Case Study : George Lawler's Diagnosis

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Case Study 2: George Lawler Diagnosis 296.44 Bipolar I Disorder, most recent episode manic, severe with mood-congruent psychotic features Relevant V Codes V15.89 - other personal risk factors (family history); V62.2 – occupational problems; V61.9 – relational problems related to mental disorders Rationale George was diagnosed with Bipolar I Disorder, severe with mood-congruent psychotic features. Previously to being admitted to the hospital, George experienced his first serious depressive episode in college. He began to lose interest in everything, including his friends, girlfriend, and sports. Soon he began taking taking antidepressant medication and attending individual counseling sessions and was back to normal within several weeks. However, his symptoms for bipolar disorder came back over time (see below). While in college, he also experienced manic episodes. He was described as having periods of unusual ambition and energy. However, these symptoms went undiagnosed because his excess verbosity, his lack of need for sleep, and his ambitious goals did not seem pathological. This was due to the fact that his energy was productive, and probably adaptive in the competitive university environment. 8 months before his current state, George experienced yet another depressive episode. He began to worry excessively about his team and had trouble sleeping but felt tired all the time. His mood changed from tension and anxiety to severe depression. He began to blame himself for

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