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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