Thumbnail for Case study clinical example: Session with a client with Bipolar Disorder (fluctuations in mood) by Judith Johnson

Case study clinical example: Session with a client with Bipolar Disorder (fluctuations in mood)

Judith Johnson

14m 45s1,712 words~9 min read
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[0:30]Okay, nice to see you again, Tom. How are you today? I'm okay. So I understand that, um, since I was seeing you, um, that a while ago, uh, that you were in hospital again. Yeah. So can you tell me a bit more about what happened before that? Um, well, it was a few months ago now. Um, yeah, I'd done quite well for a number of years. I sort of kept it, um, under control, really. But, uh, Yeah, I mean, I've not, I've not seen you since your gap year, wasn't it? Yeah, so that was four years ago. Um, and so, yeah, it was quite disappointing to, to go through it all again. Uh, but it sort of started, um, at the, uh, towards the end of university. Um, because I was doing law. And, uh, well, I was on course, um, for a first and I was just coming up to my, um, my final exams, and I had a few essays and a few exams. And, uh, So I just, I started working really hard. I felt like, right, now is the real time to, um, put the effort in and to, to put the work in. So I started to stay a bit later, um, take on a bit more work. Um, so my stress levels sort of started to increase, um, over a while. I, uh, I was drinking a lot more coffee, took a few, uh, caffeine tablets, um, and energy drinks. A few people, well, because sort of the environment at the time was a lot of people were pushing themselves that they wouldn't normally, uh, do. And some people were taking Ritalin. Oh, wow. Okay. Yeah. Which and Did you take any Ritalin? Yeah. Um, because it was just like, it was, it was that was necessary at the time. And, uh, how did that affect you? Well, I, it sort of increased my confidence at the time. Like, all, all, everything that was going on, I was becoming a lot more productive, um, you know, a lot more confident, a lot, um, was working harder, my brain was working faster. And so I, yeah, my, my, my momentum was building up and up, um, throughout the period. Um, yeah, and so I was, I was relishing it and I was, um, yeah, doing a lot of work and, uh, So what did that mean to you then to be at that time? Because it sounds like you put quite a lot of pressure on yourself, you've been doing really well at uni and and, you know, this was it, this was the time. What did it mean to you to be feeling like that? Kind of more awake and and more energized, maybe. Yeah. Well, for me, it was, it was my sort of time. So I'd spent, I'd spent three years, I'd, I was in control, I was doing well. I didn't, I didn't, it wasn't really part of my life at the time. I didn't really talk to any of my friends about it. Um, but then, I, yeah, I started to, to, to grow into it. Um, and I, took the opportunity to, yeah, enjoy this time. Um, and it sort of didn't really reach its peak until after my exams. I was still, um, I was still functioning, um, throughout my exams. Um, I, I have since found out that, um, I didn't get the results I, that I wanted to. I only got a two-one. Why do you think that was? Um, well, I, I thought that I was working harder than ever. But, uh, I, it was misjudged, I think. And so I, uh, yeah, I didn't perform to, the best of my ability, um, in, like, when it came to, to the exams. And so, I, I didn't achieve, I didn't achieve a first. I, uh, What else was happening for you around that time? I mean, you talked about the pressure of your exams and staying up for them. Was anything else going on for you, around the same time? Um, well, so it was the end of, the end of university and that was the time where, well, as soon as that period stopped of work, then I was sort of let off the leash, um, a bit. And, yeah, I just sort of to, to grow, uh, even further.

[5:32]Um, so I, I, I mentioned I was, um, I was taking Ritalin, drinking a lot of coffee and, as, as soon as my exams had stopped, I just substance abuse sort of took a bit, um, more of a hold. Um, and yeah, I just sort of grew into this person who I thought was him, was, um,

[6:10]So this is like the, the gap after you finished the exams but before the results are out, those kind of few weeks. Yeah. Um, so we were just, we were just going out a lot. Every, like, if not every night, um, You said that you were taking Ritalin and drinking a lot of coffee. And, um, using other drugs as well. Yeah, it sort of developed into, um, cocaine, a lot, cocaine, um, MDMA, um, M cat. And how did they affect you?

[6:46]I honestly was on cloud nine at the time. Um, yeah, I, uh, was just, I was the person everyone, everyone wanted to know. In my head, I was, I put myself at the center of the universe. And, um, I even, I convinced a friend of mine who develops apps, um, that we should, um, as if I had an idea to develop an app about when you go into, uh, an alcohol shop. That, um, it all weigh up, put, like, what's the most cost-effective way to get wasted? Right. So, um, yeah, I mean, I at the time, I was spending a lot of money, a lot of, uh, my parents' savings. I'd got a credit card, which I didn't tell them about. And, um, and so in this sort of role as the man, as the man about town, I was spent a lot on, yeah, alcohol, drugs, clothes. Um, I, invested in this technology. Um, and, yeah, I was, yeah, it sounds like it began with kind of the exam pressure and putting more pressure on yourself to stay up using kind of stimulants keep yourself awake. And then you started to feel like you were more and more the man, you were, you were kind of popular, you were successful. I guess how did that affect you? How did you respond and cope with those symptoms? What did you do once those are kind of begun? Well, having not, had to deal with, um, my illness throughout university, and for it not being a part of that world, I, I didn't confront those symptoms in a, in a way that's going to have long-term stability. Um, as far, well, it began with doing the work that I needed to do. That's just, it was, that's just what I needed to do in order to achieve my goals, and to achieve what I want to. And then it just, I just let it take hold. And I, it was all part of, it wasn't, it wasn't, yeah, it wasn't the illness, it was me. It was just, I was, I was the master of this whole situation. And I was, everything that was happening was down to my own doing. So it sounds, you said on the one hand, you didn't confront it, you kind of just let it roll, um, and on the other hand, you said that you were, it was very energetic, you were powerful, this was all kind of explained about who you were. And, I guess, how did that affect you?

[11:09]It s-it gradually diminished. I think. Um, it began at, six, five, and then was ended up at about three and two hours. And what kind of things did you notice? Did you notice any changes from having less and less sleep?

[11:30]In your body, maybe, or the way you were thinking. I think the harder I was working, the faster my brain then would work. And how much, yeah, the harder I worked, the more I would do. So it was, it wasn't, it was just a, yeah, the momentum was building more than anything. And my thoughts were firing and my goals were stronger and my, um, yeah, my determination was bigger. And how did you feel in your body? Did you notice any changes physically?

[12:15]Not that I can recall at the time, maybe I was trying to, maybe I was avoiding, avoiding confronting, um, any negative effects. But, nothing powerful comes to mind.

[12:33]Okay. And once you'd kind of things were a bit further along after your exams, you said you were going out a lot, you convinced your friend to do this app. Was there anything else that you did that maybe you wouldn't normally do, that you think might have been a sign to you that your mood was much higher than you'd like it to be? Um, there was, I hired a lot of savings that my, uh, that my parents had had for me, which, um, it doesn't really exist anymore, either through, um, and, yeah, well, the money I invested and through, drugs, clothes. Um, I, uh, I had a girlfriend at the time, um, but, because it was, because I was the main character, in, in a sense. I, I, I was only the only person that mattered. And so, sort of those around me, did, especially at her, it just sort of didn't really have as much importance. And so on nights out, I, I wouldn't, she just wouldn't be in my mind. And so there would be other women. Okay. And how do you feel about that now, looking back on it?

[14:17]I think it's, it's those moments where it's not just me. It is those, those closest to you and those around you that have to suffer them more than anyone else, um, that brings like a lot of the, uh, shame. Yeah.

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