1 bipolar disorder 8 Captain of the Ship: Bipolar Disorder The following case study details the treatment approach for a 35-year-old Caucasian male who presented to the clinic for help with his mood disorder. The assessment and intake supported the diagnosis of bipolar disorder, subtype II. The following analysis presents the details related to both pharmacology and psychotherapy, as well as information related to medical management, community support resources, and appropriate follow-up. Chief Complaint The client came to the clinic reporting that he “could no longer deal with his up-and-down mood swings and that he was at the end of his rope.” History of Presenting Problem This client stated that he has had mood swings for as long as he could remember, and that right now he was in the “up” phase of this alternating mood pendulum. From an inspection of the genogram that the client provided, there was a noticeable inheritance pattern of the bipolar. Notably, this client had evidence of bipolar on both maternal and paternal sides of his genogram. Research has shown that bipolar has a high heritability rate. Kern (2014) reported on the concordance rates of twins with bipolar, stating the rate was from 60-80%. In other studies, the heritability of bipolar is demonstrated albeit at lower rates (Maier et al. (2005). The DSM-V characterizes bipolar II disorder as one in which individuals experience a period of at least 4 days of hypomanic symptoms; once this criterion is met, the person fits the diagnosis of bipolar II regardless of the duration of future hypomanic episodes (APA, 2013). Additional symptoms to support this diagnosis were the client’s admission that he was taking on several projects and tasks at work simultaneously; sleeping little; experiencing racing thoughts; and feeling invincible. The intake showed the client’s extremely fast talking, switching subjects haphazardly, and admission of both depressive and hypomanic episodes, all of which point to a diagnosis of bipolar II (296.89 F31.81) (APA, 2013). Current Medications This client denied taking any medications, either over the counter or from a doctor. Although he claimed he was in good health, he did report that he frequently got headaches but not of migraine proportions. He described them as more of an annoyance than a health problem. He gained relief from either Motrin or Tylenol during these headache episodes. He denied taking any vitamins or herbs or any other OTC substances. Relevant History The client reported that his mood swings began when he was in his early 20s. As he witnessed other family members suffering from these mood swings, he came to believe they were normal. The client appeared to be in good health, was not overweight, and appeared to take good care of himself. He was dressed well and was oriented x4. He stated that he earned a good living working as a financial consultant, enjoyed his work, but could not deal with the revolving mood swings anymore. His p ...

1. 1
bipolar disorder 8
Captain of the Ship: Bipolar Disorder
The following case study details the treatment approach for a
35-year-old Caucasian male who presented to the clinic for help
with his mood disorder. The assessment and intake supported
the diagnosis of bipolar disorder, subtype II. The following
analysis presents the details related to both pharmacology and
psychotherapy, as well as information related to medical
management, community support resources, and appropriate
follow-up.
Chief Complaint
The client came to the clinic reporting that he “could no longer
deal with his up-and-down mood swings and that he was at the
end of his rope.”
History of Presenting Problem
This client stated that he has had mood swings for as long as he
could remember, and that right now he was in the “up” phase of
this alternating mood pendulum. From an inspection of the
genogram that the client provided, there was a noticeable
inheritance pattern of the bipolar. Notably, this client had
evidence of bipolar on both maternal and paternal sides of his
genogram. Research has shown that bipolar has a high
heritability rate. Kern (2014) reported on the concordance rates
of twins with bipolar, stating the rate was from 60-80%. In
other studies, the heritability of bipolar is demonstrated albeit
at lower rates (Maier et al. (2005).
The DSM-V characterizes bipolar II disorder as one in which
individuals experience a period of at least 4 days of hypomanic
symptoms; once this criterion is met, the person fits the
diagnosis of bipolar II regardless of the duration of future
hypomanic episodes (APA, 2013). Additional symptoms to
support this diagnosis were the client’s admission that he was

2. taking on several projects and tasks at work simultaneously;
sleeping little; experiencing racing thoughts; and feeling
invincible. The intake showed the client’s extremely fast
talking, switching subjects haphazardly, and admission of both
depressive and hypomanic episodes, all of which point to a
diagnosis of bipolar II (296.89 F31.81) (APA, 2013).
Current Medications
This client denied taking any medications, either over the
counter or from a doctor. Although he claimed he was in good
health, he did report that he frequently got headaches but not of
migraine proportions. He described them as more of an
annoyance than a health problem. He gained relief from either
Motrin or Tylenol during these headache episodes. He denied
taking any vitamins or herbs or any other OTC substances.
Relevant History
The client reported that his mood swings began when he was in
his early 20s. As he witnessed other family members suffering
from these mood swings, he came to believe they were normal.
The client appeared to be in good health, was not overweight,
and appeared to take good care of himself. He was dressed well
and was oriented x4. He stated that he earned a good livi ng
working as a financial consultant, enjoyed his work, but could
not deal with the revolving mood swings anymore. His purpose
for coming to the clinic was get help for this apparent mood
disorder.
Diagnostic Impression
As stated, the client’s symptomatology and relevant history
align with a diagnosis of bipolar disorder, subtype II. Running
along a continuum from mild to severe, this disorder is saliently
circumscribed by the major depressive phase alternating with
the hypomanic phase (Antokhin et al., 2010; APA, 2013). The
DSM-V clearly states that the bipolar II diagnosis is confirmed
by individuals’ experience with at least one episode of major
depression and at least one hypomanic episode (APA, 2013;
Samalin et al., 2016). Because the client has never experienced
a full-blown mania, so typical of the bipolar I subtype, the

3. diagnosis is best supported by the criteria of the bipolar II
subtype.
Psychopharmacology and End Points
Both subtypes of bipolar can be extremely debilitating to
individuals who suffer from these illnesses. For one, this client
reported regular sleep disturbances and an omnivorous appetite
for increased responsibilities at work, the result of which could
be extreme overwhelm. Sadock et al. (2014) described such
overwhelm, stating that bipolar individuals often experienced
extreme emotional distress because of such unrelenting task
assumption. The typical treatment for bipolar patients and one
directed at mood stabilization is lithium therapy (Stahl, 2013).
The recommended regimen based on all the information for this
case would be 600mg of a lithium salt TID. Ward (2017)
reported on the efficacy of this treatment to target the up-and-
down nature of the disorder. During lithium therapy, clients
must have their blood monitored regularly to ensure that the
target of 1-1.5mEq/L blood serum levels is established (Sadock
et al., 2014). Supplemental pharmacology might include the
drugs venlafaxine and olanzapine, the first an antidepressant
and the second an antipsychotic (Stahl, 2013). These meds
would help with any psychotic episodes that the client might
experience (Sadock et al., 2014). To avoid overprescribing of
psychotropics, no adjutant therapy would commence until the
results of lithium therapy have been established. The
therapeutic endpoint would be improvement in the client’s mood
swings over the ensuing weeks after initiation of pharmacology.
Psychotherapy and End Points
The gold standard of psychotherapy is cognitive behavioral
therapy (CBT) and will be recommended on a weekly basis. The
literature is replete with research supporting the efficacy of
CBT in bipolar cases (Jones et al., 2012; Sadock et al., 2014).
Gabbard (2014) reported that bipolar patients who attended
regular CBT therapy enjoyed welcome relief from the nefarious
symptoms of the illness. But as with other mental health
disorders, bipolar is best treated with a multimodal approach.

4. Antokhin et al. (2010) discussed the benefits of sociotherapy to
complement modalities like CBT and other group behavioral
therapies. The endpoint of psychotherapy would be to restore
normal functioning to the client, as much as is realistically
possible, and see him begin to be less hampered by the disorder,
especially insofar as his sleep disturbance and feelings of
invincibility.
Medical Management and Follow-Up
Importantly, lithium therapy can be dangerous if blood
levels rise to 2.5mEq/L (Sadock et al., 2014). For this reason,
the client will be sent for regular blood draws to ensure levels
remain within the safe zone. Moreover, the client will be
enjoined to see his regular doctor for routine vaccinations and
other preventive routine diagnostic tests. The client will be
educated on the important side effects of pharmacology.
Notably, lithium can produce side effects of diarrhea, muscle
fatigue, and shaky gait (Stahl, 2013). The client will be advised
to notify his doctor immediately of any of these problems and to
report to the nearest hospital for emergency care.
Support Resources
The National Alliance on Mental Illness (NAMI) offers a
wide range of social support services through its website and
national hotline. These services encompass everything from a
suicide hotline to help finding a mental health specialist to
books and other printed materials on bipolar (NAMI, 2018).
Another online resource is the Depression and Bipolar Support
Alliance (DBSA), which offers abundant information on bipolar
and related mood disorders (DBSA, 2020). The FAIR START
program helps persons with bipolar to find expert clinical
research on the disorder (FAIRSTART, 2019). This program is
run by Stanford Medical School and offers help for bipolar
individuals to get evaluated properly and find appropriate
treatment.
References
American Psychiatric Association (APA). (2013). Diagnostic

5. and statistical manual of mental disorders (5th ed.). APA.
Antokhin, E., Bardyurkina, V., Budza, V., Kryukova, E., &
Baldina, O. (2010). Bipolar depression of the II type:
Psychopathology, therapy. European Psychiatry, 25.
Depression and Bipolar Support Alliance (DBSA). (2020).
https://www.dbsalliance.org/
FAIR START. (2019). From affective illness to recovery:
Student access to rapid treatment (FAIR START).
Stanford Medicine.
http://med.stanford.edu/bipolar/Fairstart.html
Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric
disorders (5th ed.). American Psychiatric Publications.
Jones, S., Mulligan, L. D., Law, H., Dunn, G., Welford, M.,
Smith, G., & Morrison, A. P. (2012). A randomized
controlled trial of recovery focused CBT for individuals with
early bipolar disorder. BMC Psychiatry, 12: 204.
Kerner, B. (2014). Genetics of bipolar disorder. Applied
Clinical Genetics, 7: 33-42.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966627/
Maier, W., Höfgen, B., Zobel, A., & Rietschel, M. (2005).
Genetic models of schizophrenia and bipolar disorder:
overlapping inheritance or discrete genotypes? European
Archives of Psychiatry and Clinical Neuroscience, 255(3),
159–166.
National Alliance on Mental Illness (NAMI). (2018). Retrieved
June 30, 2020 from https://www.nami.org/
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan &
Sadock’s synopsis of psychiatry: Behavioral sciences/clinical
psychiatry (11th ed.). Wolters Kluwer.
Samalin, L., de Chazeron, I., Vieta, E., Bellivier, F., & Llorca,
P. (2016). Residual symptoms and specific functional
impairments in euthymic patients with bipolar disorder. Bipolar
Disorders, 18(2), 164–173.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology:
Neuroscientific basis and practical applications (4th ed.).
Cambridge University Press.

6. Ward, I. (2017). Pharmacologic options for bipolar disorder.
Clinical Advisor, 20(3), 17–25.
We Want Our MTV
Ja’Niya Ladson
Department of Business and Entrepreneurship
BA130OL- Introduction to Business
Dr. Wilton Stewart
March 21, 2021
MTV, a division of Viacom International Media Networks and a
mainstay of American pop culture, is just as popular in
Shanghai as it is in Seattle and Sydney, or in Lagos (Nigeria) as
it is in Los Angeles. MTV is a division of Viacom, and thei r
international divisions are called the Viacom International
Media Networks. London-based MTV Networks International,
the world’s largest global network, has taken its winning
formula to 167 foreign markets on six continents, including
urban and rural areas. It reaches 4 billion homes in 40
languages through locally programmed and locally operated TV
channels and websites. While the United States currently

7. generates about 70 percent of MTV’s profits, 85 percent of the
company’s subscriber base lives outside the United States.
The MTV brand has evolved beyond its music television roots
into a multimedia lifestyle, entertainment, and culture brand for
all ages. In addition to MTV and MTV2, its channel lineup
includes Nickelodeon, VH1, Comedy Central, LOGO, TMF (The
Music Factory), Game One, and several European music,
comedy, and lifestyle channels, as well as Paramount Channel,
Spike, and a growing number of flagship local networks such as
Channel 5 in the UK, Telefe in Argentina, and COLORS in
India. Adding to the complexity is MTV’s multimedia and
interactive nature, with gaming, texting, and websites, as well
as television. Another challenge is integrating acquisitions of
local companies such as South American Telefe, which it
purchased in 2016.
The company also has an international insights team that
gathers the latest consumer insights from around the world. You
can get some insight into this initiative at
https://insights.viacom.com. The local perspective is invaluable
in helping the network understand its markets, whether in terms
of musical tastes or what entertainment children like. For
example, Alex Okosi, a Nigerian who went to college in the
United States, is chief executive for MTV Base, which launched
in sub-Saharan Africa in 2005. Okosi recommended that MTV
consider each country as an individual market, rather than
blending them all together.
One reason for MTVNI’s success is “glocalization”—its ability
to adapt programs to fit local cultures while still maintaining a
consistent, special style. “When we set a channel up, we always
provide a set of parameters in terms of standards of things we
require,” an MTV executive explains. “Obviously an MTV
channel that doesn’t look good enough is not going to do the
business for us, let alone for the audience. There’s a higher
expectation.” Then the local unit can tailor content to its
market. MTV India conveys a “sense of the colorful street
culture,” explains Bill Roedy, former MTV Networks

8. International president, while MTV Japan has “a sense of
technology edginess; MTV Italy, style and elegance.” In Africa,
MTV Base features videos from top African artists as well as
from emerging African music talent. According to company
executives, the goal is to “provide a unique cultural meeting
point for young people in Africa, using the common language of
music to connect music fans from different backgrounds and
cultures.” (Excerpt from Chapter 3 of the textbook (pp. 126-
127). Respond to the following questions.
· Do you think that MTV’s future lies mostly in its international
operations? Explain your reasoning.
· What types of political, economic, and competitive challenges
does MTV Networks International face by operating worldwide?
· How has MTV Networks International overcome cultural
differences to create a world brand?
· By definition, would you consider MTV a multinational
business? Explain why or why not? What advantages would
MTV have if it were a multinational organization?
Your original post to this forum must be at least 250 words.
Original post is due by midnight Thursday, March 18, 2021.
Responses to two classmates are also required and due by March
21, 2021 by midnight. Users must post in order to see
classmate replies to this discussion.
EXPECTATIONS:
BA 130 OL – Introduction to Business (3cr. hrs.)
Page 1 of 6
This document will outline the Professor’s expectations
required for successful completion of
this course. While you will receive a slightly different

9. experience in each of your classes at
Voorhees College, based on my style of teaching, there are
some general guidelines I would like
to go over with you so that you will have a consistent
experience throughout this course.
Forum Topic Activities
• Etiquette (Netiquette) – I am committed to providing open,
frank, yet civil dialogue in the
forum topic discussions. To achieve this, students should abide
by the following
guidelines:
• Never post, transmit or distribute content that is known to be
illegal
• Avoid harassing, threatening or embarrassing fellow learners
• Avoid language that is: harmful, abusive, racially or ethnically
offensive, vulgar,
or sexually explicit.
• If you provide information/facts in your post that are from
another source, I
encourage you to cite a source. While not necessary, this
practice would make it
easier for those reading your post to locate the source for
personal reference.

10. PLEASE NOTE: APA format does not have to be used for citing
sources in a
discussion post. Points will not be deducted if the citation is
not in APA format.
• The original discussion post for each specific topic should be
a minimum of 250 words
unless a more significant number of words is specified in the
actual forum discussion
instruction. If it is apparent there is no substantive evidence or
content that contributes
to the discussion, regardless of word count, reduced points will
be awarded. Original
discussions posted after midnight Thursday evening will receive
reduced credit.
• Responses post to discussions after midnight Sunday evening
will receive zero credit.
If the number of responses is not specified, a minimum of two,
posted are required.
Further, a response post to a fellow student or the instructor
should be a minimum of
150 words unless more words are specified in the forum
discussion instructions.
• If a student neglects to respond to a professor’s follow -up
posted question(s) or query

11. for additional information to a student’s forum discussion post,
there will be a reduction
of points in the participation category.
• For maximum credit on participation level for a forum
discussion, the original post and
at least the prescribed number or more response posts must be
posted during the week.
Written Assignments and Case Studies
• All written assignments are to be typed, double-spaced, 12 pt.
Times New Roman font,
in APA style. APA style means there must be a cover page on
the assignment. In
addition, the cover page must have the following features:
o A running head title (in the upper left-hand corner). Please
see the example
below:
CASE STUDY 1
o A title for the assignment that is not more than 12 words.
o Student’s name
EXPECTATION (cont.):
BA 130 OL – Introduction to Business (3cr. hrs.)
Page 2 of 2

12. o Course Title & number (i.e. BA 130 OL – Introduction to
Business)
o Institutional affiliation (i.e., Department of Business &
Entrepreneurship)
o Assignment Date
o Professor’s name (i.e., Wilton R. Stewart, PhD)
Please note – the running head title should appear on all
subsequent pages following the
cover page in a submitted written assignment.
• Academic honesty is highly valued. Always submit work that
represents your original
words or ideas. If any words or concepts used in a class posting
or assignment submission
do not represent your original words or ideas, you must cite all
relevant sources in APA
format and make clear the extent to which such sources were
used.
• Most plagiarism issues are unintended. For example, a student
forgets to put quotation
marks around a direct quote or paraphrases research without
adding a reference citation.
The consequences of plagiarism, however, do not decipher
unintended from deliberate
practice. Please have a working knowledge of how to reference
others in your written
work, including knowing the differences between quoting,

13. paraphrasing, and
synthesizing.
• The APA Manual1 will be used by the professor to cite all
format discrepancies that are
noted in a graded assignment. Twenty percent of your overall
grade on a written
assignment will be based on APA format and reference list.
• One must provide a textual citation using the APA author-date
system format and also
provide a reference listing at the end of a written assignment if
you use the ideas or
directly quote other authors. That also includes the definition
of words.
• Using just the web address to cite a source does not provide a
reader all the information
needed. Nevertheless, it is also not proper APA format. APA
format is how you
communicate in writing to cohorts that are human service
professionals.
Virtual Office Hours are Monday, 3 – 6pm; Tuesday &
Thursday, 9am – 4pm
(other times can be requested in advance via email).
Phone number(s): (843) 412-4754
College e-mail address: [email protected]

14. With respect,
Wilton R. Stewart, PhD
Adjunct Professor,
Voorhees College
1 The specific reference source that will be used for grading
APA format is The APA Manual
(2020). Publication manual of the American psychological
association (7th Ed.). Washington,
D.C: American Psychological Association