Carries Fisher is an American actress and screenwriter diagnosed with bipolar disorder at the age of 29. She began her career at the age of 12 when she was featured in the trilogy of the film Star Wars . Fisher has been very open about her use of drugs such as cocaine and alcohol. Her first diagnosis was made while she was 24 years and the outcomes indicate that she suffers from manic depression. Fisher did not receive any medication or intervention after the diagnosis. Despite suffering from addition and maniac disorder, Fisher was still featured in several other films.
Section 2
Demographic Information
The patient was born in 1956 in Beverly Hills, California. She a daughter to Debbie Reynolds, who was also an actor, and Eddie Fisher, who was a singer. At the age of two, the patient was a victim of a broken marriage. Eddie Fisher left her mother and married Elizabeth Tylor, her mother's best friend (Chapter 8: Mood Disorder, n.p). However, Fisher attests that the experiences she went through while young did not impact her manic depression disorder. She has grown up in a life where she is a public image as the media was all over her family because of the popularity of her parents.
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Presenting Problem
The presenting problem is that of maniac depression. The patient is not in a position to effectively manage her moods. She has tried seeking assistance but attest that her physician wanted to place her under medication instead of treating her. It appears that Fisher has a problem with some of the psychiatric recommendations in treating her problem. For instance, she considers the prescribed electro-conductive therapy barbaric and cannot undergo the treatment (Chapter 8: Mood disorder, n.p). The patient was not willing to receive any help being provided as, at; first, she was in denial and only thought that she was suffering from drug addiction.
Relevant History
The patient has a history of drug abuse. She started using cocaine and alcohol at the age of 12 after featuring a movie that made her famous. At the age of 13, she has a history of using marijuana. The patient has been hospitalized in the past because of substance abuse. Also, she is a victim of a psychotic break while she was seeking medication for her manic depression disorder (Chapter 8: Mood Disorder, n.p). The patient has been hospitalized for six days and underwent another six months of outpatient treatment. She has been placed in electro-conductive therapy as a treatment for both mania and depression.
Symptoms
One of the symptoms shown by the patient is extreme mood. Fisher attests that she was using drugs to manage some of her extreme mood episodes (Chapter 8: Mood Disorder, n.p). Another symptom that she was showing is they of being self-centered. Since she was famous in Hollywood movies, she always thought everything was about her. Fisher would open the television with the expectation that all the media channels were talking about her. She was being consumed in her fame. The last symptom presented by the patient is that of being overwhelmed and defeated. Fisher was depressed at all times, and that was because of her maniac disorder.
Case Formulation
The case being investigated is that of an actress who has been diagnosed earlier with maniac depression. However, the symptoms being presented by the patient indicate a different thing as the point in the direction of bipolar disorder. The patient has mood swings and is also addicted to drugs such as cocaine and alcohol. She has been receiving treatment in the past, but it has not been effective as expected.
DSM-IV Equivalent
The DSM-IV equivalent shows that there are several criteria that Fisher will have to meet so that she can be diagnosed with bipolar one disorder. The first criterion is for manic episodes, which states that the patient needs to go through a marked episode consisting of strange and continuous elevation of bad moods in one week. Fisher meets the criterion as she goes through episodes in situations where a person would upset her. The situation can last for four days and end up making her very angry. The second criterion, according to DSM-IV, is for the patient to have undergone a drastic change in the mood and has three symptoms that have been listed multiply for normal behavior (American Psychiatric Association, 2013). The patient shows symptoms of inflated self-esteem, making her meet the second criterion.
Treatment Plan
How will the symptoms be managed?
It will be possible to manage the symptoms through a change in the lifestyle of the patient. For instance, there is a need to maintain a regular sleeping routine for Fisher and make sure that she avoids alcohol and cocaine at all costs. The focus is to minimize some of the things that can stress and start developing the symptoms, such as episodes. Another intervention towards the symptoms is support. There is a need to partner with support groups that will allow her to share her experience living with the condition (American Psychiatric Association, 2013). An essential intervention in managing the symptoms is to take a break from the screen. Fisher will have to be placed on bed rest and ensure that she is relieved from all her stressful situations, such as work.
Problematic emotions, thinking, and behavior
Physiotherapy will be the most effective strategy to use in the management of problematic emotions. The focus is to ensure that Fisher is in a position to cope with the situation at hand. It will be possible to cope with some uncomfortable emotions and repair the patient's relationship with others. It is possible to use interventions such as meditation in the process. The focus will be to create an integration between the mind and the body. In the process, it will be possible to relieve the patient from stress and balance her emotions. Meditation will relieve her from excessive thinking and train her to behave when they feel depressed or offended.
Stabilization of the client through medication
Stabilization through medication entails the use of mood stabilizers. The focus is to minimize the high and low bipolar disorder and to keep the symptoms under control. Some of the medications that will be more effective include the anticonvulsants that will assist in the control and prevention of seizures. Also, there is a need to include the SSRIs that will effectively ease the symptoms of the depression moods and any form of anxiety that might arise. Inclusion of the antipsychotic medication will relieve Fisher of any psychiatric conditions that might be developing because of bipolar disorder.
How alterations in personality and relationships will be addressed.
Alteration in personality and relationships will be addressed using family therapy. The intervention involves going through counseling to resolve any pending conflicts and enhance the mode of communication. Cognitive and behavioral therapy will be more effective in managing any alteration that might have occurred in Fisher's personality. The focus of the intervention will be on modifying the negative thoughts, behavior and responses.
References
American Psychiatric Association. (2013). Substance related and addictive disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm16
Chapter 8: Mood Disorder. Carrie Fisher: Bipolar Disorder. Disorder Involving Alteration in Moods. Pp. 180.
