According to the Center for Clinical Interventions (n.d.), “There are a number of factors that interact with each other that may contribute to the development of this disorder in some people”. The factors can be both environmental and genetic. Although genetic factors are considered the most important for the bipolar disorder development, “episodes that develop after the first one appear to be more heavily influenced by environmental stress, sleep disruption, alcohol and substance abuse, inconsistent drug treatments, and other genetic, biological, or environmental factors” (Milkowitz, 2010, p. 74). Patient M had already suffered two similar episodes of strange behavior and her family history includes mood disorders concerning states of depression...
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... would suggest is sleeping medication because she has not slept for five days, so her sleep needs to be taken care of first. Family-focused therapy will be necessary to solve the environmental influences that shaped her while she was a child, particularly the rules imposed on her by her parents. It will improve her relationship and communication with her parents. However, it would be a better option to start with interpersonal and social rhythm first. That way, she would establish a schedule that could improve her sleep, cognition, and social relationships. Since this is not the first time this kind of behavior has occurred in her life, she needs to sort it out before starting family-focused therapy. She needs to have clear cognition and proper reasoning before solving the environmental issues her parents had created with their over-demanding and overprotective rules.
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