Psychology: Bipolar Disorder

This document discusses the pathophysiology, etiology, patient risks, underlying needs, signs and symptoms, and recommendations for bipolar disorder.

Running head: PSYCHOLOGY: BIPOLAR DISORDER
PSYCHOLOGY: BIPOLAR DISORDER
Name of the Student:
Name of the University:
Author note:

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Pathophysiology
As evident from the case, Mattie is currently inflicted with Bipolar I Disorder, otherwise
known as ‘Manic Depressive Disorder’. Individuals with Bipolar I are characterize to encounter
to a minimum of one episode of mania, which indicates a state of intense and unpredictable
shifts in mood, such as tendencies to engage in extreme or even damaging behaviors, irritability,
expansiveness and severe bouts of uncontrollable energy (Varcarolis, 2004). Such pathologies
can be observed in Mattie’s engagement in rash driving, agitation upon social interaction,
aggressiveness directed at the police as well as reckless financial behaviors. Till date, no
scientific evidence has been successful in establishing associations between biological factors
and emergence of manic symptoms (Grande et al., 2016). However, individuals with manic
disorders are generally found to be euphoric and energetic individuals with a heightened sense of
self control after engaging in reckless behaviors (Vieta et al., 2018). With time, increased
engagement in such exhilarating activities exerts damage, which the individual is oblivious of,
resulting in mania intensification and psychosis (Varcarolis, 2004). Such pathologies can be
attributed in Mattie’s engagement in flamboyant, impulsive and energetic lifestyle behaviors,
resulting in her feeling powerful and empowered and emergence of symptoms of aggressiveness
and agitation.
Etiology of Bipolar Disease
As discussed previously, there remains a lack of evidenced identification of biological
markers which may act as determinants of bipolar disorder. However, the pathological symptom
of the disease may be genetically inherited, and hence, the prevalence of depressive and manic

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episodes across her mother and grandmother, may be a causative factor of Mattie’s current
mental state (Torrey, 2017). Additional etiological factors associated with bipolar disorder may
be associated with imbalances in structural components of the cerebral context, neuroendocrine
disruptions in hypothalamic-pituitary-thyroid-adrenal axis, disturbances in the hormonal and
neurotransmitter equilibrium, along with past occurrence of a traumatic life experience
(Varcarolis, 2004). Additional, bipolar disorder may also be caused due to lack of mitigation of
initial engagement in manic, impulsive behaviors – which perhaps can be the case with Mattie.
In criticism however, it must be noted that there is no mention on Mattie’s assessment of her
hormonal or chemical imbalances, as well as occurrence of past traumatic events (Li et al.,
2015). Hence, there is a need to conduct further assessments in Mattie to accurately target the
etiological factors of her manic symptoms.
Patient Risks
As observed from the above pathologies and etiological factors, if Mattie’s condition is
left untreated, she may be at risk for the following consequences:
Risk for Injury: Patients with manic episodes, as observed in Mattie, are prone to
undergoing sudden shifts in mood resulting in emotional and behavior outbursts, a strong sense
of power, euphoria, self control and hyperactivity resulting in tendencies to engage in reckless
behaviors. Such impulsive behaviors, which the patient may engage in to fulfill his/her ‘high’, if
left unchecked, can instill harm and damage to the patient resulting in fatal consequences (da
Silva Costa et al., 2015). This can be observed in Mattie’s engagement in reckless and rash
driving, which increases her risk for injury and could have caused her death or damage, had the
police not approached her.

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Risk for Violence: Patients with Bipolar I disorders, while suffering from a manic
episode, may display behaviors which are impulsive resulting in aggression, agitation and
hostility as defense mechanism when met with obstacles to fulfill their desired behaviors (Lewis
et al., 2018). Hence, such patients are at risk of violence as can be observed in Mattie physically
harming the police officer when she was stopped in her reckless driving.
Risk for Altered Thought Process: A key characteristic feature in Bipolar I disorder is
the patient’s susceptibility to encounter unpredictable, sudden and intense shifts in mood which
results in him or her to engage in unprecendented, harmful behaviors, which may damage the
patient physically, emotionally, socially and psychologically. Such risks are further aggravated
when a patient does not adhere to his or her medication course (Stanley et al., 2017). Mattie’s
risk for altered thought process can be emphasized in her engagement in uncontrolled monetary
spending as well as in her sudden aggression and violence towards the police after she stopped
taking her medications.
Underlying Needs
Considering Mattie’s history and present preoccupation with aggressive, violent,
impulsive and self-injurious behaviors, she may be required to be isolated from other patients
and kept under constant supervision and monitoring (Halter, 2017). Patients with Bipolar I
disorder are often susceptible to engagement in unpredictable and aggressive behaviors which
not only can cause harm to them but also to their surrounding individuals hence resulting in the
need for isolation, monitoring and supervision (Goodwin et al., 2016). Further, it can be
observed that Mattie is still hostile towards the health professionals which is why, the nurse must
engage in empathetic, therapeutic communication. Nurses are recommended to interact with the

4PSYCHOLOGY: BIPOLAR DISORDER
patient in a calm, composed and firm approach and use concise, brief explanations and limited
stimuli considering the drifting span of attention and the tendency to be startled in stimulating
environments in the patient (Halter, 2017). Adherence to a nutritious diet and antipsychotic
medication plan can be effective in controlling manic symptoms in the patient (Wulsin et al.,
2018). Hence, there is a need for Mattie to adhere to a strict medication plan and self care
activities like a balanced diet for optimum health.
Signs and Symptoms
The key signs and symptoms in Bipolar I disorder include: outbursts of sudden
hyperactivity, pacing, restlessness, sleeplessness, irritability, paranoia, slurred and rapid speech,
short span of attention, lack of judgment and self-control and engagement in harmful behaviors.
Such symptoms can be observed Mattie’s aggression and reckless driving, agitation at social
presence, feelings of grandeur and flamboyance, impaired lifestyle and incoherent speech
(Varcarolis, 2004).
Recommendations and Future Actions
It is recommended that further assessments be conducted to comprehensively assess the
underlying reasons for Mattie’s condition. These can include assessments associated with
substance abuse, family or medical history, mood and causes of lack of medical compliance. A
comprehensive, holistic assessment will result in targeted therapy and improved recovery
(Chatterton et al., 2016). Further, there has been a lack of inclusion of Mattie’s family, to whom
she is close to, in the care plan which may aggravate her hostilities (Fredman et al., 2015).

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Hence, it is recommended that family centered therapy and support be incorporated, which will
motivate the patient to work towards recovery.

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