Learning Goal: I’m working on a psychology project and need an explanation and answer to help me learn.Chelsea was a 43-year-old married librarian who came to an outpatient mental health clinic with a long history of depression. She described being depressed for a month since she began a new job. She had concerns that her new boss and colleagues thought her work was poor and slow, and that she was not friendly. She had no energy or enthusiasm at home. Instead of playing with her children or talking to her husband, she watched TV for hours, overate and slept long hours. She gained six pounds in just three weeks, which made her feel even worse about herself. She cried many times through the week, which she reported as a sign that “the depression was back.” She also thought often of death but had never attempted suicide. Chelsea said her memory about her history of depression was a little fuzzy, so she brought in her husband, who had known her since college. They agreed that she had first become depressed in her teens and that she had had at least five different periods of depression as an adult. These episodes involved depressed mood, lack of energy, deep feelings of guilt, loss of interest in sex and some thoughts that life wasn’t worth living. Chelsea also sometimes had periods of “too much” energy, irritability and racing thoughts. These episodes of excess energy could last hours, days or a couple of weeks. Chelsea’s husband also described times when Chelsea seemed excited, happy, and self-confident — “like a different person.” She would talk fast, seem full of energy and good cheer, do all the daily chores and start (and often finish) new projects. She would need little sleep and still be up the next day. Because of her periods of low mood and thoughts of death, she had seen mental health care providers since her mid-teen years. Psychotherapy had given some help. Chelsea said that it “worked okay” — until she had another depressive episode. She could then not attend sessions and would just quit. She had tried three antidepressants. Each gave short-term relief from the depression, followed by a relapse. An aunt and grandfather had been in the hospital for mania, although Chelsea was quick to point out that she was “not at all like them.” What is your diagnostic impression in this case? Write your diagnostic impression correctly. What are the symptoms reported? Make a list of symptoms that will substantiate your diagnostic impression. Point out the onset of the symptoms. Explain the development of the disorder using one etiological perspective of your choice. What is your treatment of choice for this case? ANSWER: Chelsea was diagnosed with bipolar II disorder and as having a current depressive episode. Her husband’s information about her moments of hypomania helped in making the diagnosis. People with bipolar disorder experience periods of unusually intense emotion, changes in sleep patterns and activity levels, and unusual behaviors. These distinct periods are called “mood episodes.” Mood episodes are drastically different from the moods and behaviors that are typical for the person. Extreme changes in energy, activity, and sleep go along with mood episodes. CASE 3: Case of Jill You see Jill (age 24) in the emergency room of a hospital where her parents have brought her for evaluation. They are worried because she is giving away all of her possessions and says she is planning to move to Seattle so she can “save the world.” Her parents say that she has hardly been sleeping at all, but she seems very energetic. They say she has appeared to be “in a frenzy” lately. When you interview Jill, you notice that she speaks very rapidly. It is hard to get her to be quiet long enough for you to ask questions. She seems agitated and has difficulty sitting still. What is your diagnosis/diagnostic impression? Please indicate specifiers and type, if any. What are the symptoms manifested in the case? Make a list of symptoms that would warrant your diagnostic impression. CASE 4: Case of Morris Morris has been referred to you for psychotherapy following a suicide attempt. When you interview him he is very teary. He speaks slowly and looks down at the ground as he speaks. He reports difficulty in falling asleep and staying asleep for the past month. Morris states that he hasn’t had much of an appetite and has lost 15 pounds. He reports that things he used to like just don’t seem enjoyable anymore, and he thinks that life is not worth living. Morris doesn’t expect things to improve in the future, which is why he tried to kill himself. What is your diagnosis/diagnostic impression? Please indicate specifiers and type, if any. What are the symptoms manifested in the case? Make a list of symptoms that would warrant your diagnostic impression. CASE 5: Case of Lenore Lenore has been feeling very sad since her husband died 12 days ago. She has eaten very little and has difficulty sleeping. She is weepy most of the time. Lenore is preoccupied with thoughts of her dead husband and does not want to do much other than thinking about him. She has declined all invitations by friends and spends most of her time alone. What is your diagnosis/diagnostic impression? Please indicate specifiers and type, if any. What are the symptoms manifested in the case? Make a list of symptoms that would warrant your diagnostic impression. CASE 6: Case of Elise Elise is a 35-year old architect. She comes to you in great distress, feeling that she is unable to work, and generally unable to function. She says that she feels tired all the time, to the point of feeling completely exhausted. She says that she cries easily, and almost every day. She is having difficulty sleeping, and has lost 20 pounds in the last 2 months without trying. She says that things have been “real bad” for the last 2 months; she doesn’t enjoy doing anything and thinks frequently of suicide. However, she also says that she has never been a very happy person. She says that things rarely go right for her, and she has given up on expecting good things to happen for her. What is your diagnosis/diagnostic impression? Please indicate specifiers and type, if any. What are the symptoms manifested in the case? Make a list of symptoms that would warrant your diagnostic impression.
Requirements: 2-3 paragraphs
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