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Mental Health Essay Analysing Medical Condition of Bipolar Affective Disorder

Question

Task: The purpose of this mental health essay is to assess your ability to critically examine the treatment plan of a consumer presenting with complex care issues with a view to achieving better outcomes.

In a number of mental health settings (in-patient, community, rehabilitation etc) clinical reviews provide the opportunities for the interdisciplinary care team to engage in discussions about the care that is provided to consumers particularly in situations where the usual treatment is resulting in poor health outcomes for the consumer. As Clinicians we often reflect on the care we are providing to consumers and wonder if a different treatment approach could produce better outcomes. Some examples that could be considered include: a consumer that may be experiencing multiple readmissions, a consumer that poses a high risk of violence and aggression or a consumer that is continuously experiencing drug and alcohol issues. It could also be serious physical health issues complicated by the mental state. These issues have a tendency to lead to poorer health or recovery outcomes for the consumers. Since everyone works within different clinical settings, below is a suggestion on how to decide the consumer to choose.

Suggestion on how to choose consumer for Review:
There are 2 ways you can choose the consumer (retrospectively or prospectively):
1) Retrospective: This could be a consumer that you have worked with and the intervention that you describe has already been put in place with success either by you or the team you are part of.

2) Prospectively: You can choose a consumer you are working with who is experiencing these issues and you are proposing a new course of action.

Instructions:
1. You are to provide a detailed background (completely de-identified) of the chosen consumer. This would include their history and the main issue of concern that makes this a complex case requiring a critical clinical review.

2. Provide details of the previously (or currently) trialled interventions for this particular consumer and the outcomes that this has produced. Provide possible explanations as to why you believe previous interventions have been unsuccessful.

3. Provide a clear, detailed and evidence-based intervention that could be trialled to produce a better outcome for the consumer or what was put in place. This section is very crucial, and you will need to be quite specific on how your intervention is distinct from what has been tried previously. You will also need to state the outcome measures you will use to indicate success.

Answer

1. Introduction
It is evident herein mental health essaythat social deprivation, mental health challenges, and multimorbidity are complex issues in the public healthcare sector that create needs for special care and service for patients. It is no different in the case of selected consumers in public health with complex mental health problems that require medical and psychosocial assessment equally. Co-morbid physical conditions of patients with mental health problems create challenges for complex treatment that cannot be done through sole intervention. This essay presents a detailed background of selected consumers from a retrospective aspect through an evidence base for implemented interventions. Successful interventions will be mentioned in this case along with a distinctive approach of the intervention to measure indicated success.

2. Background of chosen consumer
The chosen consumer suffers from severe mental illness (SMI) related to bipolar affective disorder with physical complications such as cardiovascular disease and diabetes. Bipolar affective disorder in this patient is identified at the age of 45 that is also interlinked with the occurrence of this disease. It has also been identified in the case of present patients that social determinants of health such as condition of family income and support from friends and other family members played a vital role in this case (Abdel et al. 2019). Along with that, side-effects of medications, sleep disturbance, and lifestyle have also affected the entire procedure of facing problems regarding managing overall conditions of mental health of the patient.

Name of the patient is Zara Mandock, a banker of 45, and she has five children. She does not get enough time to have a proper diet and exercise. At the same time, she only gets the opportunity to have junk and fast food at the time of lunch, and she often skips lunch due to work overload. This lady also has a habit of smoking, and she smokes 5-6 cigarettes per day. At present, she has shared her experience regarding depressive and manic episodes while trying hard to maintain work-life balance (Carpenter et al. 2019). Sometimes, she experiences excessive strength and “euphoria” with a tendency of showcasing her creativity and perception. At the same time, self-confidence and activities reach to an extent sometimes while sometimes, she witnesses decreased sleep, energy, and strengths.

Sometimes, she feels extreme irritability, unpredictable and rapid emotional changes due to changes in the environment of her life. Prolonged sadness, feelings of guilt, difficulty concentrating, major changes in eating and sleeping habits, along with lack of interest in normal activities come with depression in this consumer. Delusion was witnessed in the case of Zara when it comes to providing support and care to her.

3. Trialled interventions
Active participation of the patient was the most essential aspect of the trialled interventions in the case of helping Zara to get rid of her complex situation related to bipolar disorder and physical issues. Isolation is the critical aspect that should be out of the process to help the patient to recover from any critical situation. In the first days working on this case, the consumer went through a physical examination. These examinations include lab tests for the multi-morbid conditions, including diabetes and cardio-vascular diseases (Carvalhoet al. 2020). For example, in this case, the lab-tests identified that this consumer was in need of proper support and care of the patient from the point of view of physical fitness.

In this phase, the practitioners have talked to the family members of Zara to identify the exact position of the mood changes and critical aspects of going beyond problems of this consumer. For example, close friends have identified that Zara has a problem of not having proper dietary charts and exercise. At the same time, she does not behave consistently in any perspective (David et al. 20187). Sometimes, she feels excessive happiness and strengths to work harder; however, sometimes, she feels less motivated and fails to work efficiently. Therefore, mood charting is another critical aspect that has helped in completing this treatment rightly after diagnosing the major issue. Medication was the first thing that was used in this case to provide a better service and care to the consumer after identifying her needs. She was not interested in staying in the health centre to stay fit. However, with passing time, she continued the treatment through counselling on having required medicines as prescribed time (Gordovez& McMahon, 2020). It has been identified in the case of Zara that she was not interested in taking medicines for her cardio-vascular diseases and diabetes on time. This approach affected her health, and it has increased chances for falling sick frequently. With depression and full-blown mania she failed to create a better dimension in her life that could help her to get counselling support as per proper need.

Risk management was another critical part of the medical intervention that has been maintained to identify the potential risks that could harm her life. For example, extreme positive behaviour and negative approaches towards counselling could affect the entire process of meeting expected outcomes on time (Linardonet al. 2017). It has also been identified that difficulties regarding managing bipolar disorder needed to be identified to eliminate them. From that aspect, it became easy for the entire team to identify the major issues regarding feeling depressed in the case of Zara. For example, her habit of smoking increased her risk towards heart disease, diabetes, lung diseases, and stroke.

In this case, diabetes and heart disease were present in the case of Zara. Therefore, it became essential to create better opportunities for the consumer to know about risks of consuming such things. Along with that, cognitive behaviour therapy was used all through the intervention process to let her feel better in such a situation where she was expecting motivation and care from the practitioners.

Self-monitoring is the only concern of Zara that helped her to understand the importance of staying fit and fighting this issue. It was jot possible for her to manage the entire situation without working efficiently to have medicines on time (Miller & Black, 2020). For example, 6-month follow up have helped the practitioners in the case of Zara to manage her situation along with identifying the unique prodromal symptoms through timely medications. Mental health professionals played a critical role in treating Zara through action plants and prompt treatment. For example, simple intervention of clinical practices has helped in managing the general psychiatric practices to meet the expectations of the consumer regarding her treatment. It has also been identified that community samples are other essential aspects of providing cognitive behaviour therapy. For example, it is not possible for the medical practitioners to give only medicines and treat the consumer without her proper help. In this case, Zara has played the most important role in identifying the reasons for such an issue. It has also been noticed the positive interests of Zara to stay happy and fine. In such a condition, timely medications for the treatment have helped in sensitising the entire system of help.

Anti-depression medication has equally helped to manage the case of Zara along with recognising her abnormal moves related to consequences and different mood states. Depressive symptoms have helped in reaching a conclusion regarding if the medicines and the therapy of motivation and cognitive behaviour is working or not (Linardonet al. 2017). In the case of Zara the positive participation of the consumer has only helped in identifying the nature of the improvement of her situation. Mood stabilizers medication has also helped in addressing the remission and symptoms of improvement. Moreover, recording and documenting the entire procedure of improving conditions of Zara have created slow improvement in practicing positive conversations with acquaintances, family, and friends. Primarily, CBT reflects the importance of implementing therapy to treat people by interacting with others along with showing emotions.

This therapy helps in treating people with different mental health problems when it comes to behavioural changes. For example, Zara behaves differently as per the changes in the circumstances and her mood. A Consistent approach towards any aspect is absent in the case of Zara that requires it to be implemented (Rowland &Marwaha, 2018). However, it is also crucial to understand that it has helped in changing the behaviour of Zara. However, this process has helped the health practitioners to manage the entire process as Zara is a sensible lady. Most importantly, Zara was aware of every activity that she was doing under impulsive anger or happiness. Moreover, she felt helpless sometimes after reacting to any situation. In such a condition, it was only medication that could help her.

The problem of Zara regarding medicines was mainly only about her less time to focus on the healthy habits and processes to manage her health. In such a condition, she was expecting to get help from the practitioners regarding having food and medicine on time. At the same time, the team provided singing and painting classes to Zara. The consumer revealed that she was so much interested in singing and painting in her young age, and with the passing time she failed to fulfil her dreams and continue her habits. In such a condition, a long break from her work happened due to her hospitalisation, and she was becoming more exhausted as she was in love with her work. However, she has found support and care from the group of practitioners in the form of a positive attitude when it comes to meeting her emotional needs.

Social, emotional, and cognitive needs of the patient were identified and tried to be me in this case. This approach has also helped in eliminating discomfort from her life by providing her counselling on the identified issues. It has been noticed that the consumer was partly happy with her life as she had five children and a wonderful family without having any emotional breakdown from the aspect of her family. On the other hand, she had issues related to confrontations in her working life along with her promotions even after working so well. Due to this reason, these practitioners have developed a framework of helping her through CBT interventions. This approach of helping her to find herself again in the form of her painting and singing has helped her in practicing new skills to showcase her talent. In this way, she started to stay happier from inside.

Identification of negative thoughts was another efficient approach of the team to manage her depression and disorder to go beyond any issues. Self-discovery is the only critical thing that was done all through the intervention. Along with that, triggering a relapse has been avoided in the case of the consumer to set goals and solve problems. Goals of this consumer revolve around having mental fitness and life-goals (Vietaet al. 2018). For example, she started to reveal her capacity to find time-based approaches that are relevant and measurable to reach a proper conclusion. In this case, self-monitoring is another critical part that has helped the practitioners to help the entire process of managing the intervention by encouraging her to have a proper diet and follow instructions regarding exercise.

4. Interventions for better outcome
Successful intervention of CBT was the only concern of the intervention along with helping the consumer to get the expected outcome. It was no different in the case of Zara as she started to go beyond anxiety and depression that could affect the entire procedure of managing relationships and maintaining the behavior all through the participation in this medication process. Behaviour and feeling are parts of lives that can help the patients to create better memories for them while getting treatment. Practitioners in this case were active in recording the improvement of Zara every now and then. At the same time, the challenges were also measured in her case to go beyond those aspects. For example, keeping track of paperwork and data regarding her improvement along with the procedure of managing diabetes and cardiovascular diseases have also helped practitioners to support the consumer.

Thought exercises have assisted Zara to know herself better. It is not possible for anyone to grow more efficiently in both professional and personal life without having patience to keep mental health positive. In such a condition, Zara goes through the entire plan of treatment. This aspect has helped her to know more about her present condition and expected condition.

Most important part in the case of Zara was to help her know about the consequences of her present condition along with the possible positive impact of the therapy that can change her life forever. In this aspect, her mental health conditions and work environment have a keen relationship as she used to become depressed in her working environment due to not getting proper support from family and friends (Carpenter et al. 2018). In such a condition active participation of family members in supporting or have also helped in this case. Moreover, it would become easy for the patient to stay normal after getting the opportunity to show her talent and skills. In such conditions, positive practices of her singing and painting have helped her to manage the process of releasing her emotions.

Determination of the physical condition of the patient has also helped in creating the plan and framework to manage the disease and disorders. For example, bipolar disorder is quite common among the Australian population. However, the government is providing 24 hours care to the patients to go beyond the boundaries and barriers of the illness. In this case, positive support from the practitioners has helped in involving the families and friends in this intervention. Most importantly, Zara could not become successful in becoming an active part of the intervention without having personal motivation. Hence, self-motivation and confidence have helped in reaching the required dimension of health and care. Mobility in the entire process of delaying the task has helped in creating examples in the field of CBT. It has also been identified that this therapy often comes with insufficient support to the consumer related to complex situations. However, the practitioners identified equal opportunity and risks regarding working in this field. It has also been noticed the creative approach of the situation that could involve every activity of the patient to reach the expected outcome (Carvalhoet al. 2020). Community and population related to disorders such as bipolar conditions can only get sufficient support by identifying reasons for such a fact. Moreover, this intervention becomes successful only after identifying the process of eliminating the reasons for Zara's life to manage these issues.

5. Conclusion
The essay revealed every aspect of the mental health condition of the chosen consumer when it comes to providing a proper intervention successfully to meet the expectations. Along with that, it was also essential for the determinant of success in this case of treatment. For example, mood swings were identified in the case of Zara all through her activities. In such a condition, anti-depression medications and lab tests were done to check the physical fitness of the consumer. Diabetes and cardiovascular disease were noticed in the case of Zara that have created complexities in managing her treatment. The practitioners use CBT to manage the entire procedure of physical fitness along with mental fitness through proper medications and therapy. ?

References
Abdel-Basset, M., Mohamed, M., Elhoseny, M., Chiclana, F., &Zaied, A. E. N. H. (2019). Cosine similarity measures of bipolar neutrosophic set for diagnosis of bipolar disorder diseases. Artificial Intelligence in Medicine, 101, 101735.https://www.sciencedirect.com/science/article/pii/S0933365719303021

Carpenter, J. K., Andrews, L. A., Witcraft, S. M., Powers, M. B., Smits, J. A., & Hofmann, S. G. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta?analysis of randomized placebo?controlled trials. Depression and anxiety, 35(6), 502-514.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5992015/

Carvalho, A. F., Firth, J., &Vieta, E. (2020).Bipolar disorder. New England Journal of Medicine, 383(1), 58-66.https://www.nejm.org/doi/full/10.1056/NEJMra1906193 David, D., Cristea, I., & Hofmann, S. G. (2018). Why cognitive behavioral therapy is the current gold standard of psychotherapy. Mental health essayFrontiers in psychiatry, 9(2), 4.https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00004/full Gordovez, F. J. A., & McMahon, F. J. (2020).The genetics of bipolar disorder. Molecular psychiatry, 25(3), 544-559.https://www.nature.com/articles/s41380-019-0634-7

Linardon, J., Wade, T. D., De la Piedad Garcia, X., & Brennan, L. (2017). The efficacy of cognitive-behavioral therapy for eating disorders: A systematic review and meta-analysis. Journal of consulting and clinical psychology, 85(11), 1080.https://psycnet.apa.org/record/2017-48283-005

Miller, J. N., & Black, D. W. (2020). Bipolar disorder and suicide: a review. Current psychiatry reports, 22(2), 1-10.https://link.springer.com/article/10.1007/s11920-020-1130-0

Rowland, T. A., &Marwaha, S. (2018). Epidemiology and risk factors for bipolar disorder. Therapeutic advances in psychopharmacology, 8(9), 251-269.https://journals.sagepub.com/doi/pdf/10.1177/2045125318769235

Vieta, E., Salagre, E., Grande, I., Carvalho, A. F., Fernandes, B. S., Berk, M., ...&Suppes, T. (2018). Early intervention in bipolar disorder. American Journal of Psychiatry, 175(5), 411-426.https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2017.17090972

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