Case study of bipolar disorder sufferer

People with bipolar disorder have extreme mood swings (symptoms). They can go from feeling as if they are on top of the world, hyperactive, creative, and grandiose- mania to feeling very sad, despairing, helpless, worthless, and hopeless -depression. This disease is called bipolar disorder because the mood of a person with bipolar disorder can alternate between two completely opposite poles, euphoric happiness and extreme sadness. The extremes of mood usually occur in cycles, in between these mood swings, people with bipolar disorder are able to function normally, hold a job, and have a normal family life. The episodes of mood swings tend to become closer together with age. When a person is in the grip of this disease, chaos can occur. Bipolar disorder can cause major disruption of family and finances, loss of job, and marital problems. In Jim’s case he becomes completely dependant of his parents.

Because of the extreme and risky behaviour that goes with bipolar disorder, it is very important that the disorder be identified. With proper and early diagnosis, this mental condition can be treated. Bipolar disorder is a long-term illness that will require proper management for the duration of a person’s life.

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Jim is in his mid fifths and he still live with his parents, whose are in their late seventies. He is the only child and his parents overprotect him over the years owing to that he became completely de-skilled, dis-empowered and total dependant. He is not able to negotiate and he was not included in family discussions to show his opinion. The only way that he has to show that he is not happy is by screaming and crying. Jim definitely also suffers from Eternal child syndrome, also know as Peter Pan syndrome, and is to blame his parents who been treated him like a child all his life.

Psychologists warn that overprotective parents can be responsible for this disorder as this prevents them from developing necessary skills to confront life. Jim chronologically grows older but in truth he has not grown up. Like Peter Pan he breaks societal norms to serve their own purposes and do not care much for the feelings and rights of his parents. He wants all the power but is not willing to share the responsibilities, not ready to sacrifice and reject moral structures which are part of mature adulthood. As the World Health Organization has not yet recognized Peter Pan Syndrome as a psychological disorder, the syndrome is not currently considered a psychopathology.

Psychologists make a clear distinction between Peter Pan Syndrome and other, more serious, mental conditions involving adults who behave as children both emotionally and mentally. This is because it is often found that people suffering from Peter Pan Syndrome are mentally fully developed adults who often carry professional activities requiring strong intellectual skills.

This syndrome is often associated with narcissism, although not in a negative way, self-centered sense. They are attracted to introspection in an attempt to find that imaginative comfort inside their own minds. On a positive sense this characteristic is seen as being in touch with the unbridled imaginational freedom of childhood. While succumbing to the prescribed order of things, most people forget all that they knew as an idealistic child, the eternal child is able to draw from their own raw, creative energy to remind us of how colorful life really is.

Men suffering from the Peter Pan Syndrome display the following traits in their relationship with parents:

Are obsessed with their mothers

Have estranged relationship with the father

They believe that it is not possible to obtain the father’s love and approval

They have difficulty interacting with figures of authority

Are not mature emotionally

Exhibit silly behavior

Hide their inner insecurity with macho attitude

Males diagnosed with having this syndrome were found to exhibit the following psychological traits:

Either exaggerated or paralyzed emotions

Anger taking extreme form of rage

Joy turning into hysteria

Disappointment grows and develops into depression or self-pity

As a result males diagnosed with this syndrome find it difficult to express love, refuse to share feelings, feel guilty and have difficulty relaxing. Men with Peter Pan Syndrome find it difficult to make genuine friends and as a result feel desperately alone.

They don’t feel sorry for inappropriate actions but blame others for their shortcoming.

Males diagnosed with having this syndrome were found to exhibit the following psychological traits:

Either exaggerated or paralyzed emotions

Anger taking extreme form of rage

Joy turning into hysteria

Disappointment grows and develops into depression or self-pity

As a result males diagnosed with this syndrome find it difficult to express love, refuse to share feelings, feel guilty and have difficulty relaxing and find difficult to make genuine friends and as a result feel desperately alone.

This has a huge impact in Jim’s parents who are finding difficult to cope with all this matters, especially in during the winter. They are gradually worried about their ability to cope and what will happen with Jim when they die. They might feel a host of emotions: distress, vulnerability, anger, guilt and, surely they probably are exhausted. As an “informal carer” for several years, Jim’s parents revolved all their life on him, they devoted all their live to him.

Like Jim who does not has friends (apart form his parent’s friends), some people that experienced the same condition as him generally have a very limited social network as well, and normally the people that they interact are mainly “informal careers”.

4

First of all Jim’s parents have take him to GP and if he is diagnosed with bipolar disorder, the GP will refer him to a psychiatrist (a medically qualified mental health specialist), psychotherapist and /or CPN.

At his appointment he will be given an assessment. The psychiatrist will ask him a number of questions to determine whether or not he has bipolar disorder and, if he has, what treatments will be most suitable for you.

He will be asked about his symptoms and when he first experienced them. The psychiatrist will also ask him, about how he, usually feel leading up to, and during, an episode of mania, or depression, and whether he has had thoughts about harming yourself or others.

The psychiatrist will also want to find out about his medical background and his family history in order to determine whether any of your relatives has had bipolar disorder. If someone else in his family had the condition, the psychiatrist may wish to talk to them.

After the assessment the psychiatrist will prescribe the right drugs and refer him to a psychotherapist. Psychotherapists work with individuals, couples, families and groups to help them overcome a range of psychological and emotional issues. With the client as an active participant, psychotherapists use personal treatment plans and a variety of non-medical-based treatments to:

address the client’s thought processes, feelings and behaviour;

understand inner conflicts;

find new ways to deal with, and alleviate, distress

They take a variety of approaches according to the theoretical models they adopt and the therapy they practice. These ‘talking therapies’ include:

cognitive behavioural therapies;

psychoanalytic and psychodynamic therapies;

humanistic and integrative psychotherapies;

systemic therapies;

hypno-psychotherapy;

experiential constructivist therapies.

Community Psychiatric nurses (CPNs) would be helpful to Jim as they can visit him in his new house and provide him support through the difficult periods of his illness, they also will see him when is well to check that everything is okay and be the first point of contact if he becomes unwell again. The CPN will help Jim with his medication and make sure that he understands what he should be taking and when. They also help patient’s family (in this case Jim’s parents) and careers understand and cope with the illness.

Jim and his parents would benefit of Occupational therapists (OTs) as well. An occupational therapist can have many different roles. They will help Jim and his parents (when he moves out of his parents house) to adapt to the new environment and to cope with their daily life .OTs may work in hospitals or in the community. They supervise and assess a person’s ability to look after themselves, e.g. self-care, cooking and housework, I would like point out that Jim does not know how to cook, clean or do his laundry. . OTs work with both individuals and groups. They can set goals for individuals with depression to encourage them to achieve more than they have been able to do while ill. They might get patients involved in specific job-related training schemes to improve their decision making and planning about the future. Group work is often aimed at increasing people’s social interactions. OTs may use many different types of therapy on an individual or group basis, including cognitive behavioural therapy and art and music therapy. They may also be involved in providing relaxation training to patients referred to them by the mental health team or GPs.

Social workers are employed by social services rather than the health service. However, most mental health social workers are based in multidisciplinary community mental health teams.

Social workers may see patients referred to the team by GPs. They are likely to be involved if patients have social problems, such as housing, money and work. They may provide counselling and advice or more specific therapies. They may control access to some services such as day centres, respite care, residential care and other community support services, eg home helps. A social worker will also provide Jim a supported tenancy service which will help and teach him how to gain his independence and improve his quality of life.

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