In her case, she had different types of delusions: persecutory and grandiose. This grandiosity is usually seen as part of the manic phase in bipolar. Along with this is irritable mood which she exhibited when she first came to the hospital. She did not want to talk to anyone and became loud and visibly upset when people asked her too many questions. However, just because she exhibits these symptoms, does not mean that she is manic. In fact, she is missing key characteristics that would classify her as manic or even depressive. No information was obtained about her history of mania, however, it is known that there has never been any documentation of her experiencing depression. When asked if she had ever felt depressed in her life, she remarked “I have never been sick before. I am perfectly healthy.” Currently, she seems to be in a phase of an absence of bipolar disorder symptoms. However, this helps clarify her diagnosis of schizoaffective disorder because the delusions are still persistent. The cause of schizoaffective disorder is currently unknown. To further complicate matters, schizoaffective disorder is often not studied specifically on its own and is repeatedly wrapped up into schizophrenia. Therefore, the predisposing factors are often considered one in the same. When explaining the predisposing factors an effort will be made to tease these two disorders …show more content…
Since LL is on Valproic Acid (VPA) the focus will be on this drug. One hypothesis for bipolar disorder is a decrease in GABA, an inhibitory neurotransmitter. VPA causes an increase of GABA to be released from different parts of the brain, potentially being part of the reason that this drug works for bipolar symptoms (Grunze & Amann, 2003). Another theory is similar to that of schizophrenia, where bipolar symptoms are thought to be caused by an excess dopamine changing brain structures (Townsend, 2015). VPA is shown to cause an increased metabolism of dopamine in the brain leading to a decreased amount of dopamine (Grunze & Amann, 2003). VPA continues to help substantiate many theories about the root cause of bipolar disorder being due to neurotransmitters functionality and impact. Of course, these medications cannot affect all parts of my patient’s symptomatology. She is also currently receiving milieu therapy. According to Townsend (2015) “psychotropic medication is more effective at all levels of care when used along with milieu therapy” (p. 441). Milieu can be effective for my client because it gives her the freedom she wants but also calls for her to be a responsible person. Hopefully with medication and therapy, the predisposing factors can be combated or their effects can be