Individual treatment plan

Individual Treatment Plan:Bipolar Mood Disorder

Presentation and Graphics: Andrew Nolen

Client Information

• Client #9• George Lawler• Address: 2650 Virginia Avenue• Phone: 867-5309• Referral: Wife • Insurance • Account #31415

Client Information

• Medications – Haloperidol• 5mg – 2-3 times a day for 3 weeks

– Lithium• 900mg on the first day• 1800mg per day over the next 2 weeks• 2100mg per day for maintenance after

third week

History

Client History

• 35 years old• Married• 2 children• Works at a small junior college• Teaches physical education• Coaches men's and woman's track

teams with outstanding seasons

First Serious Episode

• During his junior year of college• Defensive back on football team• Good academic student• Fairly popular• Found that he was losing interest in

everything

First Serious Episode

• Did not look forward to classes or studying

• Never been an outstanding student• No longer enjoyed going out with

friends• Friends said he seemed depressed all

the time• George said he just didn’t care

anymore

First Serious Episode

• Starting finding faults with his girlfriend

• Spent most of his time watching t.v.• Had no concentration• T.V. was mostly a distraction not

entertainment

First Serious Episode

• Football Coach recognized problem• George told coach that – He couldn’t make it through the

simplest of practices– Did not care about the team or his

future• Coach referred him to a Psychiatrist

First Serious Episode

• Began – Anti-depressants – Counseling sessions

• Back to normal in several weeks• Treatment was discontinued• From there George found himself

with periods of unusual ambition and energy

First Serious Episode

• Friends to amphetamines to stay awake • George seemed able to summon

endless, internal reserves of energy• Hypo manic episodes• Had tendency to toward excess

verbosity• Behavioral excesses went unnoticed in

competitive university environment

Subsequent Episodes

• 8 months prior to hospitalization suffered a depressive episode

• Loss funds for travel• Began to inadequate sleep• Assistant coach took leave of

absence in which he took personal• Began having suicidal tendancies

Subsequent Episodes

• After treatment form same doctor in college he began a manic episode

• Became consumed on athletes and their performance

• When home he talked endlessly about team

• Began planning intricate strategies for important events

Subsequent Episodes

• Wife thought it was just pressure from job

• During pre conference meet George began pacing back and forth

• Talking about specific events and virtues of winning

• Pulled ceremonial sword out and gave “the most inspirational pregame performance he had ever seen in a locker room” according to reporter

Subsequent Episodes

• Wife thought it was just pressure from job

• During pre conference meet George began pacing back and forth

• Talking about specific events and virtues of winning

• Pulled ceremonial sword out and gave “the most inspirational pregame performance he had ever seen in a locker room” according to reporter

Subsequent Episodes

• Next day during interview George went into a grandiose tirade– Began rambling for three hours– Boasting– Stated he planned chaperoning a star

jumper to a NCAA national meet that wasn’t going to happen

– Told the reporter to quote him as it wasn’t every year he got to take a free trip with a pretty girl

– Stated it could end in a genuine romance

Subsequent Episodes

• In his picture for the paper he was disheveled

• When director confronted George a shouting match ensued in which George stated that he was just named coach of the Olympic track team

• Was making calls for potential assistants and any interference would be attributed to foreign countries

Subsequent Episodes

• George was then escorted to the hospital by the police.

• Involuntary commitment was necessary

• Psychiatrist testified in court that George might be a danger to himself or others

Current Episode

• George is seeking both prescription and psychotherapy treatment

• Wife did divorce however he took it well

• Work friends are a constant support

Treatment

Treatment

• Haloperidol – 5mg – two to three times a day for

three weeks• Lithium – 900 mg on the first day– 1800 mg per day over the next two

weeks– 2100 mg per day for maintenance after

the third week• Continued Therapy

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