Bipolar Disorder Case Study on Diagnosis, Treatment, and Recovery

Patient Information:

• Age: 32
• Gender: Female
• Location: Mumbai, India
• Background: Working professional, marketing executive

History or Cause:

The patient, 32, is from a middle class household in Mumbai. She showed mood swings from a young age. However, these were dismissed as a part of her personality. Her family referred to her as “intense” and “highly energetic”, particularly during her teen years when she participated in numerous extracurricular activities. She was known for her creative epochs but also for periods of serious withdrawal and sadness, especially when she would withdraw from her friends and family. 

Her parents were supportive but not intimately aware of her emotional fluctuations. They blamed her mood swings on typical teenage angst and academic pressure. Her dad, a businessperson, had a reputation for mood instability himself: frequently having bursts of energy followed by exhaustion. Her mom, a homemaker, was more emotional and found it hard to discuss her personal difficulties at home.

Throughout the patient’s twenties, she had more severe mood swings but continued a successful career in marketing. Her highs included overconfidence, too much work hours and grand plans for future projects. In those periods she'd overcommit to work and social engagements and then cancel them when the emotional crash struck. When depressed she would feel exhaustion, self doubt and failing to perform and would take some time off work to manage. She experienced her very first major manic episode at 29. This was characterized by rash spending and unsafe choices which prompted her to leave her job on a whim and go alone abroad. Immediately after this particular trip she suffered a serious depressive state for several months or more, failing to get out of bed or do something daily. Her family recommended her to visit a professional but she declined, citing work burnout. Her family only intervened when she experienced another manic episode at 32 years old, this one more severe.

Her choice to quit her job again, impulsive financial choices and strained friendships drove her family members to look for professional assistance. The patient herself started to recognize that such mood swings weren't something she could control by herself. Her parents and family encouraged her to get treated at Jagruti Rehabilitation Centre where she would start her journey towards recovery.

Diagnosis:

On arrival at Jagruti Rehabilitation Centre the patient underwent a psychological assessment. The clinical team of skilled psychologists evaluated her condition through structured interviews, mood charts and past medical history. The professionals ruled out some other potential mental health disorders and diagnosed her with Bipolar I Disorder, characterized by episodes of depression and mania.

Her manic episodes were described as lasting several days where she was loaded with energy, too optimistic and made risky choices. These were followed by depression episodes, where she lost interest in life, became very tired and powerless. Additionally, she displayed anxiety and moderate insomnia, especially during her manic phases. The diagnosis provided her and her family clarity on what was impacting her life for so long.

Treatment:

Knowing that bipolar disorder needs to have long-term management, the team at Jagruti Rehabilitation Centre devised a 12 week treatment program that aimed to stabilize her mood and give resources to maintain long-lasting wellness.

Approach:

Mood stabilization and emotional regulation were the important components of the treatment plan developed. It involved medication management, psychotherapy and lifestyle adjustments.

Program:

• Cognitive Behavioral Therapy (CBT): CBT was used to help her control her thoughts and behaviors in depressive and manic episodes. The sessions covered: 

• Recognizing and challenging distorted thinking patterns.
• Learning to cope with depressive feelings.
• Tactics for recognizing early warning signs of depression or mania.
• Psychoeducation: The patient attended educational sessions on bipolar disorder and its management to understand the nuances attached with bipolar disease. This included: 

• Maintaining a steady routine and sleep schedule.
• Stress management along with relapse prevention techniques.
• Family Therapy: Her family was part of her treatment. Family therapy sessions were put together to: 

• Inform her family of the condition.
• Improve communication and enable them to understand her needs.
• Rebuild trust and support in the family dynamic.
• Mindfulness-Based Therapy: For self-awareness and emotional regulation purposes the patient did mindfulness exercises. This enabled her to stay grounded and control her overpowering emotions, especially the depression episodes.

Medical Treatments:

• Mood stabilizers: These were prescribed for her mood swings. The objective was to control her depressive and manic episodes with a lesser number of unwanted side effects.
• Antidepressants: In smaller doses, antidepressants were added during her depressive phases under close surveillance.
• Sleep Aids: Short-term sleep medicine was prescribed for her insomnia.

Therapy:

• Individual Therapy: Weekly one-on-one consultations with her therapist helped her process her emotions, frustrations and progress. She learned to observe her moods and recognize triggers that may send her into depression or mania.
• Group Therapy: Group sessions with others who faced similar challenges gave her a sense of being part of a community. Sharing her stories and paying attention to others helped her feel much less alone in her difficulties.
• Lifestyle Adjustments: Part of her treatment included establishing sleep and exercise routines to stabilize her mood. The structured environment at the rehab facility offered her great relaxation.

Improvements/Recovery Timeline:

• Week 1-2: Initial Stabilization - Upon arrival, the main objective was stabilizing her mood. Within the very first 2 weeks she was monitored while her medication was modified by the healthcare team. The manic tendencies diminished and her mood swings reduced.

• Week 3-4: Beginning Therapy Sessions - Her mood stabilized and she started individual therapy sessions. Group therapy made her understand she wasn't on her own with bipolar disorder.

• Week 5-8: Emotional Awareness along with Routine Development - In this phase she started practicing mindfulness and lifestyle modifications. She became conscious of her emotional patterns by recognizing early symptoms of depression or mania. Additionally, she started gaining command of her daily routine, managing stress and staying away from emotional triggers.

• Week 9-12: Consolidating Gains - By this particular time her mood had stabilized and she knew her condition better. Her sessions focused on maintaining the positive changes she'd made. She began to feel certain she could manage her disorder outside the organized setting of the rehabilitation facility.

Our Success:

Treatment at Jagruti Rehabilitation Centre changed the patient's life. By the conclusion of her stay, her mood was stable and she had tools to control her condition in the future.

Impact on Patient's Life:

The patient was overwhelmed before treatment with the variability of her mood swings. Following the program, she stated she was more in control of her emotions and confident she can handle the highs and lows. She returned to her work with purpose and stability and reconstructed relations with family and friends which were strained by her condition.

Family and Community:

Her mood stabilization in addition to expression of feelings improved enormously for her family. They learned how to support her in ways that promoted her wellbeing through family therapy. This enhanced their relationships and her support system in her own home helped her maintain her success at home.

Future Steps:

She needed to continue her progress and stability in her everyday life after her time at Jagruti Rehabilitation Centre. Future steps for her continuous care included:

• Continued Outpatient Therapy: The patient was encouraged to attend outpatient therapy once per week to observe her mood and balance her triggers. 

• Medication Management: Medication monitoring was scheduled at regular follow ups with her psychiatrist. 

• Lifestyle Maintenance: The patient was urged to keep a healthy routine which included constant sleep patterns, consistent exercise and mindfulness to help manage her mood and avoid further episodes.

• Support Groups: She was also invited to enroll in a local bipolar support group so she can continue sharing her knowledge and learning from others going through similar battles. This peer support was regarded as crucial for emotional stability.

Following these measures and remaining connected with her support system may enable her to continue living a significant life while controlling her bipolar disorder.