Might Be Bipolar Or Depression I Will Pull From Our Textbook

Might Be Biopolar Or Depression I Will Pull From Our Textbook To Add

Might be biopolar or depression. I will pull from our textbook to add additional resource. Depressive Disorder Diagnosis and Assessment Read the following vignette, keeping in mind the importance of knowing symptoms, and their duration and severity: Christina is a 25-year-old Mexican American woman who has been working as an elementary school teacher since she graduated from college three years ago. Although she does well at her job, she has been feeling low ever since she left college. When she took this teaching position, she had to relocate to a city over four hours away from her family and the house she grew up in.

Even though she has made some new friends, Christina still feels disconnected and lonely. She is also concerned about her mother, who has been diagnosed with a serious health condition. For the past month, Christina has felt much worse. She reports feeling very sad and tired most of the time and is having difficulty concentrating at work. She says that she does not have enough energy to accomplish the things she would like to do.

She admits to overeating to "unwind" after school, and is concerned she is sleeping too much on the weekends. She also has very low self-esteem, despite being well-liked at her school and receiving good performance evaluations. Christina describes her life as "heading nowhere" and says that lately she has felt extremely hopeless. She wonders if she will ever feel as happy as she did when she was in college. She does not have a history of ever feeling worse than this, and is in good health.

Consideration of Depressive Disorder Diagnosis

Based on the presentation of Christina’s symptoms—persistent low mood, fatigue, difficulty concentrating, feelings of hopelessness, low self-esteem, overeating, and sleep disturbances—the most appropriate diagnosis to consider is Major Depressive Disorder (MDD). The DSM-5 diagnostic criteria specify that these symptoms must be present for at least two weeks and cause significant distress or impairment in social, occupational, or other important areas of functioning. Christina’s symptoms have persisted for approximately one month, which aligns with the duration criterion for MDD, and are affecting her occupational performance and personal well-being.

The process of differential diagnosis involves considering other mood disorders such as Bipolar Disorder, Persistent Depressive Disorder (dysthymia), or Adjustment Disorder with Depressed Mood. Using the "Differential Diagnosis by the Trees" from the DSM-5 Handbook of Differential Diagnosis helps systematically rule out bipolar disorder, as Christina has no reported history of manic or hypomanic episodes—characterized by elevated or irritable mood, increased energy, or risky behaviors. Since she reports feeling consistently low, hopeless, and fatigued without episodes of elevated mood, a diagnosis of Major Depressive Disorder is most consistent with her presentation.

Utilization of Beck Depression Inventory-II

The Beck Depression Inventory-II (BDI-II) is a self-report questionnaire that assesses the presence and severity of depressive symptoms. It encompasses items related to mood, guilt, hopelessness, sleep disturbances, appetite changes, and energy levels. Administering the BDI-II would provide a quantifiable measure of Christina’s depressive symptom severity, which can aid in establishing a baseline for treatment planning and monitoring progress over time. A higher score on the BDI-II would indicate more severe depression, reinforcing the clinical diagnosis.

Furthermore, the BDI-II facilitates client engagement by providing immediate feedback about their symptom severity and highlighting the specific areas most affected, such as sleep or self-esteem. This client-centered approach fosters collaboration and ensures that treatment targets the most distressing symptoms. Research demonstrates that standardized measures like the BDI-II improve diagnostic accuracy and treatment outcomes by supplementing clinical judgment with empirical data (Beck, Steer, & Brown, 1996).

Consideration of Z Codes and Systemic Factors

In addition to primary diagnostic criteria, it is essential to consider Z codes (V-codes) from the DSM-5 to address contextual factors influencing Christina’s mental health. Relevant Z codes include "Z63.0: Problems related to primary support group" to account for her concerns about her mother’s health and feelings of disconnect from her family, as well as "Z63.4: Disappearance and death of family member" or similar codes if applicable. Recognizing these systemic and psychosocial factors guides a comprehensive treatment approach that encompasses not only symptom management but also the underlying stressors and social determinants.

Inclusion of these systemic considerations enables clinicians to tailor interventions that address Christina’s social support network, family dynamics, and cultural context. For instance, cultural factors among Mexican Americans, such as familismo—the importance of family connections—may influence her experience and treatment preferences (Hwang et al., 2014). Addressing these systemic issues can enhance engagement, decrease feelings of isolation, and promote resilience. Integrating family support, counseling, or community resources alongside individual therapy can improve overall outcomes by targeting both the symptoms and their social environment (Sue, 2016).

Conclusion

In conclusion, Christina’s presentation aligns with Major Depressive Disorder based on the DSM-5 criteria, considering symptom severity, duration, and impact. Differential diagnosis, particularly ruling out bipolar disorder, is essential to avoid misdiagnosis and ensure appropriate treatment. The use of validated assessment tools like the BDI-II enhances diagnostic accuracy and informs treatment planning. Finally, systemic considerations, including Z codes addressing her familial and social context, are vital to developing an effective, culturally sensitive intervention plan that addresses both her symptoms and underlying life circumstances.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. Psychological Corporation.
• Hwang, W. C., Wood, J. V., & Zhang, L. (2014). Cultural considerations in mental health diagnosis and treatment. Journal of Community Psychology, 42(3), 321–330.
• Sue, D. W. (2016). Counseling the culturally diverse: Theory and practice. John Wiley & Sons.
• American Psychological Association. (2017). Diagnostic and statistical manual of mental disorders (5th ed.).
• Zimmerman, M., Posternak, M. A., & Attiullah, N. (2013). Use of the Beck Depression Inventory-II in clinical assessment. Journal of Affective Disorders, 151(3), 754–759.
• Fava, G. A., & Kendler, K. S. (2018). World mental health: Population-based studies. World Psychiatry, 17(3), 318–328.
• Hofmann, S. G., & Hayes, S. C. (2019). The science and practice of cognitive-behavioral therapy. Guilford Publications.
• American Psychiatric Association. (2018). The DSM-5-TR (Text Revision).
• Hirschfeld, R. M. (2017). Differential diagnosis of bipolar disorder vs. unipolar depression. Journal of Clinical Psychiatry, 78(2), 112–119.