Depression or Bipolar Disorder

This paper explores depression and bipolar disorder.

CASE STUDY

Steve is a 20-year-old, single, Caucasian male, who is a third-year undergraduate student majoring in Engineering at the University of Wisconsin Madison. He currently lives with a male roommate on campus. His parents, his younger brother and younger sister all live together in Indianapolis, and he went back home during summer break.

CURRENT REASON FOR SEEKING HELP

Steve reports feeling significant anxiety about being isolated from everyone due to COVID-19, as well as keeping up with schoolwork, which he is concerned might impact his chances of securing an internship during the upcoming summer. He reports some symptoms of anxiety, including excessive worry about many things during most of the days of the week for the past 2 months, sleep difficulties, reduced appetite, concentration problem and fatigue.

The worrying reported also persist when he is playing video games with his friends. He also reports feeling sad and down, feeling socially isolated from others. In addition, he also reports feeling guilty and ashamed about his lack of control over his symptoms, and often tries to avoid talking with anyone. He states that some of these symptoms started since the beginning of the pandemic in March, 2020, but exacerbated since the semester started in September.

 Case Formulation 

The patient presents with a significant depressive episode, which has been exacerbated by the stress of the pandemic. The patient has a history of anxiety, which has also been triggered by the current situation. The patient is currently struggling with maintaining his academic performance, as well as feeling isolated from others. The patient's symptoms are impacting his ability to function in day-to-day life. There is a high risk for the patient to develop suicidal ideation or attempt suicide if his current symptoms are left untreated.

Diagnostic Impression:

Major depressive disorder, single episode, moderate

300.4 (F32.1)

Bipolar Disorder has also been considered a diagnosis, but given the patient's history and current presentation, Major Depressive Disorder is the more likely diagnosis. However, given the patient's young age and the fact that this is his first episode of depression, it is possible that he could develop the bipolar disorder later in life.

TREATMENT PLAN

The treatment plan for Steve includes medication, weekly therapy sessions, and self-care. The medication prescribed is an SSRI, which will help to reduce the symptoms of anxiety and depression. The weekly therapy sessions will help Steve to talk about his feelings and thoughts, as well as develop coping mechanisms to deal with his symptoms. The self-care plan includes maintaining a healthy lifestyle, including exercise and a balanced diet, as well as getting enough sleep. In addition, Steve will be encouraged to find ways to connect with others, such as joining a club or group, or volunteering.