PSYCHOLOGY PROJECT

CASE STUDY

BY :
MANOHA MARIAM
MATHEW
CLASS XII C
ROLL NO 23

INTRODUCTION
Bipolar Affective Disorder is a long-term
mental health condition that affects
thoughts, feelings, and behavior. It is
common in adults and marked by
repeated changes in mood, energy, and
activity. People may experience manic
episodes, where they feel unusually
cheerful, energetic, or irritable, and
depressive episodes, where they feel
sad, tired, and lose interest. These mood
shifts are stronger than normal ups and
downs and disturb daily life, work, and
relationships.
During mania, individuals may also
develop suspiciousness, false beliefs
(delusions), or unusual experiences
(psychotic symptoms). Disturbed sleep,
poor hygiene, and difficulty managing
routine activities are common. The
illness often lasts for years with
recurring episodes, but with proper
treatment and support, people can
manage symptoms and lead a stable,
productive life.
BIPOLAR AFFECTIVE DISORDER
Bipolar Affective Disorder is a psychiatric
illness marked by recurrent episodes of
mood disturbance, including periods of
abnormally elevated or irritable mood
with increased energy and activity
(mania or hypomania) and periods of
significantly lowered mood with loss of
interest, reduced energy, and impaired
functioning (depression). These episodes
may be accompanied by changes in
sleep, appetite, behavior, and cognition,
and in severe cases by psychotic
symptoms such as delusions or
hallucinations. For diagnosis, at least
one manic or hypomanic episode must
have occurred, and the condition
typically follows a recurrent, relapsing
course.
CAUSES OF BIPOLAR
AFFECTIVE DISORDER
Bipolar Affective Disorder is a
multifactorial illness caused by the
interaction of genetics, brain chemistry,
and environmental stress. Its exact
cause is unclear, but it develops from a
mix of biological, psychological, and
environmental factors.
1. Genetic Factors:
 Bipolar disorder tends to run in
families.
 Individuals with a first-degree relative
(parent or sibling) with the illness have
a higher risk.
 Twin studies also support the strong
genetic influence.

2.Neurobiological Factors:
 Imbalances in brain chemicals such as
dopamine, serotonin, and
 norepinephrine are linked to mood
changes.
 Structural and functional changes in
brain areas like the prefrontal cortex,
amygdala, and hippocampus have
been observed.

3.Psychological Factors:
 Certain personality traits, such as high
sensitivity to stress or poor coping
skills, may increase vulnerability.
 Early negative experiences (like
trauma, neglect, or abuse) can
contribute to onset or worsening.

4.Environmental and Social Factors:

 Stressful life events, such as marriage
conflicts, financial problems, or job
stress, can trigger episodes.
 Disturbed sleep patterns and
substance use may worsen the
condition.

5.Other Biological Factors:

 Hormonal changes and medical
conditions can sometimes act as
triggers.

SYMPTOMS OF BIPOLAR
AFFECTIVE DISORDER
The symptoms are divided into two main
phases:
1. Manic Episode (High Mood
Phase)
 Unusually happy, excited, or irritable
mood.
 Talking very fast, with racing thoughts.
 Less need for sleep but still full of
energy.
 Overconfidence or feelings of great
importance.
 Doing risky things like spending too
much money, driving carelessly, or
making sudden decisions.
 Distracted easily and unable to focus.
 In severe cases – hallucinations or
delusions (false beliefs, suspicious
thoughts).

2. Depressive Episode (Low Mood

Phase)
 Feeling sad, hopeless, or empty most
of the time.
 Loss of interest in activities once
enjoyed.
 Tiredness, lack of energy, or feeling
very slow.
 Sleeping too much or too little.
 Changes in appetite and weight.
 Difficulty in concentration and
decision-making.
 Thoughts of worthlessness or guilt.
 In severe cases – suicidal thoughts or
self-harm.

TYPES OF BIPOLAR
AFFECTIVE DISORDER
1. Bipolar I Disorder
 In this type, the person experiences at
least one manic episode in life.
 Mania means extremely high mood,
too much energy, less sleep,
overconfidence, and risky behavior.
 Depressive episodes may also occur,
but the presence of mania is the key
feature.

2. Bipolar II Disorder
 The person has at least one
hypomanic episode (similar to mania
but less severe).
 Hypomania does not cause as much
damage as full mania, but the person
may still show unusual energy and
irritability.
 Along with hypomania, the person
experiences major depressive
episodes, which are usually more
troubling.

3. Cyclothymic Disorder
(Cyclothymia)
 This is a milder, long-term form of
bipolar disorder.
 The person has many periods of mild
depression and mild hypomania
lasting for 2 years or more.
 Although the symptoms are not very
severe, the constant mood swings can
still disturb daily life

TREATMENT OF BIPOLAR
AFFECTIVE DISORDER
 Cognitive Behavioral Therapy (CBT):
Helps people notice and change
negative thoughts, control mood
swings, and build better coping skills.
 Interpersonal and Social Rhythm
Therapy (IPSRT): Teaches the
importance of keeping a regular
routine (like sleep, meals, and
activities) to avoid sudden mood
changes.
 Psychoeducation: Teaches patients
and families about the disorder,
treatment options, and lifestyle
management, which improves long-
term recovery.
 Family Therapy: Family members are
guided on how to support the person,
reduce stress, and spot early warning
signs of mood problems.
 Medicines: Doctors may give mood
stabilizers, antidepressants. These
help control mania and depression and
work best along with therapy and
healthy lifestyle habits.
CONCLUSION
Bipolar Affective Disorder is a long-term
mental health condition that significantly
affects a person’s mood, behavior, and
daily functioning. Though its exact cause
is not fully understood, it arises from a
complex interaction of genetic,
biological, and environmental factors.
The illness usually follows a recurring
course of manic and depressive
episodes, which can disrupt personal,
social, and occupational life if left
untreated.
With timely diagnosis, proper treatment
through psychotherapy, medication, and
psychoeducation, along with family and
social support, individuals can manage
their symptoms effectively. While it
remains a lifelong condition, many
people with bipolar disorder are able to
lead stable, productive, and fulfilling
lives when provided with consistent care
and understanding.
METHOD OF STUDY
The method adopted for the study is the
case study method. A case study is an
in-depth examination of an individual,
group, or situation over a certain period
of time. In psychology, this method is
highly useful for studying mental health
conditions as it provides a deeper
understanding of the person’s
background, symptoms, and treatment
process in a real-life context. Information
is usually gathered through interviews,
direct observations, and personal or
medical records, which helps build a
detailed profile of the individual and
track their progress over time.

The sample selected is a 33-year-old

male who has been diagnosed with
Bipolar Affective Disorder.
CASE STUDY
DEMOGRAPHIC INFORMATION

Name: M.A.S.
Age: 33 years
Sex: Male
Marital Status: Married
Religion: Christian (Knanaya Jacobite)
Qualification: Diploma in Hotel
Management
Occupation: Runs family wholesale
business
Duration of Illness: 6 years
Diagnosis: Bipolar I Disorder.
CASE PROFILE
The case study is based on a 33-year-old
married male from a Christian Knanaya
Jacobite family, residing with his parents
and wife in Chingavanam, Kottayam. He
has completed a Diploma in Hotel
Management and is currently managing
the family wholesale business of betel
leaves, arecanut, eggs, oil, and fast food
at Vakathanam.
He was referred by his father, sisters,
son, and a relative when his behavior
worsened with suspiciousness,
irritability, verbal abuse, withdrawal from
church and social life, and refusal to
work. He had earlier sought psychiatric
help in 2012 during his stay abroad,
when he first developed religious and
grandiose delusions. In April 2018, he
again came for treatment and
psychotherapy due to relapse with
suspiciousness toward family, poor
hygiene, irritability, and refusal to attend
work.
Before the illness, he was known as a
responsible, sociable, cooperative, and
religious person, but during episodes he
became demanding, irritable, socially
withdrawn, neglectful of hygiene, and
rigid in beliefs

CHIEF COMPLAINTS
 Not going to work for the last 2
months.
 Avoiding church and prayers.
 Increasing suspiciousness toward wife
and family.
 Demanding, irritable, and verbally
abusive.
 Neglect of personal hygiene.
 Reduced sleep – waking early, not
rested.
 Religious and grandiose delusions
(believed he was God/prophet).
 Persecutory ideas – thought family was
hiding things from him.
 Social withdrawal, avoided
interactions.
 Sudden dietary change (became
vegetarian).

CASE HISTORY
The patient is a 33-year-old male who
had a normal early childhood with timely
developmental milestones. He grew up
in a supportive family, with no history of
psychiatric illness, though his father has
diabetes and his mother has
hypertension. After completing a
Diploma in Hotel Management, he
worked abroad in Abu Dhabi and later
Saudi Arabia, before returning to India to
join his family’s wholesale business. He
did not face major financial crises or
traumatic incidents at work. His first
psychiatric episode occurred in 2012
while abroad, when he showed increased
religiosity, irritability, and grandiose
delusions, which required medical
treatment. He remained in remission for
years, but in 2018, following his
marriage, he experienced a relapse. At
this time, he became suspicious of his
wife and family, avoided church and
social gatherings, was irritable and
verbally abusive, grandiose beliefs,
claiming to be a prophet or God. These
symptoms gradually affected his daily
life, relationships, and social functioning.
His increasing irritability, suspiciousness,
and religious delusions led him to stop
attending church, withdraw from social
interactions, and neglect personal care.
These changes caused significant
distress within the family and disrupted
his ability to manage work and
responsibilities. Over time, what began
as stress and mood changes turned into
a full-blown disorder with recurring
manic episodes and psychotic features.
Recognizing the severity of his condition,
his father, sisters, son, and a relative
(Mr. Monicha) referred him for
psychiatric treatment and psychotherapy
in 2018.

PLAN OF ACTION
 Cognitive Behavioural Therapy
(CBT): To manage suspicious
thoughts, irritability, and grandiose
ideas.
 Family Therapy &
Psychoeducation: Given to parents,
wife, and relatives to improve
understanding of the illness, identify
early warning signs, and provide
support at home.
 Medical Management
Mood stabilizers and antidepressants
were prescribed to control manic
symptoms and prevent relapse.

FOLLOW-UP
The patient was advised to attend
regular follow-up sessions every 2–3
weeks initially, to monitor symptoms,
check medication response, and provide
family support. Once his condition
stabilized, the follow-up gap was
extended to every 1–2 months for
maintenance and relapse prevention.
Improvement was noticed gradually after
the first few weeks of treatment, as his
irritability reduced, sleep improved, and
he began participating in daily activities
with family support.
CONCLUSION
This case presents a 33-year-old male
diagnosed with Bipolar Affective
Disorder, current episode manic with
psychotic symptoms. The patient
showed symptoms such as irritability,
suspiciousness toward family, reduced
sleep, neglect of hygiene, social
withdrawal, and grandiose religious
delusions. These symptoms disrupted his
personal, social, and occupational
functioning, leading to referral for
psychiatric care. Through a combination
of Cognitive Behavioural Therapy,
psychoeducation, family therapy, and
medication, along with regular follow-
ups, he began to show gradual
improvement.