1. Masters of Education in Counselor Education
Elementary School Counseling
Background DIAGNOSIS: AXIS I-IV & GAF
I: 296.43 Bipolar I Disorder, Recurrent Episode Manic, Interview
Severe Without Psychotic Features
-55 yr. female, single V61.20 Parent-Child Relational Problem
-American actress, novelist, II: V71.09 No diagnosis
III. None
Q: Can you tell me about when the symptoms began?
Assessments
screenwriter, & performing artist A: I attributed the sypmtoms, not sleeping, constant talking, to
IV: Problems with primary support group, BAC & 10-panel Urine screening
-family history of mental illness Occupational Problems
Hollywood, at first. I was originally diagnosed with bipolar at 24.
NEGATIVE
-history of alcohol and substance abuse V: GAF= 37 (at admission)
SASSI-3: low abuse (current)
Q: At 24, what was your treatment plan?
-divorced; 20 yr. old daughter GAF= 58 (current)
A: I was prescribed medication but at that time I was highly addicted
BDI-II: 18 (mild depression)
-great r.ship with mother, resentment The results of the assessments confirm a diagnosis of bipolar disorder.
to alcohol and illict drugs so it was difficult to decern the cause of Mood Disorders Questionnaire:
towards father The Patient has relationships problems with her father, causing much
confirmed BIPOLAR diagnosis
-pattern of traumatic relationships distress. She also is unable to find creative outlets during depression,
and cannot write during extreme manic episodes due to lack of cohesive
my mood swings.
-history of inconsistent medication though patterns. Q: What was the mania like when it was escalated?
schedules At time of admission, the patient reported racing thoughts, could not A: Like being a balloon going up into the sky. You keep going up
sleep, and had racing thoughts.
-goals: continue to write and perform, After implementation of medication, the patient has moderate symptoms and it gets faster and faster until you can’t see the ground anymore.
lose weight, repair r.ship with dad but has returned to her regular lifestyle.
I stop being able to connect.
-weaknesses: impulsivity, inconsistency
Q: What kind of problems has this caused in your personal and professional life?
Recommended Interventions A: The relationship with my daughter is affected because I can’t
-ECT for depression
Presenting Problem
properly care for her. It inhibits my writing. I haven’t been able to
-Solution Focused Brief Therapy--instilling life heal the relationship with my dad.
-trouble regulating moods with skills that will help reduce stress and trigger the Q: What would you like to get out of our time together
medication onset of symptoms A: I would like to figure out how to stop the moods. I have never The graph shows the patient’s up’s and down’s
-concerned about effect of her disorder -Enhancement of communication skills--to assist been good at following a medication schedule. experienced in the recent years. The prediction is that
she will likely experience a depressive episode since she
on her daughter in repairing r.ship with dad; building a better r.ship is currently recovering from a manic episode.
-fear of cycling into depression with daughter
Q: What are some things that you have tried that offset the moods? Part of the treatment utilizes ECT therapy in order to
reduce the severity of depression.
-Continued monitoring of medication schedule A: The medication helps. Sobriety. A good support system.