Introduction
Mental illness, also known as bipolar disorder, is a mental health illness characterized by significant mood fluctuations such as emotional hypomanic symptoms and sadness. Mood swings might occur infrequently or frequently throughout the year. While most individuals will have emotional problems in between bouts, some will not. Although the bipolar illness is a chronic condition, patients may control their mood changes and other indicators by adhering to a care plan. Bipolar disorder is often treated with medicines and psychological treatment (Carvalho et al., 2020). There are several forms of manic depression and associated illnesses. Mania or hypomania, as well as depression, may be present. The client is a 26-year-old lady of Korean origin who comes in for her first consultation after being hospitalized for 21 days for the development of severe mania. The patient has experienced at least one manic episode, which might have been accompanied or preceded by a hypomanic or severe period of depression. This work was written to study a particular case of mental illness in a woman of Asian American descent.
Decision 1
By comparing the effects of some of the medications provided, I was able to counsel the patient on two medications. Likening fluoxetine to amitriptyline, the issue of efficacy was predominant on sleep factors. The patient reported having difficulty sleeping, and therefore, it was important to advise her on the appropriate medication to use to have a better sleep (Hirschfeld, n.d.). When using amitriptyline, the patient would encounter more unwanted effects, and their frequency would be more severe. However, by using fluoxetine, the patient would encounter relief against major depression, particularly that resulting from anxiety (APA, 2010). Furthermore, with Seroquel approved for the treatment of depression on bipolar patients, the patient would encounter a greater improvement in bipolar-related depression symptoms with her overall life quality and satisfaction in how she functions. Risperidone is useful in treating specific mood disorders, like bipolar-related mood disorders (Traeger et al., 2016). The medication is effective in helping the patient think clearly and helps in participating in everyday life by helping restore the balance of certain natural substances within the patient’s brain.
Even with the list of potential medication, I have selected to start her on Lithium 300 mg orally BID because this is what she was administered while in the hospitalization, which gives compelling evidence that she reacted well enough to the medicine to be released with a regular dose. I was hopeful that by beginning the Lithium, the patient would be able to return to her wildly in the post position. Lithium therapy is complete remission of bipolar, treat until complaints have faded or recoveries are stable, and maintain medication with continuous improvements noted in order to avoid recurrence (Perlis & Ostacher, 2016). When she reappeared to the physician four weeks later, there had been no development from her original appointment. This was owing to her failure to take medicine as prescribed.
Ethical Considerations
Due to the common signs of mania in bipolar illness, as shown in this patient, judgment is compromised during the acute period. Patients suffering from hypomania can generally operate in social and occupational settings. It is still debatable because bipolar disorder impairs the patient’s capacity to make solid judgments and decisions during significant episodes. Interventions raise ethical concerns for physicians about the extent to which patients can engage in decisions about their medical treatment. Finally, it is critical to assess the patient’s capacity to safely make treatment decisions and to examine the ethical ramifications of doing so when one’s cognition is clouded by a severe shift in emotions.
Decision 2
During this stage, I will address the patient’s reasons for disobedience and lecture her on why taking the prescription medicine would be significant in helping her overcome the challenges caused by her condition. I would demonstrate the impact of Lithium’s efficacy on her condition and explain to her how the medication had been helpful when she was using it before. Through the explanation, the patient would understand why she began feeling a positive self. In addition, I would make it clear that quitting the drug suddenly after usage may result in a resurgence of her mania, which is what brought her to me in the first place. Moreover, I would ensure to advise the patient on the possible effects of withdrawing from Lithium during reliable repair work in patients. Particularly among patients presenting with schizophrenia and bipolar disorder, withdrawal has a high risk of preterm birth occurrences of illnesses, particularly mood swings. I hoped to increase adherence to the medication regimen and see some results. When the woman went to the hospital, she reported vomiting and constipation, two frequent side symptoms, and she was still not using the medication regularly with this choice.
Ethical Considerations
Likewise, due to the common signs of mania in bipolar illness, as shown in this patient, judgment is compromised during the acute period. Patients suffering from hypomania can generally operate in social and occupational settings. It is still debatable because bipolar disorder impairs the patient’s capacity to make solid judgments and decisions during significant episodes. Interventions raise ethical concerns for physicians about the extent to which patients can engage in decisions about their medical treatment. Finally, it is critical to assess the patient’s capacity to safely make treatment decisions and to examine the ethical ramifications of doing so when one’s cognition is clouded by a severe shift in emotions.
Decision 3
I had initially planned to switch the patient from Lithium 300 mg orally BID to Depakote ER 500 mg at HS. I made the decision to switch since I believed she would handle another drug better than Lithium 300 mg orally BID. The outcome of the intended switch would require greater cooperation from the patient, presumably, resulted in her madness being completely cured. According to the student advice, while nausea and diarrhea are common symptoms, switching to an extended-release formulation typically prevents them from developing. As a health practitioner, I understand it is my responsibility to discuss the issues with the patient. That is the case since it is a requirement described in the Prescribers Guide. My main objective as a health professional currently is to support the patient with her core condition. To be able to realize this, my mandate is to educate the patient on the importance of adhering to prescriptions and the potential effects of withdrawal. I had also disproved the reason I had initiated her on Lithium 300 mg orally BID in the very first circumstance. The reason for the disapproval was founded on the role played by Depakote ER 500 mg at HS on her possibility to be completely cured.
Ethical Considerations
Due to the common signs of mania in bipolar illness, as shown in this patient, judgment is compromised during the acute period. Patients suffering from hypomania can generally operate in social and occupational settings. It is still debatable because bipolar disorder impairs the patient’s capacity to make solid judgments and decisions during significant episodes. Interventions raise ethical concerns for physicians about the extent to which patients can engage in decisions about their medical treatment. Finally, it is critical to assess the patient’s capacity to safely make treatment decisions and to examine the ethical ramifications of doing so when one’s cognition is clouded by a severe shift in emotions.
Conclusion
Because functioning is a complicated and demanding undertaking, psychiatric nurses should assess the client’s function not only during admission but also throughout remission and prepare for rehabilitation treatments. However, it is critical to return the client to his most extraordinary potential level of ordinary life by organizing excellent disease therapists, individual counseling, and offering problem-solving methods to the patient and the family. Many medications are available to treat bipolar illness, but the expert must carefully pick the prescription that will be the best treatment for the patient. It is essential to understand that genetics impacts medication absorption, administration, evacuation, and circulation. Moreover, some patients encounter different reactions when prescribed antidepressants. The reason associated has been antidepressants have the potential to trigger bipolar disorder or mania and are as such not recommended, especially when used alone. Therefore, when used, antidepressants should be used concurrently with mood stabilizers since while they suppress depressive symptoms, they might trigger the condition. Drug use among bipolar patients should therefore be used as necessary.
Bipolar disorder generally starts in early adulthood, while the symptoms can occur at any time. Everyone with bipolar illness and is pregnant or expecting to be pregnant should explore the likely impacts and any required modifications to treatment with their healthcare provider. Some drugs for bipolar illness can influence how birth control tablets work because they stimulate the synthesis of liver enzymes. Treatment for bipolar illness varies wildly, depending on a person’s individual symptoms. The prescription of Asian-descent bipolar illness must be done with caution and in compliance with the Food and Drug Administration’s standards. Finally, the practitioners’ primary concern should be the client’s safety as well as the well of friends and relatives.
References
American Psychiatric Association. (2010). Practice guideline for the treatment of patients with bipolar disorder (2nd ed.). Web.
Carvalho, A. F., Firth, J., & Vieta, E. (2020). Bipolar disorder. New England Journal of Medicine, 383(1), 58-66.
Hirschfeld. R. M. A. (n.d.). Guideline watch: Practice guideline for the treatment of patients with bipolar disorder (2nd ed.). Web.
Perlis, R. H., & Ostacher. M. J. (2016). Lithium and its role in psychiatry. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.). Massachusetts General Hospital Psychopharmacology and Neurotherapeutics (pp. 48-60). Elsevier.
Traeger, L., Brennan, M. M., & Herman, J. B. (2016). Treatment adherence. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.). Massachusetts General Hospital Psychopharmacology and Neurotherapeutics (pp. 20-26). Elsevier.