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Stacy’s Post:

Start by identifying the symptom or diagnosis you searched and the name of the case study you chose.

The symptom that I searched for was depression and the case study I chose was Sarah (Bipolar Disorder).

Describe the patient’s symptoms and the available demographic and historical data.

Sarah is a 42-year-old woman who suffers from depressive and hypomanic episodes.  She has a long history with both of these symptoms.  She has been diagnosed with a variety of illnesses ranging from major depression, borderline personality disorder, and bipolar disorder.  The signs have shown that the depression originated in her late teenage years, but the hypomanic episodes came later in life.  During her hypomanic episodes, the elevation of her interpersonal conflict, hyper-sexuality, and alcohol use have led to her borderline diagnosis, but in the context of all of her symptoms together, bipolar disorder diagnosis is the best choice for Sarah.  At this time in her life, she is not currently in a relationship and she feels isolated from her family.  Sarah takes medication to control her depression, but the symptoms still persist.  She has gone off of her medicine several times but feels she gets into trouble for that and she would like to try and focus on some individual psychotherapy.

Evaluate the plausibility of prescribing medication to a person who is vulnerable to schizophrenia, considering medication is often effective for most people who have psychotic symptoms. What are the possible advantages and disadvantages of this proactive approach to treatment?

It is crucial to try and diagnose psychosis in the early stages because it can be challenging, and early treatment is essential.  Schizophrenia is a mental illness that can cause psychosis.  A case study on a 14½-year-old girl that was in treatment showed she responded very well to medications (Need for medications in early-onset psychosis: APA meeting, 2018).  During the presentation of the case study, Ragy Girgis, M.D. discussed how important it is to treat early psychosis with medication (Need for medications in early-onset psychosis: APA meeting, 2018).  An advantage of a proactive approach is that medications have been shown to work on reducing symptoms, but a disadvantage is that the medicines can have side effects that have metabolic changes that can be dangerous to children (Need for medications in early-onset psychosis: APA meeting, 2018). 

Evaluate the most important forms of mental health services that would be helpful, both to these patients and their families, in addition to medication.

The most important forms of mental health services for people with psychotic disorders in addition to medication are psychological treatment, cognitive behavior therapy, social skills training, and family therapy (Getzfeld, 2018).  Therapies offer solutions from a different perspective that can be beneficial to the patient.  Cognitive therapy educates the patient on the biological causes of their issues and helps them learn to identify which situations cause symptoms (Getzfeld, 2018).  Social skills training teaches people how to interact with others, so they will get a good outcome with their interactions (Getzfeld, 2018). 

Analyze the political variables surrounding the cost of treatment. Who should pay for mental health services to patients with serious mental disorders such as schizophrenia or bipolar disorder? Should they be included in standard health insurance programs? Should they be prioritized like other medical disorders, such as cancer and heart disease?

Treatment costs can be costly for mental health, and I believe that insurance should help cover the costs.  I feel these services should be included in the standard insurance programs with stipulations regarding mental health.  I so insurance for a living and I see services being denied all the time.  People cannot help if they get an illness and I believe their insurance should cover the costs.  Mental health issues should probably be prioritized like other illnesses; that way, people may focus on them more.  There is such a stigma related to mental health issues that I feel is sometimes denied the attention it needs.

Need for medications in early-onset psychosis: APA meeting. (2018). Brown University Child & Adolescent Psychopharmacology Update, 20(6), 1–3. doi (Links to an external site.): 10.1002/cpu.30300

Getzfeld, A. R. (2018). Abnormal psychology (2nd ed.). Retrieved from https://content.ashford.edu

Janet’s Post:

For this discussion, I searched hallucinations, delusions, psychosis, and schizophrenia and other severe mental illnesses. The only case from the search was for a young male named Chris. Chris is a 20-year-old male that is a college student. He has been experiencing paranoia and fear that campus security and the local police department are spying on him. His fear of being followed by authorities is causing such anxiety that it is beginning to affect his ability to function daily. Any electronic devices cause more worry that he is being watched. His paranoid delusions are affecting him socially, and he is beginning to show inappropriate emotions. The history given is not clear if this is the first instance of Chris having these thoughts, but it seems that this a new-onset.

Each individual is different, and some may have factors that may make them a higher risk potential for developing schizophrenia. According to Getzfeld (2018), some factors that increase the incidence of developing schizophrenia is if a family member has schizophrenia if there was an infection contracted by the mother while pregnant, stressful life events, socioeconomic situations, and brain chemistry. Those that are at risk of developing schizophrenia can show decreases in cognition before developing schizophrenia. According to Getzfeld (2018), the symptoms that begin to exhibit are considered negative symptoms. If an individual were recognized to be at risk for schizophrenia and given an antipsychotic to prevent psychotic symptoms before they start, it would have advantages and disadvantages. According to Chien and Yip (2013), administering antipsychotic medications in the early phases of schizophrenia can help decrease the positive symptoms, which are delusions, hallucinations, and disordered speech. Since one may know that a client has factors that make them vulnerable, putting them on antipsychotics before a full diagnosis is made could help head off the positive symptoms. A disadvantage to this proactive approach is that antipsychotic medications are not effective in treating negative symptoms and can actually make them worse (Chien & Yip, 2013). Negative symptoms are also a part of schizophrenia. According to Getzfeld (2018), negative symptoms are flat emotions, lack of motivation, and social withdrawal, which can be the beginning signs of the development of schizophrenia. Considering that negative symptoms are the first symptoms to appear in someone at risk, then a disadvantage to given antipsychotics in a proactive approach could worsen the negative symptoms. Getzfeld (2018) also posits that people with schizophrenia have a high rate of suicide. If the medication they are taking to prevent the development of positive symptoms increases their social isolation and flattens their emotions, it could lead to suicide.

Since there are broad symptoms for schizophrenia, the proper treatment modality for each individual is paramount. First, I think that cognitive-behavioral therapy would be a useful treatment. According to Getzfeld (2018), CBT can help a client learn to differentiate between what is reality and what is not. Being able to recognize what is a hallucination or delusion can help them lead a healthier life by overcoming things that are not real. Second, family therapy can aid in the treatment of individuals with schizophrenia. According to Getzfeld (2018), a lot of those with schizophrenia live with their families. If the families are educated and learn how to help the individual cope with their symptoms, the patient may decrease the chance of relapse. Placing the person on an antipsychotic medication will help reduce the positive symptoms associated with schizophrenia and may also aid in preventing relapse.

The burden of cost to treat those with schizophrenia or bipolar disorder is great. I think that there need to be some changes in how mental health services are paid for and how they are classified. I believe that mental health treatment should be included in health insurance plans so that it can be affordable to the patients and their families. I think that mental illness is a sickness, just like those that have cardiovascular disease or diabetes. Those with these medical diseases can have genetic factors that make them susceptible to their development just as those with mental disorders are susceptible. If health insurance companies are willing to pay the cost for all that entails treating diabetes, then they should be willing to do the same to ensure that those with mental disorders can afford their treatments.

Reference

Chien, W., & Yip, A. L. (2013). Current approaches to treatments for schizophrenia spectrum disorders, part I: An overview and medical treatments. Neuropsychiatric Disease and Treatment, 2013(9), 1311–1332. https://doi.org/10.2147/NDT.S3748 (Links to an external site.)

Getzfeld, A. R. (2018). Abnormal psychology (2nd ed.). Retrieved from https://content.ashford.edu

EXAMPLE OF RESPONSE:

Hi Lynette-

It is no secret that having a mental disorder can be challenging times in a person’s life. Take Chris for example, he is constantly worried that someone is watching him and tracking his electronic devices. That must make getting through a regular day at college very frustrating as well as exhausting. I could not imagine experiencing those kinds of symptoms. Not knowing the difference between what is real and what is not. Because of the symptoms, I can understand why some people who are diagnosed with schizophrenia have a hard time accepting the fact that they need treatment. Admitting you have a problem is the first step, but I can see why a person might be hesitant. Because there is no cure for the disease, I can see why a person may not want to take medication because they think it will not help. Although medication has been shown to reduce some of the positive symptoms of the disease, there can be negative effects of the medication as well. I enjoyed reading your perspective on the four bodies, physical, mental, spiritual, and emotional. I agree with you that they are all a part of who we are, and the hope is that all parts will work well together. However, we all know that is not possible for everyone. Great post!