Symptoms And Treatment Of Bipolar Disorder - 1247 Words

This is a 25 year old African American female still grieving the loss of her mother who presents with fatigue, lack of appetite, sleep disturbances, suicidal ideations, and anhedonia. Plan: 1. Suicidal Ideations: The patient revealed that she has thought about committing suicide once a week for the past 2-3 weeks. The patient has not created a plan to commit suicide, though. She states that what prevents her from committing suicide is that she does not want to put those around her through that. Possible causes for these thoughts are depression, bipolar disorder, substance abuse, depression secondary to hypothyroidism. With respect to assessment for depression or bipolar disorder, I would like to refer the patient to a psychiatrist†¦show more content†¦2. Sleep Disturbances: The patient’s history also revealed issues falling asleep. Since the onset of these sleeping issues came about around the same time as the fatigue, the sleep disturbances may be contributing to the fatigue and it is important to see if fatigue remains in absence of the sleeping disturbances. Her sleep disturbances could be due to depression or primary insomnia. Evaluation for depressi on should be done by a psychiatrist immediately. The patient should keep a sleep diary to track her sleeping patterns, with an eye seeing if her fatigue is better on days where she gets better sleep. Given the patient’s fatigue, anhedonia, and affect cognitive-based therapy for her sleeping issues, although, the preferred way to treat primary insomnia, does not seem appropriate. Instead, for now, the patient should be prescribed a melatonin receptor agonist (Ramelteon) to assist her in getting to sleep, until the psychiatrist makes their evaluation, which may lead to reassessment of treatment. Schutte-Rodin S, Broch L, Buysse D, Dorsey C, Sateia M. Clinical guideline for the evaluation and management of chronic insomnia in adults. J Clin Sleep Med. 2008 Oct 15. 4(5):487-504. 3. Lack of appetite: Based on the history taken from the patient, she has a lack of appetite, going so far as to consuming just a grilled chicken sandwich and water over the course of an entire day. The lack of appetite came around the same time as her fatigue and may play a role in it. Her