PSYCHODYNAMICS Predisposing Factors Biological
Patient said that his auntie also has Bipolar Disorder He manifested hypomanic episodes like childish behavior, that suggests possible imbalance in neurotransmitters (norepinephrine, serotonin, and dopamine) that caused Bipolar Disorders Has poor personal hygiene
Psychological
Patient said that when he do something like going home late at night and is drunk, his parents doesn’t care His father left for Dubai before for work and he said that he was greatly affected by it as verbalized “Close man gud mi sa akong papa, naguol ko atong nilarga siya.” He is the youngest in the family
Sociocultural/Environmental
Client verbalized, ”Sige mi balhin-balhin ug balay sauna tungod sa trabaho ni papa na bisag asa ra siya ma-assign ug lugar.” Patient said that he keeps on repeating Grade and because as verbalized by patient, “Buluyagon man ko, sige ko tuyok-tuyok sa classroom bisag gasugod na ang clase, dili ko maminaw sa maestro.” Patient also said that he stopped schooling when he was in second year high school and was admitted to Talay Rehabilitation Center. He said that he has many friends in their home place
Precipitating Factors Coping Resources/Support System
Mr. L is his “bantay” He said that all of the patients there in Talay are his friends that’s why he still enjoys being there even though he is far away from home
Stressors
Lack of family support systems because his family are all in Cebu Lack of communication to his parents and he said, “Dili man sila tig-reply, busy dagay.” He is seldom visited by his parents except his ate who visited him last year His father left for Dubai before and he said that “Naguol ko ato.” Lack of sleep
Coping Mechanisms
Substance abuse like alcohol (before when he was not yet admitted to Talay) are his ways to cope up with problems or difficult situations Cigarette smoking are his ways to relieve anxiety and maybe due to medication taken
Attitudes and Behaviors Inflated self-esteem Pressured speech Flight of ideas Easy distractibility and attention-deficit similar to ADHD Increase in psychomotor agitation Hypersexuality
HYPOMANIC EPISODES (BIPOLAR II DISORDER)
BEHAVIORS
Cognition Cognition is the ability to acquire knowledge. (Encarta dictionary 2006) It involves awareness and judgment that enable the brain to process information in a way that ensures accuracy, storage, and retrieval
Easy distractibility and attention-deficit similar to ADHD Flight of ideas
Perception Perception is the process of acquiring information about the surrounding environment or situation through the use of the senses.
Somatic Delusion – Miss D would always tell us that she is ok and
doesn’t feel any pain when ask about her pas wound that was bitten by Mam Lydia.
ANALYSIS
When we asked our client about why she was admitted in Talay she
verbalized, “Wala ra man.”
Emotion In psychiatry, emotions are described in terms of mood and affect. Mood is defined as an extensive and sustained feeling tone that can be experienced for a few hours or for years and can noticeably affect the person’s world view. Affect refers to behaviors such as hand and body movements, facial expression, and pitch of voice that can be observed when a person is expressing and experiencing feelings and emotions.
Behavior and Movement Maladaptive behaviors in schizophrenia include deteriorated appearance, lack of persistence at work or school, avolition, repetitive or
Depressed persons are drawn to a state of inactivity and withdraw from life. They lack all spontaneous desire and wish only to remain passive. Because they expect failure, they lack the ordinary energy to even make an effort.
stereotyped behavior, aggression, and agitation, and negativism.
Increase in psychomotor agitation Slouched posture Perceptual problems are often the first symptoms in many brain illnesses. Hallucinations and delusions are the most common perceptual problems.
Socialization This is the ability to form cooperative and interdependent relationships with others. We observed that our patient is sociable, all of the patients in
Talay are his friends as verbalized by patient, “Amigo man nako sila tanan.”
Spiritual
Emotions are generated from interplay of neural activity between the hypothalamus, limbic structures and higher cortex centers. Emotions can be hyperexpressed or hypoexpressed. People with schizophrenia commonly have symptoms of hypoexpression. Alexithymia, difficulty naming and describing emotions; Apathy, lack of feelings, emotions, interests, or concern; Anhedonia, inability or decreased ability to experience pleasure, joy, intimacy, and closeness. Patients may perceive that they no longer have feelings. In addition,
Although she haven’t attended masses for more than 15 years, she
still believed in God and that miracles can still happen. According to her, she seldom prays but if there are masses being done in the social hall, she attends to hear the mass.
people with schizophrenia can also have mood disorders. A major depression may develop. Client with schizophrenia may sometimes manifest blank stare. One of the negative symptoms of schizophrenia is a labile affect. (Antai-Otong, 2003) Ocular apraxia is the inability to direct their gaze to a target or visual interest.
Depression is a reaction to schizophrenia in the same way that depression is a reaction to a physical illness. This often refers to their hopeless awareness of their own pathology. Families of persons with schizophrenia tend to have inappropriate cohesion and family members may be over involved, hostile and critical. (Keltner, 2002)
Deterioration in appearance includes disheveled and dirty clothes, sloppy and unkempt appearance, and poor or absent personal hygiene. Accompanying deterioration in appearance is lack of persistence at work or school. As problems in brain function begin to appear, the cognitive skills seem to “short circuit” and the person can no longer perform routine tasks. Avolition means lack of energy and drive. This is a result of the brain changes and frustration with the inability to accomplish tasks that required little effort in the past. Unfortunately, at this point most people with Schizophrenia are mislabeled as lazy, disinterested, and unmotivated. Repetitive behaviors appears similar to obsessive-compulsive behavior but are related to a private meaning rather than to thoughts.
Depressed persons are drawn to a state of inactivity and withdraw from life. They lack all spontaneous desire and wish only to remain passive. Because they expect failure, they lack the ordinary energy to even make an effort.
Social problems may result from the illness directly or indirectly. Direct
effects occur when symptoms prevent the person from socializing within accepted sociocultural norms or when motivation deteriorates. Indirect effects on socialization are secondary consequences of the illness. Specific problems in the development of relationships include social inappropriateness, disinterest in recreational activities, inappropriate sexual behavior, and stigma-related withdrawal by friends, families, and peers. (Antai-Otong, 2004)
