Following the clinical manifestations in the patient’s case for the past two weeks as narrated by her husband, the mood fluctuations, as well as the abnormal energy experienced by WG, are fundamental diagnostics for acute bipolar disorder. The mood can fluctuate from extreme depression highs to depression depths depending on various genetic and lifestyle factors.

Always, in most cases, the dramatic mood changes are more than one due to the mental illness (Almeidaet al., 2018). However, in between these mood swings there can be a period without any significant complication developing. The patient was also having an elevated blood pressure (150/90) with low levels of sodium (123d/L) in her blood, which is an indicator of manic episodes. Therefore, this patient has bipolar disorder type 1 with mania episodes, which might include hypomania or mania and depression. The symptoms could cause unexpected alterations in behavior and mood, leading to considerable difficulty in life as well as distress. With Bipolar 1, the patient has at least a single manic episode, which might be followed or preceded by major depressive episodes or hypomanic.

Therefore, the recommended treatment isSeroquel which is suitable for managing bipolar disorder with sudden mania or depression episodes. It usually restores the neurotransmitters’ balance in the brain (Atagun&Tunc, 2016). The patient’s blood pressure and sodium levels should be monitored during treatment.

The monoamine hypothesis of depression suggests that the existing monoaminergic neurotransmission imbalance in the CNS is causally linked to the clinical symptoms of mania or depression (Janiriet al., 2017). And, it has been supported by the mode of actions of anti-depressants. Also, several patient genes associated with bipolar disorder encode compounds directly affecting monoamine neurotransmitter system.

References

Almeida, K. M., Nery, F. G., Moreno, R. A., Gorenstein, C., & Lafer, B. (2018). Personality traits in bipolar disorder type I: a sib-pair analysis. Bipolar Disorders, 13(7-8), 662-669. doi:10.1111/j.1399-5618.2011.00965.x

Atagun, M. L., & Tunc, S. (2016). The Importance of Auditory Cortex Abnormalities in Type I Bipolar Disorder. Bipolar Disorder: Open Access, 1(1), 78-83. doi:10.4172/2472-1077.1000e101

Janiri, D., Giuseppin, G., Spinazzola, E., Maggiora, M., & Sani, G. (2017). Impulsivity and brain volume in patients with bipolar disorder type I and bipolar disorder type II. European Psychiatry, 41(7), S75. doi:10.1016/j.eurpsy.2017.01.241

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