Lori Schiller's Diagnostic Analysis

Based off of the information provided in case 4.1, Helen’s symptoms and behaviors that are consistent with Bipolar 1 Disorder. Therefore, her diagnosis would be bipolar 1 disorder (F31.13), current episode manic, severe severity, with mixed features. According to the Diagnostic and Statistical Manual of Mental Disorders,

She went on to speak of other episodes with symptoms of delusions and hallucinations which she says are “hallmarks of the illness”. She explained that schizophrenic is not disorders of multiple personality or split personalities, a schizophrenia mind is shattered. What I find incredible is the fact that with treatment she was still able to hold it together

Based on my clinical judgement, I believe the client meets all criteria for Bipolar I due to the following. Criteria A requires a distinct more than one week of abnormal and persistent expansive or irritable mood. According to the narrative, the client has demonstrated excessive energy that last from a few day to several weeks reported from his wife prior to his current hospitalization state. Criteria B requires three or more symptoms to a significant effect and represent noticeable change from usual behavior. Ezekiel currently demonstrates 1. Flight of ideas or subjective experience that thoughts are racing, mainly demonstrated when he is working and unable to focus on one thing and one task; 2. Increase in goal-directed activities, such

Current diagnostic criteria for Angela’s manic episode is described through criterion A – D in the following. Criteria A requires the individual to meet at least a one week period of distinct abnormal and persistently elevated, expansive, or irritable mood and abnormal and persistently increased goal-directed activity or energy. Angela has currently been experiencing this particular episode for ten day now and has demonstrated symptoms of increased activity for example the West Coast fight that the booked and the amount of money she has put into textbooks. Criteria B requires that during this time Angela must be experiencing at least three of the listed symptoms that represent a significant degree of noticeable change from her usual

People with bipolar I disorder have full manic and major depressive episodes. Most of them experience an alternation of the episodes; for example, weeks of mania may be followed by a period of wellness, followed, in turn, by an episode of depression. Some, however, have mixed episodes, in which they display both manic and depressive symptoms within the same episode—for example, having racing thoughts amidst feelings of extreme sadness. In bipolar II disorder, hypomanic—that is, mildy manic—episodes alternate with major depressive episodes over the course of time. When a person experiences numerous periods of hypomanic symptoms and mild depressive symptoms, but not full-blown episodes, DSM-5 assigns a diagnosis of cyclothymic disorder. The symptoms of this milder form of bipolar disorder continue for two or more years, interrupted occasionally by normal moods that may last for only days or weeks.

Multiple episodes may occur within one week or day. Rapid cycling tends to occur later in the course of the illness and is most common in women. Rapid cycling bipolar disorder occurs in up to 20 percent of bipolar I and II patients and it is very hard to differentiate from mixed states (Martin, 2006, p. 305).

Furthermore, Monica is also diagnosed with Bipolar Disorder. According to the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM), Bipolar Disorder is characterized as a mood disorder consisting of major depressive and manic episodes (American Psychiatric Association, 2013). One must display at least 5 of the following symptoms of a major depressive episode within a 2-week period which must include a depressed mood most of the day or a diminished interest or pleasure in daily activities (American Psychiatric Association, 2013). The manic episode must persist for one week in which the individual displays an irritable or euphoric mood (American Psychiatric Association, 2013). Based

Schizoaffective disorder could be diagnosed according DSM-IV that if the patient is with manic ‎episode, major depressive episode or mixed episode along with hallucination, delusions, ‎disorganized speech, disorganized behavior as well as negative symptoms. In order to identify ‎whether patient is in manic episode, there should be an uninterrupted period of illness for one ‎week and the patient is in persistently elevated or irritable mood with symptoms such as inflated ‎self- esteem, decreased need of sleep, distractibility, flight of ideas, more talkative than usual and ‎excessive involvement in pleasureful activities. If a patient is in depressed mood during most of ‎the time for a two-week period with five or more symptoms such as markedly

Major Depressive disorder (MDD): Due to patient’s problems with concentration, poor sleep (he reports sleeping 2-3 hours nightly) and inability to focus, MDD was considered but substantial symptoms presented outweighs this diagnosis (Association, 2013).

There is no indication she has had a manic or hypomanic episode. Her depression may be complicated by grief due to her father’s death one year ago. Her symptoms seem to get worse after his passing.

The first major treatment that was administered to Lori was electroshock therapy. After getting many treatments of electroshock, it did not seem to work particularly well for Lori, the voices and such were still there. After she underwent electroshock therapy several times, she fully believed that this treatment destroyed her brain cells, she says that it fried her brain and all of her memories she did not remember a lot of memories earlier from her life. It is not uncommon to lose bits of memories after treatment is administered, but it is known not to cause any long term damage, but Lori thought otherwise even after the doctors had explained this to her. Another treatment was being taken to the quiet room. The quiet room was meant to be a safe and peaceful place to go to relax and calm themselves down before, during, or after having an episode. Lori was usually forcefully carried into the quiet room, she never voluntarily wanted to go to the quiet room. Once being brought to the room, you are alone in and empty room and Lori was given a tranquilizer, sodium amytal. She believed this room to be better known as the punishment room, when she would calm down the voices would torment her, she was left alone with them and had no escape. Lori returned to the quiet room time and time again with no hope of this helping her episodes. But after time, Lori had to receive the Cole-pack method where they

A Schizoaffective disorder is a mental illness. The symptoms of this illness include having strange or unusual thoughts or perceptions, paranoid thoughts and ideas, delusion (i.e. having false, fixed beliefs), hallucination, such as hearing voices, and experience disorganized thinking (i.e. unclear and confused thoughts). They may have manic episodes or a sudden increase in energy and behavioural displays that are out of character. They may become irritable and have poor temper control, and even have thoughts of suicide or homicide. Their speaking style can be erratic, and difficult of others to understand, they may have problems with attention and memory. Their behaviour will be at extreme ends of the normal spectrum (catatonic behaviour)

Bipolar II however, is very similar to Bipolar I except the person affected will have mood changes that will cycle between highs and lows over a period of time. The persons’ affected will never reach a full mania during one of their “up” moods. Another form of bipolar disorder is called Rapid Cycling. A person who has Rapid Cycling will experience four or more episodes of mania in a single year. Only about 10% to 20% of persons’ diagnosed with a bipolar disorder will be diagnosed with Rapid Cycling. Mixed Bipolar disorder would consist of somebody that will experience mania and depression simultaneously or in a rapid sequence. Cyclothymia is the mildest form of bipolar mood disorder. Symptoms of Cyclothymia must last for at least two years. Also, the person cannot have gone two months at a normal state.

82)This emphasizes the book’s point of saying that some criteria are “abnormally increased activity or energy,” and “flight of ideas or subjective impression that thoughts are racing,” (Kring et al. 2016, p. 140). She mentions that during these episodes that her friends would tell her to slow down (Jamison 1995, p. 37). This can also be considered as the symptom characterized by unusual talkativeness and rapid speech (Kring et al. 2016, p. 140). According to the textbook, a decreased need for sleep also characterizes mania, which Jamison often refers to, saying that “Decreased sleep is both a symptom of mania and a cause,” (Jamison 1995, p. 69). During her manic episodes, Jamison also had a tendency to dress provocatively and overspend money, which the DSM-5 characterizes as “excessive involvement in activities that are likely to have painful consequences, such as reckless spending, sexual indiscretions, or unwise business investments,” (Kring et al. 2016, p. 140). She also mentions that during one of her manias, she bought snakebite kits because “God had chose me, and apparently only me, to alert the world to the wild proliferation of killer snakes in the Promised Land,” (Jamison 1995, p. 76), which can be classified as the DSM-5 criteria “increased self-esteem; belief that one has special talents, powers, or abilities,” (Kring et al. 2016, p. 140). As for her depressive

When looking at differential diagnosis that overlap or resemble those of MDD, requires careful observations and careful clinical evaluation. Sarah presents with no underlying medical condition that can be associated with a mood disorder. It also appears she lacks irritability in her behavior that would contribute to a manic episode with irritable mood. With no current or past substance abuse/use, her symptoms are not etiologically related and can not be deem to be part of a substance, or medication induced disorder. Bipolar is also ruled out, base on the fact that her episodes and symptoms have not required hospitalization in the past. Attention-deficit/hyperactivity disorder is also ruled out because her mood is not