2.

Hstory of the Present illness

Patient I.R., 56 years old is diagnosed with bipolar affective disorder, manic depression with psychotic
symptoms.

When he was a child un his school age, he actively participates in school activities and can also mingle
with classmates. As he grows up, he learned to become more sociable and meet more friends and
people of different walks of life . And most likely his common friends are girls to whom he is comfortable
with. He learns also to become independent and firm but with the moral a financial support of his loving
family. He is able to finish his degree and come to and becoming mechanical engineering. He decides to
work abroad o work his own mney. Until such time that he met his lawfully beloved wife who happens
to work in Saudi. He is blessed with one child. Furthermore, in order to sustain the needs of the family
one must sacrifice, so as the bread winner he is the one who wrks abroad After how many years, they
decided that his wife will go abroad also to searchfor greener pasture leaving teir son with him. In their
marriage life, it ismerely a long distance relationship and according to him it is so difficult to deal with
but it is a kmust to do. So, there way of communication is really hard because it is through etter.
Sometimes letters is being received one week or more after osting it . His wife has only uality life for
them if she comes home for vacation. When his wife is at home during visits, he is realy happy as if he
owns the whole workld. According the patient, thr most traumatic experience he had is the death of his
sister. That is the time he feels very sad because he claimed that the relationship they had is really strng
nd close. To is other siblings, he visits them occasionally and whenever theres a problem with one of the
member of the fsmily he and the others lend their hands and intervene to any problem to resolve it. He
has misunderstanding to his neighbor but not identified, every noe and then they are almost having an
argument.

In the case of the patient, there is no mental illness in the family. There is no past edical historyof any
knowndisese, no known history of any known hospitalizations, accidents, trauma and operation.
However he is just only diagnosed with hypertension when he was admitted at the psychiatric hospital
ward. The time that he is firstly observed when manifestations aof the disorder was the patient was
involved in the treasure hunting which he started when she met an old women dictating him to do and
where to haunt. He’s being manipulated by the old woman. Since then, the patient always dig around
their backyard and preoccupied in doing unnecessary things, but depite this, the patient still chores and
acts inaccordingly. He maybe helpful in dong house chores but observe that he loves his social life. His
friends are not visiting him anymore. Afterwards,the patient’s haunting activites and also stop seeing the
old woman. He was observed happy during those times. The patient’s wife went back again to Saudi,
and after sometime; the patient resumes his usual activites digging around the house. But perhaps the
cheerful, optimistic, happy, full of energy. This tim the atients starts tomumble and walks from the
house to and fro and sometimes utters icoherent words. Despite this the patient does not regularly
takes a bath. As the days goes by, 5 day prior to admission, the patient feels abnormally good , high,
excited, hyper and irritable. Hese can be so extreme that the sufferer loses contact with the reality and
starts to believe in strange things, have ppor judgment, and behaves in embarrassing manner, harmful,
or event dangerous ways. These maybe accompanied by; an elvated mood, overwhelming sense of well
beng and self importance; increase energy and over activity, increase speech, often rapid and louder
than usual, which may difficult for others to follow; a very grand, over optimistic ideas and plans may be
expressed.; the patient develop”psychotic” symptoms of delusion and hallucinations. The content of this
is usually in keeping with the euphoric mood and unrealistic sense of self importance. One day prior to
admission, the patient was brought to their relative to Balatk Mines to show him how mning is done.
Because patient keeps on saying Smith Berto, patients relatives who works in mining company. Afte
went to Balatok mines, during the night when his son was watching tv, the patient comes to him saying,
Sino ka..Sino ka?” Peter Finder (their neighborhood whom he had a misunderstanding). So , the son
introduce himself. Afterwards, the patient went to his room shouting and shouting over and over again.
Out of fear, the son called their relatives and asked help at nearby police station to capture the patient.
The patient was seen half naked, praying on the road, kissing the ground saying “I am the savior”. The
[atient also has bag with stones and books and saying he would go to Zamboanga leaving a treasure
tohis son. He was captured and brought to the institution hence, admission.