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  • Prepared by:
  • Mental Health Story Board
  • Dr. S. Goldberg M.D.
  • Psychiatry and Neurology
  • T & T
  • Good Morning, my name is Jenny, I’m here for my appointment with Dr. Goldberg.
  • Dr. S Goldberg M.D.
  • Psychiatry and Neurology
  • Good morning Jenny, Dr. Goldberg is waiting to see you. Right this way.
  • Trinidad & Tobago
  • Neurology
  • Psychiatry
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  • Thanks for seeing me Dr. Goldberg. My mother was just diagnosed with bipolar disorder and anxiety, and I don’t know how to approach it. I scheduled this appointment to learn more about mental health, that I can be in a better position to not only assist my mother, but also educated persons around me.
  • Jenny, I am sorry to hear about your mother, but i must applaud your effort to learn more about this issue; one that affects a great deal of our community and the world.Mental illness is a health issue that largely affects how a person feels, thinks, behaves, and how they interact with other people.To this day, there are more than 200 classified forms of mental illnesses, some more than common, but all with unique categories of symptoms and outcomes.
  • Hi Jenny, what can I do for you today?
  • Psychiatry
  • University of the West Indies Psyc2031 - Mental and Physical Health Course Coordinator - Kerissa NelsonGroup Assignment - StroryboardDue date: November 19th, 2021
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  • Vernel Leriche - 320017657 - %100Nickesha Johnson - 310101805 - %100Daenah Johnfinn - 320020137 - %100Keneisha Gumbs - 313100830 -%100Javon Liburd - 320016800- %100
  • Doc, I cant seem to shake the fact that my mother was diagnosed with two mental illnesses. How is this even possibly? Should I be even more worried?
  • Psychiatry
  • 24 year old Jenny out of Trinidad has recently been exposed to the grave effects of mental health, as her mother was recently diagnosed with borderline bipolar disorder and anxiety. Jenny took the initiative and scheduled an appointment with a Psychiatrist, Dr. Goldberg, to learn more about mental health and issues surrounding mental illnesses, as well ways means and best practices of improving mental and overall health. Jenny has compiled number of questions and concerns she would like to be addressed by Dr. Goldberg, including the potential causes and triggers of mental health, and what type of medication is usually prescribed to deal with these type of issues.
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  • Thanks for that information Dr. Goldberg. Can you help me understand why this is happening to my mother? What are the reasons or causes that brought on bipolar disorder on her, or anyone, for that matter?
  • Well Jenny, there is no single cause for bipolar disorder, however, there are multiple factors that play a role in its development, such as brain chemistry/functioning, genetics, or environmental factors. You can have this pamphlet that expounds on these factors.
  • Psychiatry
  • Jenny begins to process all the information she received thus far. However, despite now learning that a great deal of persons around her suffer from mental health issues, she cannot stop thinking about her mother, and the fact that she was not diagnosed with one illness, but two. This is something she needs to seek information on.
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  • Can you tell me more about the environmental factors? Can stress trigger the disorder?
  • Jenny begins to understand mental health, and why her mother maybe affected but more than one illness. Having done research prior, she understands how the mental and behavioral effects of bipolar disorder may lead to other illnesses, including anxiety. She now fully understand that when a person is affected by more than one illness at the same time, this is referred to as comorbidity.However, Jenny always considered her mother to be happy and healthy, and is ambivalent as to how her mother came to be affected by these two mental illnesses.
  • Neurology
  • Jenny, quite often one disorder may lead to other issues. This would will result in persons being affected by or diagnosed with multiple illnesses and disorders. This is what we refer to as ‘Comorbidity’.
  • So as is seen with your mother, issues that are often comorbid with bipolar disorder are different types of anxiety disorders, impulse-control disorders, and problems relating to the excessive use and misuse of drugs and alcohol.
  • -Dell’Osso & Pini, 2012-Valderas et al, 2009-Xuan, Kirchdoerfer & Norwood, 1999
  • Neurology
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  • McGuffin et al., 2003Gershon & Thompson, 2001National Institutes of Health, 2009Ayano, 2016
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  • Genetics 
  • Research has yielded convincing results that suggest Bipolar Disorder is a biological occurrence due to its high rate of heritability. This simply means that the disorder is believed to run in families. Children with parents or siblings who suffer from this disorder are four times more likely to develop the illness. This does not however mean that other family members will develop the illness since most children with a familial history of the disorder will not develop it.
  • In addition to brain function, other research suggests there is a strong correlation between bipolar disorder and neurotransmitters as they play an important role in mood regulation and can affect other brain chemicals. Irregular serotonin levels for example can cause mood swings. An increase in epinephrine and norepinephrine reportedly causes mania, while a decrease in these levels causes depression.
  • Brain imaging studies have shown differences in the brains of patients with bipolar disorder and that of healthy patients. Regions of the brain concerned with processing and controlling emotions are activated differently in people with Bipolar Disorder.
  • Brain Chemistry/Function
  • Bipolar Disorder Causes
  • Neurology
  • Yes Jenny, that is correct. Environmental stressors and psychosocial triggers may also play an important role in the development of Bipolar disorder. Severe life events like physical or sexual abuse, the loss of a loved one or overwhelming financial issues can trigger depression or mania. Changes in daily routines and sleeping habits have also been linked to increasing bipolar symptoms in patients or causing a relapse. 
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  • McGuffin et al., 2003Gershon & Thompson, 2001National Institutes of Health, 2009Ayano, 2016
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