An Introduction to Modern CBT, Assessment Example

Identification of Presenting Problem

Catherine Zeta Jones has been diagnosed with bipolar II disorder, indicating that her moods cycle between low and high over time. However, while both forms of bipolar disorder involve a cycling of moods, bipolar II disorder differs from this in that the elevated moods typically do not reach full mania, meaning that these individuals spend a majority of time in their depressed state. This disorder became problematic for Catherine because it began to interfere with her acting career. Ultimately, it became more difficult for her to control her moods, which impacted her ability to portray various characters. As a consequence, she checked in for treatment for her disorder for the first time in 2011 in addition to doing so a second time in 2013. During these periods of treatment, a brief hiatus in her acting status was observed.

It is imperative to ensure that Catherine does not suffer any major disease relapses, because this will continue to be a hindrance to her career. As a consequence, it is necessary to assess her current situation and determine whether a treatment regimen could be designed that will accommodate her busy lifestyle. Furthermore, it is necessary for her to learn to identify disease symptoms in order to determine when it is appropriate to seek medical assistance.

Identification of Symptoms and Diagnosis of Disorder

Catherine Zeta Jones reports that she first experienced symptoms of bipolar disorder after she experienced a traumatic event, which involved her husband’s diagnosis of stage IV throat cancer. During this time, Catherine began to suffer from mood swings, which were a result of her inability to mentally handle this occurrence. During this time, she noticed that she was also suffering from agitation, had bouts of insomnia, was no longer eating as frequently as she had been prior to her husband’s diagnosis, and had thoughts of suicide (Serjeant, 2011).

According to the DSM-IV, patients need to meet a certain amount of criteria in order to be diagnosed as having bipolar disorder (American Psychiatric Association, 2000). These include “the presence of a hypomanic or major depressive episode” and “significant stress or impairment in social, occupational, or other important areas of functioning”. Therefore, according to this diagnostic manual, Catherine likely has the disease. First, she reported experiencing major depressive episodes, which is evident based on the fact that she stated that she had suicidal thoughts and attempts. Normal depression typically involves chronic thoughts of suicide and helplessness, but does not result in suicide attempts. The suicide attempt is what distinguishes normal depression from a major depressive episode. In addition, it is clear that based on her report, Catherine was suffering from occupational stress. Due to her mental state, she was unable to perform at her job. Typically mental disorders are diagnosed when disease symptoms prevent an individual from being able to perform their normal day to day activities, which is evident in this situation.

Lastly, the DSM-IV states “If currently in major depressive episode, history of a hypomanic episode. If currently in a hypomanic episode, history of a major depressive episode. No history of a manic episode.” This means that individuals with bipolar II disorder typically do not suffer from manic episodes, which is the major distinction from bipolar I disorder. While Catherine had reported that she regularly feels down and suffered from symptoms such as insomnia and weight loss, she never reported any feelings of euphoria and often felt that she would never be able to bring herself out of this negative mental state. She also felt guilty that her husband suffered from such a terrible disease. Catherine also reported that she believes her career is a major stressor and could have potentially caused some of the disease symptoms to manifest. As a consequence, she is diagnosed with bipolar disorder II, since her mood swings range from very low moods to normal moods suddenly.

Treatment Plan Approach and Prognosis of Client

Fortunately, patients with bipolar II disorder are likely to live a long life, provided that they are given the support that they need during their depressive episodes. Since Catherine may be drawn towards suicide, it is important for her family and friends to keep a close watch on her to ensure that her house is a safe environment if she should quickly slip into a depressed state. Provided that Catherine continues to receive treatment according to physician recommendations, she should live for long time. It is essential for her to visit counseling and take medication as deemed necessary to ensure that her quality of life will remain high.

A key factor of Catherine’s slip into this mental state is that her husband became very sick and that she manifested guilt for this event. As a consequence, the most effective way for treatment to be provided to her is to ensure that she receives regular counseling. It is essential for her to begin to recognize that the health state of her husband was not her fault, and in doing so, she may begin to recover from some of her depression symptoms. While it is unlikely that the symptoms will reverse completely, it is necessary to consider that with effective treatment, they can lessen in intensity and in duration.

An ideal form of therapy for Catherine would be cognitive behavioral therapy because this method allows patients to recognize their own behaviors that are causing negative reactions and to change them (Hofmann, 2011). By noticing why she feels depressed, Catherine can start to change her actions in a manner that will promote happiness. Over time, she can be trained to keep some negative thoughts and actions out of her life so that her overall mental state could be improved.

While therapy is essential for Catherine’s recovery, it is important to note that since she is depressed to the point of suicide, it is helpful to medicate her as well to ensure that she does not take her own life. For this purpose, she should be provided with lithium because it works well for bipolar II patients. Ultimately, it treats both the depressive and hypomanic states that Catherine is experiencing. It is also a mood stabilizer, which means that if Catherine goes on Lithium, she will be less likely to switch between moods as quickly.

If Catherine’s disorder becomes too difficult for her to handle on her own, it is recommended that she check into a hospital so that doctors can work with her as an inpatient. This will be helpful to get her back on track so that she could continue to take care of herself on her own or with help from friends and family.

References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-IV-TR).

Hofmann, SG. (2011). An Introduction to Modern CBT. Psychological Solutions to Mental Health Problems. Chichester, UK: Wiley-Blackwell

Serjeant J. (2011). Catherine Zeta-Jones treated for bipolar disorder. Retrieved from http://www.reuters.com/article/2011/04/13/us-zetajones-idUSTRE73C6BI20110413