episode, but in
the real sense it may complicate his condition (Goracci et al., 2016).
Support services
Support services are essential in optimizing the recovery process of the patient and
promoting the wellbeing of the carer and family. A person having an acute mania requires
professional help so that the condition can be easily managed. Justin's recovery process requires
long-term treatment and management under the advice of psychologists, psychiatrists, and
general practitioners. Some of the support services available for acute mania include;
Healthcare professionals. Management of acute mania is still challenging since healthcare
providers have limited understanding of the condition. But the availability of many and diverse
healthcare providers has made it easy for the management of the condition and hence promoting
recovery. The collaborative effort between primary care providers and mental health
professionals has enabled the provision of comprehensive care. The availability of healthcare
professionals will help in promoting Justin's recovery process since there will be regular
education, follow-up, and support. Due to the availability of healthcare professionals, his
condition was diagnosed quickly, medication provided, and psychoeducation offered hence
promoting recovery. This promotes family wellbeing since they are not worried since Justin has
been offered good care. The collaborative effort promotes the wellbeing of the carer since it will
reduce work burnout since work is shared (Taylor, Galvez & Loo, 2018).
Availability of online information about acute mania. Organisations like Black Dog
Institute offer services that can support in promoting and optimizing Justin's recovery. The Black
Dog Institute helps in improving the lives of people affected by a mental illness like acute mania

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through delivering long-term public solutions. It engages in teaching people how to recognize the
symptoms of mental complications and providing psychological tools that can help them in
managing their condition (Waterreus & Morgan, 2018). This can help in optimizing the recovery
of Justin since he will be able to recognize the symptoms early and manage them using
psychosocial tools. This will help in limiting the adverse effects of symptoms.
SANE Australia. This is a government health information that offers a general overview
of bipolar disorder and connects to additional help. SANE helps in providing free call service,
providing a referral, support, and information to individuals concerned about mental
complications. It also offers information that is easy to read regarding all mental health
complications. It also offers guidelines on how community support programs can support people
with mental health complications. This can be through training and education, accommodation,
psychosocial rehabilitation, help with finding suitable work and mutual support groups
(Waterreus & Morgan, 2018). The recommended community guidelines can help in supporting
Justin's recovery process by helping him find a suitable work that seems like a contributing
factor to his condition.

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References
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