Bipolar disorder The illness tends to be highly genetic, but there are cl e a r l y environmental factors that influences whether

the illness is o c c u r i n a particular child. Bipolar disorder can skip generations and take different indiffere nt individuals. The small group of studies that have been done vary in the estimate of t h e r i s k t o a g i v e n i n d i v i d u a l . F o r t h e g e n e r a l p o p u l a t i o n a c o n s e r v a t i v e estimate individuals risk of having full-bloom bipolar disorder one percent.D i s o r d e r i n t h e b i p o l a r s p e c t r u m m a y a f f e c t 4 6 % , w h o o n e p a r e n t h a s bipolar disorder, the risk to each child is 1530%, when both parents have bipolar disorder, the risk increases to 5075%. The risk in siblings andfraternal twins is 15-25%, and the risk of identical twins is approximately70%.Bipolar disorder is classified into two, the bipolar I and the bipolar II. T h e b i p o l a r I d i s o r d e r i n w h i c h i n d i v i d u a l m a y e x p e r i e n c e o n e o r m o r e manic episodes or mixed episodes. During a manic episode must be presentt o a s i g n i f i c a n t d e g r e e . I m p a i r m e n t i n v a r i o u s o f f u n c t i o n i n g , p s yc h o t i c symptoms, and the possibility of self-harm exist. Bipolar II disorder is characterized by recurrent major depressive episodes with hypomanic (a mood between euphoria and excessive elation)episodes. It is believe to occur frequently in women than in men. OBJECTIVE OF THE STUDY This case study aims to: K n o w t h e d e f i n i t i o n a n d t h e h i s t o r y o f t h e d e v e l o p m e n t o f bipolar manic disorder. Identify the facts that may contribute in acquiring bipolar manic disorder. Formulate appropriate diagnosis on which to base the necessary psychiatric nursing interventions. Implement interventions and psychodynamic approach. Evaluate the actions done to clients and its effectivity. NURSING PROCESS A. Assessment 1.General Data Name:Nestor AG E : 2 A d d r e E c i j a C i v i r i e d D a t e A d m i t t e i e f c o m p l a i n t : 1 . P a n a abasag ng gamitI n f o r m e

4 s s : N u e v a l S t a t u s : M a r d : A u g u s t 5 , 2 0 0 7 C h n a k i t 2. Poor sleep3. Nambabato ng bahay4. Nagb a n t : W i f

2.Reason for Hospitalization Her wife brings him here at Mariveles Mental Hospital, August 5, 2007 11:05 inthe morning. She said that his husband Nestor is not in normal mental state again. Herefused to take his medicine, he had sleep disturbance and the last time he forced hisdaughter to get money to her and bought him cigarettes. And before that day, his husbandthrew a stone at his neighbors house. 3.Family History of Mental Illness According to his wife, he is the only one in the family having this mental illness.His parents and relatives have the normal state. His family work and do their daily taskslike any individual and possess good intention of living except him. 4. History of Present Illness The patient is previously confined in Mariveles Mental hospital last March 2001,the client flow up until October 2003. The last admission was August 5, 2007 (withrelatives).According to his wife, when they got home after the first exclusion, his husbandwas able to help in their financial needs. He work as a tricycle driver but still the moneythat they earned is not enough to continue and support his medication that is why theydecided to stop taking his medicine. After a few weeks, he started to have signs andsymptoms of relapses. He became destructive Nagbabasag ng kasangkapan at Nambabatong kapitbahay. He always walks and kept panic. When his mother seen his situation, she brought him medicines but the patient refuses to take it because he thinks it was a poison.She heard their neighbor said Papatayin na lang namin yan. Therefore, she decided to take him here in this mental institution again 5.Related Events/Situations to Present Health Condition According to the medical doctor, Mr. Nestor has mental illness because of traumahe experienced. One day, he said that he saw his father stabbed by his fathers friend andafter that incident, he never forget that. He also said that they have financial problem andhe thinks that their younger 11-year-old son was not his son. He think that his wife havingan affair with another man. However, he never confronted his wife about it in afraid thathis wife got angry. 6.Pre-Morbid Personality Assessment During our interaction with the patient, he seems to be kind to us and eager toanswer our question. He does not hesitate to answer although we ask about his personallife. We also noticed his kindness during the session. We almost think that we are talking toa normal person. In addition, he possesses silence quite some time as he is thinkingsomething that we do not ask. 7.Course in the Ward From August 2007 until now, according to Mr. Nestor, he only got one troubleinside the hospital. The reason of that commotion is a stick of cigarette. From then on, henever do that again because he wants to go home and return to his normal life. 8.Personal/Educational/Occupational/Marital History andSignificant Person to the Patient The client is a high school graduate, a farmer and tricycle driver in occupation.Sometimes, he is also a balut vendor at night to sustain their financial needs. He has adoubt on his wife that she is having an affair. They have seven children; his sister adoptstwo of them. He never tried to have an affair to other woman because he only wants tohave a simple and happy family. His two daughters are the special person in his life.

9.Mental Status Examination a)General Description (1) Appearance Seen this adult male in blue MMH uniform with short hair and nails, poorly keptwith body odor. With no slippers, like any body inside the hospital. Not so nourished, andslim in built. (2)Behavior and Psychomotor Activity He is not harmful as we first thought about him. He responds in every question thatwe gave. He also participates in exercise, games, drawings, or any program or activitiesthat we planned for them. He won in the pinoy henyo game. (3)Attitude toward Examiner He is sitting straight in front of us. He just staring to us at first, but in f e w moments, he answers our questions. He respects our presence in excusing himself everytime he will go to the comfort room or when he wants to walk for a while.