Answer

Treatment Plan for Mood Disorder

Bipolar is a psychological disorder that is characterized by periods depression and abnormally elevated moods that last for days to weeks each (American Psychological Association, 2013).  Grande et al. (2016) note that if the elevated mood is severe or linked to psychosis, it is referred to as mania (Bipolar I disorder), but when it is less severe, it is called hypomania. During mania, a person feels or behaves abnormally irritable or happy, and often makes impulsive choices with little or no regard for the repercussions (Geddes & Miklowitz, 2013). Also, during maniac stages, there is minimized need for sleeping. During depression periods, the individual may exhibit crying and have negative outlooks about lie and poor eye-to-eye contact with other people (Grande et al., 2016). There are high risks of suicide, self-harm, or other mental health issues, like substance abuse and anxiety disorder (Geddes & Miklowitz, 2013). To remedy the disorder, mood stabilizers, like lithium and some anticonvulsants (such as carbamazepine and valproate) are the backbone for long term relapse prevention (Grande et al., 2016). During acute maniac, antipsychotics are given. This paper aims at creating a treatment plan for Andrew, a 26-year-old man a patient living with bipolar type 1.

Bipolar disorder is a enduring condition that runs an unpredictable course off downs and ups. Let untreated, American Psychological Association (2013) states that the downs and ups can be devastating. The recurring depressive and manic phases that characterize the disorder make it hard to lead a productive and stable life. There are several treatment options available for the disorder. Mood stabilizers, like valproic acid (Depakene), valproic acid (Depakene), divalproex sodium (Depakote), lamotrigine (lamictal), and carbamazepine (Equetro, Tegretol and others), antipsychotics, like olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), ziprasidone (Geodon), aripiprazole (Abilify), lurasidone (Latuda), ziprasidone (Geodon), asenapine (Saphris), antidepressants, antidepressant-antipsychotic, and anti-anxiety medications.

For Andrew’s case, the medication I would use is Lamictal 25 mg po qd x week. For week two, I would increase the dose to 50 mg, then to 100 mg in week three, and finally increase the dose 200 (which is the maximum dose) for week four onwards. The choice of the drug is informed by the fact that Andrew is a construction worker who will sweat and have electrolyte irregularities with lithium (American Psychological Association, 2013). Equally, Lamictal does not require monitoring and has prophylactic anticonvulsant, antidepressant, and ability to stabilize mood properties (Geddes & Miklowitz, 2013). If Lamictal does not eliminate Andrew’s mania, we can add Abilify.

Regarding initial lab and blood tests, I do not think I would need to check such. According to American Psychological Association(2013), lab report is not needed for a patient who is taking Lamictal: it has not been agreed upon or approaved that the Lamictal’s concentration in a patient’s blood plasma is mandatory when treating a bipolar patient. Nevertheless, owing to the fact that Lamictal sticks to an individual’s melanin-containing tissues, tests to assess one’s vision and capability of focusing and discerning objects (referred to as ophthalmological examinations) may be considered for Andrew’s case as supported by (American Psychological Association, 2013).

While there are a myriad of therapies that can be used in Andrew’s case, the most appropriate one is psychoanalytic. According to Grande et al. (2016), psychoanalytic therapy is based upon psychoanalytic theories concerning mania and depressive states’ management with the objective of changing a person’s personality, behaviour, or character, relieving the individual of signs and symptoms by improving their capability of interpersonal trust,  intimacy, coping mechanisms, experiencing a myriad of emotions, and grief levels (American Psychological Association, 2013). The therapy is appropriate for Andrew because it will help him get increased phases of anxiety and distress for a period of time, allowing him to eventually stabilize.