Archive for July 2013

Patch Adams a Beautiful Spirit and an Example of Bipolar Disorder

 


By Abbey Mikha

Dear Readers,

A lot of people left comments that said they enjoyed my analysis of the British actor Peter Sellers who suffered from borderline disorder.  For this reason I have created another analysis of Patch Adams according to the movie by the same name.  Many of you may have seen the movie, but you may not have known that the character suffered from bipolar disorder.

Bipolar disorder is prevalent in many communities including the Assyrian community.  Four percent of Americans have bipolar disorder.  That is a lot of people!  You may know someone with bipolar disorder.

As a Psychology student I was so shocked to hear of all the various mental illnesses that I never even knew existed.  Now as a Psychology graduate I believe it is important to know about illnesses such as bipolar because people we love may suffer from them throughout their life.  I also believe it is important to share this knowledge.  If we have more information about these disorders we can help our friends, family, and anyone else who needs it.

Feel free to let me know about any other kinds of disorders you would like to know about and I will try to create an analysis for them.  For now I would like to introduce you to Patch Adams.  This movie was released in 1998 and starred Robin Williams.

 

An Example of Bipolar Disorder: Patch Adams

Identifying Information

Mr. Patch Adams is a Caucasian male, 40 years old.  He has had several jobs throughout his life, which he believes did not suit him.  He became depressed and suicidal; therefore he signed himself into a psych ward.  He eventually left the ward without the doctor’s approval and he discovered that he wanted to be a doctor.  He now attends Virginia Medical University and is in his first year of studies. He is currently single and living on campus with a roommate who questions his validity in being at the medical university.

Behavioural Observation

Patch’s behaviour varies.  One constant aspect of his personality is that he appears to be a very sensitive person who genuinely feels the suffering of others.  He is talkative and a jokester.  He dresses vibrantly and has various opinions, which he is confident enough to express, even if the person on the receiving end disagrees with him.  An example of Patch’s sensitivity is when at one point the staff of the hospital, where he was a patient, gives a hysterical patient a shot.  Patch is surprised by this act and also upset because of the way that the patient was treated.  Another example of Patch’s sensitivity is where at one point he plays with his roommate in the psych ward by shooting imaginary squirrels. This was Patch’s way of trying to help his roommate go to the bathroom.  As a result of this Patch feels a connection with his roommate and decides that he therefore wants to help people.

A further example of Patch’s immense sensitivity is when he played with the patients when at the hospital affiliated with his medical school.  He appears to have an elevated level of energy, is anxious, and appears to have some out of the ordinary behaviours.  Patch defied most of the rules. Something interesting about him is that he was a firm believer in the Golden Rule which is, “Do unto others as you would have others do unto you.” Patch believed that doctors should get emotionally involved with patients.  The problem was that while he was getting emotionally involved he was also sometimes becoming unrealistic and what is called unprofessional.  One of his older patients had told him about a dream of swimming in a pool of noodles before she died and he made that dream come true for her.  This was very sweet though insensitive individuals who would judge Patch and would most probably say he was mistaken.

Patch received a ninety eight percent on his exam although his friends said that he did not study much.  Not only was he talented in academics, the patients also opened up to him and told him about their lives and dreams.  The doctor at the hospital continuously tried to remind Patch that the patients do not need to be entertained, they rather need a doctor.  Patch said that he was concerned about improving the quality of life of the people in the hospital.  He appeared to have always wanted to be exciting and even risky.  He said that doctors did not help him when he was in the hospital rather the patients helped him.  Sometimes Patch’s dialogue seemed very rapid especially when speaking of his dream of a free hospital.  He said that he wants to open a community where, “Joy is the way of life, and love is the ultimate goal.”  He said that humour is to heal all suffering.

Current Circumstances and History

Patch’s father died when he was 9 years old.  His father was in the army and had told him that in the Korean War he had lost his soul.  When his father died Patch thought it was his fault.  At the hospital, which is affiliated with the medical school, Patch tried to reach people in unique ways.  He said that the patient must be treated as well as the disease.  He asks for the patients name first and in this way was considerate.  He felt sorry for the little cancer patients and tried to cheer them up.  He made elaborate costumes to entertain them. He had an enormous amount of energy and this is evident in every aspect of his life.

When his girlfriend at the medical school was murdered, he was very sad and blamed himself for her death.  He was contemplating suicide and was thinking about jumping off the mountain. He suggested that God should have spent the 7th day of creation on compassion instead of taking a rest.  Although Patch appeared to be depressed after his girlfriend’s death, in his record at the school the dean accused Patch of “excessive happiness.”  Patch believed that indifference is a disease.

Conceptualization

The pathology I believe Patch to be suffering from is bipolar I disorder most recent episode manic.  For a diagnosis for this disorder a person must have at least one manic episode. Patch has had elevated self-esteem, he is more talkative than usual; he has flights of ideas, a reduced need for sleep, and perhaps he is even easily distracted. The highs have led to difficulties for Patch especially where it concerns authority figures.  Patch has experienced some depression as a result of recent events such as his girlfriend being murdered as a result of visiting a patient of their small free hospital house.

The DSM-IV-TR states that there must be a presence of only one manic episode and no past major depressive episodes for this diagnosis. Also, recurrence is defined as either a change in polarity from depression or an interval of at least 2 months without manic symptoms.  It must also be noted that the manic episode is not better accounted for by schizoaffective disorder and is not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder not otherwise specified.

The etiology of bipolar I with recent episode manic is that research has shown a strong genetic component for this disorder, with the environment throughout childhood, adolescents, and adulthood playing a factor in the acceleration of symptoms.  Genetics and environmental influences triggered in Patch this disorder.  He had been spiralling out of control for some time and the disorder has now reached a peak.

Further information that is needed and is to be considered has to do with Patch’s family and past.  What stressful environmental events could have caused him to become ill?  There must be more information about his childhood and his relationship with his father, mother, possible siblings, and friends.  Did Patch have any great disappointments in his life like for example failed love relationship?  How did Patch deal with emotions before and cope with the stress of life?  This is information that is not given to us in the movie.

Formulation

Axis I: Bipolar I most recent episode manic.

Axis II: Deferred.

Axis III: No physical diseases or current medical problems.

Axis IV: Death of father early years, and after the death of his girlfriend in university.

Axis V:  Functioning of patient is moderate with GAF score of 65.

 

Patch’s symptoms appear to merit the diagnosis of bipolar I most recent episode manic. The reasoning behind the GAF score of 65 is that Patch shows some mild symptoms, some difficulty in social, occupational, and school functioning, but he is also functioning pretty good generally speaking, doing good in academics, and has some meaningful interpersonal relationships.

Other disorders to be ruled out are schizoaffective disorder, since Patch is not delusional nor does he hallucinate.  Schizoaffective disorder suggests a mixture of symptoms of schizophrenia and a mood disorder.  Schizophrenia has also been ruled out.

Treatment Recommendation

Patch should be treated with a mood stabilizer such as lithium because this medication has been proven to work effectively for patients with bipolar.  Also, Patch should seek therapy because this can be useful in helping him understand the illness he is suffering from.  It will be beneficial for Patch to try to learn when a manic or depressive episode is impending, and to prepare for this.  Learning coping skills is important.

Patch needs support because without it the illness will intensify during manic episodes when he is alone and does not have anyone to turn to for help.  Medication plus psychoanalysis plus education about mental illness is the best treatment for Patch.

It is obvious that Patch is a wonderful human being, but he needs help from mental health care professionals.  Mr. Patch Adams is a beautiful spirit and idealistic person, but he should take the medication prescribed and follow through with the care recommended, so that he can live a productive life, do the good that he wants to do, and be the change he wishes to see in the world.

 

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