Peer Response – Mental Health Case Study

Peer Response – Mental Health Case Study

Hello,

Thank you for contributing to the mental health discussion. You have well-presented your case study including providing detailed subjective and objective data on the patient, as well as recommending the various diagnostic tests to further explore the client’s mental health. Based on the data you have provided on the client; my top three differential diagnoses are:

1. Unipolar depression
2. Personality disorder
3. Bipolar 1 Disorder

My first differential diagnosis for unipolar depression is elicited from her history of current illness; she reports that she has mostly episodes of low mood and energy, and mostly feels irritated, and major maniac episodes and urges although not clear, may be urges towards self-harm or suicide. The prolonged depressed moods, indecisiveness, loss of energy, and inability to concentrate are core symptoms focused on in the diagnosis of unipolar depression (Härter & Prien, 2023). However, the presence of maniac episodes rules out unipolar depression.

My second differential diagnosis, personality disorder is based on the client’s report that she has impulsive behavior during manic episodes and difficulties concentrating. These manifestations indicate a condition within the personality disorder spectrum. However, personality disorder may be ruled out due to the client’s shifts between depressive and depressive and manic episodes which are not symptoms associated with personality disorders. My third differential diagnosis; Bipolar I Disorder, is based on the client’s report of depressive and manic episodes, and a family history of bipolar disorder.

Of the three differential diagnoses, my most likely diagnosis is Bipolar I Disorder. I have various reasons for drawing this conclusion. First, the client reports that she has depressive and manic episodes, and moods and energy levels that are generally low for a long time. According to Marzani & Neff (2021), majorly, bipolar disorders, especially bipolar I disorder are characterized by the patient experiencing manic episodes with extremely elevated behaviours and moods, and irritability as compared to other bipolar disorders. Additionally, the client reports that her family has a history of mood issues which may increase her susceptibility to Bipolar I Disorder. She also has been on treatment for the same disorder which makes it the most likely diagnosis.

 References

Härter, M., & Prien, P. (2023). The Diagnosis and Treatment of Unipolar Depression: National Disease Management Guideline. Deutsches Ärzteblatt International, 120(20), 355. https://doi.org/10.3238/ARZTEBL.M2023.0074

Marzani, G., & Neff, A. P. (2021). Bipolar Disorders: Evaluation and Treatment. American Family Physician, 103(4), 227–239. https://www.aafp.org/pubs/afp/issues/2021/0215/p227.html

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the differential dx
1-unipolar depression
2-personality disorder
3- Bipolar 1

Responding to a Peer’s Case: Respond to at least one other student’s initial case presentation and include the following:
Based on the initial case presentation, list your top three differential diagnoses.

Peer Response – Mental Health Case Study

Choose the most likely diagnosis.
Support your decision with scholarly sources

Subjective Data

Chief Complaint: The name of the chief complainant is a 32-year-old E.T. She is visiting a specialist because her depression and manic episodes are interfering with her relationships and daily life.

History of Present Illness: For five years, Ms. T’s mood has fluctuated. Her depression makes her miserable, exhausted, helpless, and unable to concentrate in manic episodes, and her mood, energy, urges, and irritation rise. She thinks mood fluctuations hinder her work and relationships. Irritation and rash behaviour have lasted three weeks.

Demographic Data: Being a white American lady, Mrs. T, works in a challenging business environment as a marketer. She owns an apartment in New York City centre. Her success and BBA are well known. Despite her achievements, she struggles with her personal life.

Risk Factors: Bad attitudes plague T’s family. For starters, her mom is constantly moody. Secondly, the patient was saddened to learn that the company was restructuring and that she would lose her job. Third, her buddies drink a lot and do not often hang out with her since she has never done drugs.

Medical, Surgical, and Mental Health History

Ms. T was sometimes sad. Therefore, antidepressants helped her before. She claims no major health issues or surgeries. She has displayed indicators of sorrow, but she has never been diagnosed, and her therapy sessions have been inconsistent. Ms. T’s tale illustrates the Bipolar I Disorder’s complexity. She is diagnosed because she has frequent mood episodes and symptoms of sorrow and mania. T’s main issue is that her mood swings harm her health, employment, and relationships. One can understand how work stress and a family history of bipolar disorder caused her symptoms to worsen. Bipolar I Disorder, a complex disorder that requires extensive research, is influenced by genetics and environment (Salagre et al., 2020). Since Ms T used antidepressants, it is crucial to review her response and side effects. One can learn how she handles difficulties and what treatments she enjoys by looking at her past therapy. The psychosocial stressors, symptom severity, and mental state exam Ms T performed will help her follow-up meetings confirm the diagnosis and create a suitable treatment plan. General Bipolar I Disorder treatment requires a collaborative and supportive therapeutic relationship. Short-term symptom treatment and long-term disease management are included.

Objective Data

In her medical exam, 32-year-old E.T. was clean and well-dressed. Her cleanliness and manner indicated normalcy. A temperature of 98.6°F (37°C) with 72 heartbeats and 16 lung breaths per minute were present. Ms. T focused and directed her psychomotor activity without getting angry or slowing down. The logic, rhythm, and sense of her speaking indicate mental and communication stability. No focal impairments and appropriate motor and sensory skills were found on a neurological test.

In the mental status test, Ms. T indicated she was agitated, reflecting her worries. She seemed nervous when we discussed job worries. She had no mental abnormalities or “flight of ideas,” and her thoughts were rational. Ms T said she acted thoughtlessly while manic and got lost when depressed. Notably, she rejected suicidal inclinations. Ms. T stated she could maintain track of time, place, and people without hallucinations. She could recall events, do simple math, and grasp her mental health issues, demonstrating good cognitive function. Despite knowing she had a mental illness, her hyper episodes may make her snap and make hasty decisions.

Ms. T’s mood swings and objective review support Bipolar I Disorder. These figures help us develop a robust treatment plan for her that emphasizes regular monitoring to help her overcome her issues and enhance her physical and mental health.

Diagnostic Tests

Ms. T’s symptoms suggest Bipolar I Disorder. To confirm the diagnosis and rule out other mental or physical disorders, she may need extra tests.

Initial blood testing should include a CBC and metabolic screen. These tests can detect mood swings caused by thyroid or metabolism issues. Mood difficulties might resemble thyroid damage (Salagre et al., 2020). To diagnose these health issues, they must be examined.
Drugs may cause mood changes; thus, a screening test may be needed. Drug and alcohol abuse, even for fun, can worsen or improve mental disease symptoms. Learning about drug usage aids in treatment and prevention.
Health practitioners should do a complete psychiatric assessment. This study may include structured therapeutic conversations, standardized surveys, and Ms. Thompson’s conduct. The mental state exam helps identify mood problems from other psychiatric conditions.
On gloomy days, Ms T’s friends may be asked about her symptoms and behaviour to learn more about her.
Because she took antidepressants, Ms. T may consider pharmacogenomics genetic tests. This test shows how a person reacts to psychiatric medications, which can help tailor the treatment to their DNA (Tokumitsu et al., 2023).
Blood tests, drug screening, mental assessment, and genetic testing for pharmacogenomics should complete Ms. T’s diagnosis. This holistic approach excludes medical and medication causes of her symptoms and assesses her mental health. This will help doctors diagnose and treat Bipolar I Disorder more accurately and effectively.

References

Salagre, E., Grande, I., Vieta, E., Mezquida, G., Cuesta, M., Moreno, C., … & Bernardo, M. (2020). Predictors of bipolar disorder versus schizophrenia diagnosis in a multicenter first psychotic episode cohort. The Journal of Clinical Psychiatry, 81(6). https://doi.org/10.4088/jcp.19m12996Links to an external site.

Tokumitsu, K., Yasui-Furukori, N., Adachi, N., Kubota, Y., Watanabe, Y., Miki, K., … & Yoshimura, R. (2023). Predictors of psychiatric hospitalization among outpatients with bipolar disorder in the real-world clinical setting. Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1078045Links to an external site.