Lori Schiller's Diagnostic Analysis

She went on to speak of other episodes with symptoms of delusions and hallucinations which she says are “hallmarks of the illness”. She explained that schizophrenic is not disorders of multiple personality or split personalities, a schizophrenia mind is shattered. What I find incredible is the fact that with treatment she was still able to hold it together

People with bipolar I disorder have full manic and major depressive episodes. Most of them experience an alternation of the episodes; for example, weeks of mania may be followed by a period of wellness, followed, in turn, by an episode of depression. Some, however, have mixed episodes, in which they display both manic and depressive symptoms within the same episode—for example, having racing thoughts amidst feelings of extreme sadness. In bipolar II disorder, hypomanic—that is, mildy manic—episodes alternate with major depressive episodes over the course of time. When a person experiences numerous periods of hypomanic symptoms and mild depressive symptoms, but not full-blown episodes, DSM-5 assigns a diagnosis of cyclothymic disorder. The symptoms of this milder form of bipolar disorder continue for two or more years, interrupted occasionally by normal moods that may last for only days or weeks.

Furthermore, Monica is also diagnosed with Bipolar Disorder. According to the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM), Bipolar Disorder is characterized as a mood disorder consisting of major depressive and manic episodes (American Psychiatric Association, 2013). One must display at least 5 of the following symptoms of a major depressive episode within a 2-week period which must include a depressed mood most of the day or a diminished interest or pleasure in daily activities (American Psychiatric Association, 2013). The manic episode must persist for one week in which the individual displays an irritable or euphoric mood (American Psychiatric Association, 2013). Based

Based on my clinical judgement, I believe the client meets all criteria for Bipolar I due to the following. Criteria A requires a distinct more than one week of abnormal and persistent expansive or irritable mood. According to the narrative, the client has demonstrated excessive energy that last from a few day to several weeks reported from his wife prior to his current hospitalization state. Criteria B requires three or more symptoms to a significant effect and represent noticeable change from usual behavior. Ezekiel currently demonstrates 1. Flight of ideas or subjective experience that thoughts are racing, mainly demonstrated when he is working and unable to focus on one thing and one task; 2. Increase in goal-directed activities, such

Current diagnostic criteria for Angela’s manic episode is described through criterion A – D in the following. Criteria A requires the individual to meet at least a one week period of distinct abnormal and persistently elevated, expansive, or irritable mood and abnormal and persistently increased goal-directed activity or energy. Angela has currently been experiencing this particular episode for ten day now and has demonstrated symptoms of increased activity for example the West Coast fight that the booked and the amount of money she has put into textbooks. Criteria B requires that during this time Angela must be experiencing at least three of the listed symptoms that represent a significant degree of noticeable change from her usual

The first major treatment that was administered to Lori was electroshock therapy. After getting many treatments of electroshock, it did not seem to work particularly well for Lori, the voices and such were still there. After she underwent electroshock therapy several times, she fully believed that this treatment destroyed her brain cells, she says that it fried her brain and all of her memories she did not remember a lot of memories earlier from her life. It is not uncommon to lose bits of memories after treatment is administered, but it is known not to cause any long term damage, but Lori thought otherwise even after the doctors had explained this to her. Another treatment was being taken to the quiet room. The quiet room was meant to be a safe and peaceful place to go to relax and calm themselves down before, during, or after having an episode. Lori was usually forcefully carried into the quiet room, she never voluntarily wanted to go to the quiet room. Once being brought to the room, you are alone in and empty room and Lori was given a tranquilizer, sodium amytal. She believed this room to be better known as the punishment room, when she would calm down the voices would torment her, she was left alone with them and had no escape. Lori returned to the quiet room time and time again with no hope of this helping her episodes. But after time, Lori had to receive the Cole-pack method where they

A Schizoaffective disorder is a mental illness. The symptoms of this illness include having strange or unusual thoughts or perceptions, paranoid thoughts and ideas, delusion (i.e. having false, fixed beliefs), hallucination, such as hearing voices, and experience disorganized thinking (i.e. unclear and confused thoughts). They may have manic episodes or a sudden increase in energy and behavioural displays that are out of character. They may become irritable and have poor temper control, and even have thoughts of suicide or homicide. Their speaking style can be erratic, and difficult of others to understand, they may have problems with attention and memory. Their behaviour will be at extreme ends of the normal spectrum (catatonic behaviour)

According to “S” she became ill when things between her and her ex-husband started having marital problems. She states “We used to fight a lot and I would call the police because I was afraid of what could happen.” “S” could not recall how many times she has been hospitalized, but she knows it was a lot. According to “S” record she was diagnosed with bipolar disorder in 2013. At the time of her diagnosis “S” expressed behaviors such as "talking rapidly", "bad language (cursing at people)"; feeling angry and aggressive but have no physical altercations at the time. Poor history of medication adherence, which is the primary reason she becomes hospitalized. “S” was hospitalized 7 times since 2013. She was first hospitalized at Runnells 2012-2013, Trinitas twice 2014, Summit

Major Depressive disorder (MDD): Due to patient’s problems with concentration, poor sleep (he reports sleeping 2-3 hours nightly) and inability to focus, MDD was considered but substantial symptoms presented outweighs this diagnosis (Association, 2013).

If the same exact scenario were to replay in present day, I believe she would be diagnosed with Bipolar Disorder 1 Manic Episode. According to Beidel, Fruen and Hersen in Adult Psychopathology and Diagnosis, Bipolar I disorder is

Schizoaffective disorder could be diagnosed according DSM-IV that if the patient is with manic ‎episode, major depressive episode or mixed episode along with hallucination, delusions, ‎disorganized speech, disorganized behavior as well as negative symptoms. In order to identify ‎whether patient is in manic episode, there should be an uninterrupted period of illness for one ‎week and the patient is in persistently elevated or irritable mood with symptoms such as inflated ‎self- esteem, decreased need of sleep, distractibility, flight of ideas, more talkative than usual and ‎excessive involvement in pleasureful activities. If a patient is in depressed mood during most of ‎the time for a two-week period with five or more symptoms such as markedly

Bipolar II however, is very similar to Bipolar I except the person affected will have mood changes that will cycle between highs and lows over a period of time. The persons’ affected will never reach a full mania during one of their “up” moods. Another form of bipolar disorder is called Rapid Cycling. A person who has Rapid Cycling will experience four or more episodes of mania in a single year. Only about 10% to 20% of persons’ diagnosed with a bipolar disorder will be diagnosed with Rapid Cycling. Mixed Bipolar disorder would consist of somebody that will experience mania and depression simultaneously or in a rapid sequence. Cyclothymia is the mildest form of bipolar mood disorder. Symptoms of Cyclothymia must last for at least two years. Also, the person cannot have gone two months at a normal state.

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There is no indication she has had a manic or hypomanic episode. Her depression may be complicated by grief due to her father’s death one year ago. Her symptoms seem to get worse after his passing.

When looking at differential diagnosis that overlap or resemble those of MDD, requires careful observations and careful clinical evaluation. Sarah presents with no underlying medical condition that can be associated with a mood disorder. It also appears she lacks irritability in her behavior that would contribute to a manic episode with irritable mood. With no current or past substance abuse/use, her symptoms are not etiologically related and can not be deem to be part of a substance, or medication induced disorder. Bipolar is also ruled out, base on the fact that her episodes and symptoms have not required hospitalization in the past. Attention-deficit/hyperactivity disorder is also ruled out because her mood is not