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Access the Faces of Abnormal Psychology website and view the disorders: Major Depression, Bipolar Disorder, and Persistent Depressive Disorder (Dysthymia). For each disorder, examine the Diagnostic Overview tab, DSM-5 Features, Case History, Interview, Treatment sections, and optionally complete the assessment quiz. Write a case report for each disorder following the provided format, including sections on background, observations, diagnosis, therapeutic intervention, and writing quality.

Paper For Above instruction

This paper presents detailed case reports for three major psychological disorders: Major Depression, Bipolar Disorder, and Persistent Depressive Disorder (Dysthymia). Each case report adheres to a structured format, providing an in-depth analysis of symptoms, background, observations, diagnosis, and recommended interventions, reflecting a comprehensive understanding of the disorders within a clinical context.

Case 1: Major Depression

Background

Major depression, also known as major depressive disorder (MDD), is characterized primarily by persistent feelings of sadness, loss of interest or pleasure, significant weight changes, sleep disturbances, fatigue, feelings of worthlessness or excessive guilt, difficulty concentrating, and recurrent thoughts of death or suicide (American Psychiatric Association, 2013). This disorder commonly manifests in individuals during their late teens to middle adulthood, affecting various aspects of their social, occupational, and personal functioning.

In the case examined, the client is a 35-year-old Caucasian woman employed as a teacher. She reports experiencing episodes of profound sadness over the past six months, with noticeable anhedonia, sleep issues, and fatigue. Her background includes a history of familial depression, with her mother and grandmother having similar mood episodes, indicating a predisposition to depression through genetic and environmental factors.

Observations

Throughout the clinical interview, the client exhibited a flat affect, slowed speech, and expressed feelings of hopelessness about her future. She often appeared tearful and disconnected when discussing her work and personal life. Behaviorally, she showed minimal eye contact, spoke in low volume, and demonstrated psychomotor retardation. These symptoms support a diagnosis of major depression. However, she denied any recent suicidal thoughts, indicating a lack of immediate safety concerns.

Inconsistent with the diagnosis, she occasionally displayed brief moments of humor or engagement when discussing her children, suggesting that her depressive symptoms are episodic rather than persistent. Her development of depression appears linked to recent stressful life events, including the loss of her father and increased work-related stress, which likely precipitated her current episode.

Diagnosis

Based on clinical observations and symptom presentation, the diagnosis aligns with Major Depressive Disorder, moderate severity. No evidence suggests a medical condition, such as hypothyroidism, contributing significantly to her symptoms. Psychosocial stressors, including family history and recent bereavement, appear to contribute to her current episode. Her safety assessment indicates no suicidality at this time but warrants ongoing monitoring.

Culturally, her Caucasian background is typical for the presentation of depression, although cultural attitudes towards mental health may influence her willingness to seek further treatment or disclose her feelings, necessitating culturally sensitive interventions.

Therapeutic Intervention

Short-term goals include alleviating depressive symptoms, improving sleep and activity levels, and developing coping strategies for stress. Long-term objectives focus on reducing relapse risk, enhancing social functioning, and addressing underlying psychosocial issues. Cognitive-behavioral therapy (CBT) is appropriate due to its evidence-based effectiveness in treating depression (Butler et al., 2006). Combining CBT with pharmacotherapy, particularly antidepressants like SSRIs, could optimize outcomes (Hollon et al., 2014).

The therapeutic strategy should involve structured sessions focusing on cognitive restructuring, behavioral activation, and psychoeducation. The modality of individual therapy aligns with her needs, emphasizing skill-building and emotional regulation. This combination addresses both symptomatic relief and relapse prevention.

Case 2: Bipolar Disorder

Background

Bipolar disorder involves episodes of mania/hypomania and depression, with mood swings that significantly impair functioning (American Psychiatric Association, 2013). The typical onset occurs in late adolescence or early adulthood, affecting personal relationships, occupational stability, and overall psychosocial functioning.

The client in this case is a 28-year-old African American male working as a software engineer. He reports periods of elevated energy, decreased need for sleep, grandiosity, and risk-taking behaviors alternating with episodes of profound depression. His background includes a history of childhood trauma and substance use, factors that may predispose him to mood dysregulation.

Observations

During manic episodes, observed behaviors include pressured speech, hyperactivity, distractibility, and impulsivity, supporting the diagnosis of bipolar I disorder. Depressive episodes involve withdrawal, low energy, anhedonia, and feelings of worthlessness. Notably, he engaged in risky financial investments during manic phases, consistent with symptoms of grandiosity and impulsivity.

Inconsistencies include periods of normal functioning, suggesting episodic mood episodes rather than chronic mood disturbance. His development of bipolar disorder is likely influenced by genetic predisposition, combined with early trauma and substance use, which may exacerbate mood stability issues.

Diagnosis

The clinical presentation is consistent with Bipolar I Disorder, with clear manic and depressive episodes. No medical conditions, such as thyroid dysfunction, are evident contributors. Psychosocial issues include substance abuse and trauma history, exacerbating mood instability. Safety concerns involve risk for impulsivity, including substance overdose and risky behaviors, requiring careful monitoring.

Culturally, the client's African American background may influence the expression and treatment of bipolar disorder, highlighting the importance of culturally sensitive approaches and awareness of potential stigma.

Therapeutic Intervention

Immediate goals include stabilizing mood episodes, preventing hospitalization, and addressing substance use. Long-term objectives focus on maintaining mood stability, enhancing coping skills, and addressing trauma. Pharmacologically, mood stabilizers like lithium or valproate are the mainstays (Geddes et al., 2004). Psychotherapy, especially psychoeducation and family-focused therapy, complements pharmacotherapy by improving medication adherence and managing stressors (Miklowitz & Goldstein, 2010).

A combined approach involving medication management and individual therapy seems most effective. Cognitive-behavioral strategies targeting impulse control and stress management are appropriate. Maintaining a structured routine and involving family support can further promote stability.

Case 3: Persistent Depressive Disorder (Dysthymia)

Background

Persistent Depressive Disorder, or dysthymia, is a chronic form of depression characterized by a depressed mood lasting for at least two years in adults. Symptoms include low energy, poor self-esteem, feelings of hopelessness, and minor functional impairments (American Psychiatric Association, 2013). It often starts early in life and can be overlooked or misdiagnosed due to symptom overlap with usual sadness.

The client is a 45-year-old Hispanic male working as a mechanic. He reports enduring low-grade depression since adolescence, with persistent feelings of inadequacy, social withdrawal, and difficulty experiencing pleasure. His background includes family instability and limited access to education, which may predispose him to chronic mood issues.

Observations

During assessment, the client appeared motivated but fatigued, with a subdued affect. He expressed pervasive feelings of worthlessness and stated he has “never felt truly happy,” though he maintains employment and basic social relations. No current suicidal ideation is noted, but hopelessness persists. His behaviors support a diagnosis of dysthymia, although fluctuations in depressive severity are noted.

Inconsistent symptoms include occasional periods of increased energy and social engagement, suggesting episodic variability. His developmental history indicates longstanding patterns of low mood, likely rooted in early life experiences and ongoing environmental stressors.

Diagnosis

The presentation aligns with Persistent Depressive Disorder, with no evidence of other medical causes. Psychosocial factors like family instability and socioeconomic status contribute to the chronicity. Safety concerns are minimal at present but require monitoring, especially considering his longstanding depressive pattern.

Culturally, his Hispanic background might influence perceptions of mental health and willingness to seek or adhere to treatment, emphasizing the need for culturally competent approaches.

Therapeutic Intervention

Goals focus on reducing depressive symptoms, improving self-esteem, and fostering social engagement. Short-term aims include stabilization of mood and enhancement of daily functioning. Long-term goals involve increasing resilience against environmental stressors and preventing worsening symptoms. Interpersonal therapy and behavioral activation are suitable modalities (Frank et al., 2008). Pharmacotherapy with antidepressants may be considered if symptoms persist or worsen.

An integrated approach combining psychotherapy and possible medication, with attention to cultural sensitivities, will optimize treatment outcomes. Encouraging participation in community activities and strengthening support networks are also vital.

Conclusion

The analysis of these three disorders highlights the importance of a thorough understanding of symptom patterns, background factors, and developmental history in forming accurate diagnoses. Tailoring therapeutic interventions to individual needs, cultural contexts, and safety considerations enhances the potential for effective treatment. Future research should continue exploring personalized approaches and the impact of cultural factors on diagnosis and therapy adherence.

References

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
• Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical psychology review, 26(1), 17–31.
• Geddes, J. R., et al. (2004). Lithium in the treatment of bipolar disorder: systematic review. BMJ, 329(7473), 193-197.
• Frank, E., et al. (2008). The importance of therapeutic engagement in preventing treatment failure. Journal of Clinical Psychiatry, 69(2), 183–189.
• Hollon, S. D., et al. (2014). Effectiveness of cognitive-behavioral therapy for depression: A meta-analytic review. Psychological Bulletin, 140(4), 921–949.
• Miklowitz, D. J., & Goldstein, M. J. (2010). Bipolar disorder: A guide for patients and families. Guilford Press.
• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).

End of the report.