Case Conceptualization of Bipolar Depression - Essay Example

Identifying Data

Peter is a 40-year old African-American ex-con who checked in at our office earlier this week. Peter wore a shattered look, and from his appearance, he looked unhappy or stressed. As he waited in the lobby to be enrolled in the registry, Peter was restless and walked to the attendant desk on several occasions, disobeying the queuing rule. His appearance indicated low hygiene; I guessed from the job he works in or maybe lack of personal hygiene. Health deterioration was surely noticeable on the face of the client, which made him look uncomfortable. He was also shy when around people and could not maintain eye contact. High temper could be spotted on his red, tired eyes every time he expressed himself.

Presentation of the Problem

Peter had been in jail for three and a half years. Since his release, which happened recently, he has under the supervision of the parole office. The parole office notice that Peter was having problems managing his temper and therefore recommended him to our facility. Some of the friends and family had also forwarded concerns about Peter's anger to his parole officer, fearing that it would again put him in trouble with the authorities. Since his release from prison, Peter has been having family issues, first; his mother had died during his time in prison and was never told, secondly; Peter found out that his wife had been having an affair with one of his cousin.

Why the Client is More Vulnerable

Peter was raised single-handedly by his mother since his father disappeared before he was born. The mother was forced to take double shifts to make ends meet. The busy schedule of the mother made Peter lonely and sought to find friends in the streets. Lack of parental guidance and poor choice of friends made Peter get into drug trafficking, where he got into trouble with the authorities. His history, coupled to the recent events that had happened in his life, including his mother's death and wife's affair with a cousin, had made him susceptible to Bipolar Depression. He could easily get mad with people or even little things that did not matter. Although he hadn’t used drugs for three and a half years, the low state of mind was tempting him to use drugs to suppress emotions. If the core issue, Bipolar Depression, is not resolved, it will be difficult for him to get by every day.

What Triggers the Patient?

What triggers the condition of Peter is the interconnection of both mental and environmental factors. Psychological factors include thoughts of losing his mother, losing his wife, and blaming the absent dad. Peter seems to be battling the guilt of not being for his mother during her last days. Another probable trigger is that Peter feels things would have turned out better if his father had been present. Environmental factors that might have triggered Bipolar Depression in Peter might have been caused by the inability to adapt to the outside world after spending life in prison. Failure to get sleep, and deep sadness might have facilitated the right environment for manifestation of Bipolar Depression. Betrayal, by a family member (Cousin) who had an affair with his wife, also worsened the situation.

The patient's Core Beliefs

During my brief interaction with Peter, I realized several disparities in his beliefs about life matters. One outstanding belief was the perception of marriage. Peter's constant fights with his wife since he got released from prison had changed his attitude of marriage. He termed marriage as a fraud that takes a lifetime to repeal. Though he believed that his married life had turned out sour, he could not give up on it without giving a fight. He had married his high school sweetheart and could not imagine that she betrayed him, after all, that time. Peter is a religious man, and this is evident through how he wished his mother to rest in peace with the angels in heaven. He also hopes that God punishes his father for neglecting him and his mother before she was born.

Memories, feeling, sensations and central thoughts that the patient is avoiding or fused with

One of the issues that Peter avoids talking about was his father's absence when he was growing. When asked what he felt about his father not being around him when he was growing, he shunned the question, saying he did not want to talk about him. Another thing that Peter felt uncomfortable talking about was divorce. When asked whether he could consider divorcing his wife and starting a new life altogether, Peter became furious and restless, indicating that he was not ready to talk about the matter. Peter was also fused with talking about his life when he was back in prison. This part of him seemed like unchartered territory, something that he won’t be ready to open up about any time soon.

Diagnosis

The symptoms of the patient showed that Peter had an underlying mental problem. Further tests found that Peter was suffering from Bipolar Depression, an issue that had bothered him all his life from childhood. The condition might have been escalated by marriage problems and adapting to the outside world since he was released from prison. Other signs that helped in the diagnosis process was the attitude of Peter of various life matters, anger, and sadness that consumed him from the inside provided the basis for the diagnosis.

A treatment plan for Peter

During the management of Bipolar Depression, both therapy and medication are applied. Medication is directed towards suppressing the symptoms, and the treatment is entirely dependent on the needs of the patient. The primary medicines prescribed for depression patients include; antidepressants, antipsychotics, mood-stabilizing drugs, and anti-anxiety medication (Dixon, Holoshitz & Nossel, 2016). Psychotherapy treatment will entail scheduled meetings with a psychologist. The therapy sessions will help the psychologist monitor Peter's response to the drugs prescribed and whether his condition was improving. Acceptance therapy (ACT) would also be very necessary. Acceptance therapy is a behavioral treatment that enables people to cope with emotional pain and, hence, feel better (Jefferies, 2018). This therapy would help Peter cope with life after losing his mother and fidelity of his wife when he was in prison. If properly followed, the treatment plan will help Peter overcome Bipolar Depression and move on with life.