Case Study – George Lawler

Biography and Background:

Client is a 35 year old man, married and father of two young children.
George worked at a small junior college where he taught physical education, and coached the Men’s and women’s track teams.
During his junior year in college George experiences his first psychological problems.
In college George played defensive back on the football team
George’s Coach in college referred him to a psychiatrist at the student health clinic.
After taking antidepressant medication and attending counselling sessions, George was back to his normal self within a couple of weeks.
George had a family history of bipolar disorder. (His uncle Ralph)
While working as a coach George experienced two other episodes with symptoms similar to his first.
The client’s wife consulted with the psychiatrist after the episode before the current one. He was prescribed, lithium carbonate.
George grew up in a small Midwestern town. His father taught history and coached high school football. He was the second of four children.
The client was awarded a football scholarship to the state university.
The client’s father was a heavy drinker who eventually joined alcoholics anonymous. For this reason George refused to drink with his friends.
Clients first fully developed manic episode happened suddenly when his track season was ending. His wife noticed he was behaving strangely. He was working excessively and demanding more from his athletes. He spoke consistently about the team, and boasted on their chance of national recognition.
Client lost control of his behavior on the day his team had their conference meet. He could be seen pacing rapidly up and down the aisles, and speaking about the merits of winning. With a ceremonial sword brought from home he led his team on to field screaming and shouting the school’s fight song. This was seen as another manifestation of psychopathology.
Client spoke uninterrupted to reporter for three hours.
Client started to appear unkempt.
Due to the fact that the client did not recognize the severity of his problems and his refusal to co-operate with his family and hospital staff, along with a testimony from a hospital psychiatrist, that he might be a danger to himself and others: George was involuntarily committed.

Symptoms

Client was showing significant signs of mania. He spoke excessively, was angry at the other patients. He was experiencing racing thoughts. He also had increased energy, pacing the hallways with rapid and erratic movements. Client had not slept for three nights.
Client was experiencing disillusionment and grandiosity. Stating that he was the coach of the U.S Olympic track team. He was offering tryouts for the other patients in the hospital.
Client was experiencing depression, in that he was having less energy, he was tired all the time from not sleeping or waking up in the middle of the night. Client contemplated suicide.
Client mood changes was affecting his family and his job.
Client mood changed from depression to severe depression. He was experiencing slowed speech. He refused to get out of bed. Client felt hopeless and empty, He thought he was incompetent at his job and wanted to quit. Client thought his family would be better without him.

Diagnosis:

George meets the DSM-5 diagnostic criteria for the following: