Abnormal behaviour is challenging to describe as many people have different views and
beliefs on what is normal and what is abnormal. Thus abnormal behaviour differs depending
on one’s culture, one’s beliefs and values (Durand & Barlow, 2016). Abnormal behaviour
essentially causes psychological dysfunctions, impairment, and distress in one’s personal life
and is not culturally accepted (Rosenhan & Seligman, 1984). Abnormal behaviour occurs in
many mental disorders such as Bipolar. Bipolar is a mental disorder that causes abrupt shifts
in one’s moods, the ability to do tasks and changes in energy levels (Durand & Barlow,
2016). People who have this mental disorder tend to experience manic and depressive
episodes (Rosenhan & Seligman, 1984). The following case study which will be presented in
the essay below makes it evident to see that Sandy suffers from a mental disorder which
constitutes to her abnormal behaviour. Firstly this essay will underline what constitutes
Sandy’s behaviour as abnormal. Sandy’s mental disorder diagnosis as well as a differential
diagnosis will be discussed in the essay. Furthermore the essay will discuss the causes of the
mental disorder, the prognosis and treatment plans.
A mental disorder constitutes to abnormal behaviour which brings upon a breakdown in
cognitive, emotional and behavioural thinking. This breakdown brings upon personal distress
and significant impairment in core aspects of one’s life. The behaviour that Sandy presents is
seen as abnormality as it brings upon psychological dysfunction, impairment, distress and is
not culturally accepted by her peers or family members (Durand & Barlow, 2016). The
delusions, hallucinations, feeling like a “third sex”, frantic thoughts, on a constant high and
paranoia (which is shown by her “scribbling” her thoughts on the wall) is all examples of
psychological dysfunction that she is experiencing (Rosenhan & Seligman, 1984). Sandy also
experiences irritation, loss of enjoyment, difficulty eating and sleeping which explains the
impairment in her everyday life as well as distress (Durand & Barlow, 2016).
Sandy’s behaviour was not culturally accepted by her peers and family members, as it was
not her “norm” behaviour and they simply could not understand it or found it unconventional
(given their standards of normal). Given Sandy’s abnormal behaviour and symptoms gives an
indication that Sandy suffers from Bipolar I with psychotic features. The diagnosis of Bipolar
I with psychotic features best suits Sandy’s symptoms, because in Bipolar I the patient will
experience a manic episode (constant high) and the depressive episode (lack of sleep)
accompanies the manic episode either after or before (Rosenhan & Seligman, 1984). In
Sandy’s case she experiences her manic episode first which is then accompanied by her
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depressive episode. These episodes are alternating, usually chronic and bipolar I has an
immense impact on daily functioning (Durand & Barlow, 2016).
Sandy experiences manic episodes for about a week, these manic episodes bring about
impairment and hospitalization (Goodwin, 2012). In these manic episodes Sandy experiences
intense abnormality due to the change of her behaviour (Goodwin, 2012). During the manic
episode Sandy experiences no need for sleep, as she has rapid, fast and exciting ideas running
through her head (running for election for the prime minister of defensive). Sandy also
experiences an inflated self-esteem, which leads her to think that she is better than everyone
as she sees herself as “superwomen” (Goodwin, 2012). During manic episodes there is an
increase in excessive involvement in pleasurable activities where the consequences are high
(Titmarsh, 2013). This is seen in Sandy’s case as she becomes very hypersexual in her manic
episode by indulging in unprotected sex and masturbation. It is also seen when Sandy
partakes in careless behaviour, as she consumes an unhealthy amount of drugs and alcohol.
By indulging in this behaviour decrease Sandy’s mental state even more as these activities
can alter her mood (Cassidy, Carroll & P Ahearn, 2001). Sandy’s speech becomes very
pressurized during manic episodes to a point where her friends do not understand what she is
saying (Titmarsh, 2013). All Sandy’s symptoms given above meets the criteria in the DSM IV
for manic episodes in bipolar I. In Bipolar I, psychotic features can come to surface during a
manic episode, as it does in Sandy (Raballo, Poletti & Henriksen, 2018).
Sandy experiences delusions and hallucinations. Sandy gets somatic delusions, as she feels
as if someone has control over a leg, Sandy also feels as if she is a “third sex”, which is a
clear sign of delusions, as it is irrational and cannot be true (Raballo, Poletti & Henriksen,
2018). The hallucinations that she experiences is visual and auditory, as she claims that she
has spoken to Jesus and has seen Jesus. This kind of abnormal thinking leads to psychological
dysfunction (Raballo, Poletti & Henriksen, 2018). All Sandy’s psychotic features given above
meets the criteria for Bipolar 1 with psychotic features in the DSM IV. Sandy’s depressive
episodes are two weeks and longer, these depressive episodes bring upon clinical distress and
impairment which constitutes to her abnormal behaviour (Goodwin & Jamison, 2007).
During the depressive episodes Sandy’s finds it difficult to sleep, she cannot concentrate, she
lacks motivation, and she has very slow or no physical movement and has a very poor
appetite (Goodwin & Jamison, 2007). This leads to her having a very low positive effect on
her life, as she loses interest in things she always use to do (such as painting) and is in a state
of anhedonia (Goodwin & Jamison, 2007). Sandy becomes extremely withdrawn from her
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