Diagnosing Using the DSM

Provide a mental health diagnosis for each of the three clients described in vignettes and discuss the DSM-5 criteria the client does and does not fit. Analyze recommended treatments for one of the three clients, supporting your analysis with a peer-reviewed article. This assessment should be 5-6 pages in length.

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ANSWER

Diagnosing Using the DS

Introduction

The Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association (APA), is the most recent version of the manual. The DSM is used by mental health professionals to diagnose mental disorders and guide treatment. The importance of DSM-5 lies in its potential to improve diagnosis, treatment and research related to mental disorders. This paper will focus on three patients and provide a mental health diagnosis for each of the three patients while discussing the DSM-5 criteria that the client fits and does not fit. The paper will then analyze a recommended treatment of one of the three clients. The DSM-5 is important because it provides mental health professionals with a common language to use when discussing mental disorders.

Jenny

Jenny complains ahs reported that she has been having insomnia for several weeks. She has been fatigued during the day and does not have the motivation or interest that she had earlier about life. She has noted that the interesting and pleasurable things are no longer interesting to her. She also complains of feeling tired and lack of concentration in her work like earlier. According to DSM-5, the symptoms described by Jenny fit within the criteria of Major Depressive disorder. Major depressive disorder is a mental disorder characterized by a persistent and significant low mood that is accompanied by low self-esteem and a loss of interest or pleasure in normally enjoyable activities (Carty Jr and Escalona, 2016). The DSM-5 criteria for major depressive disorder requires the presence of five or more symptoms from a list that includes a depressed mood or loss of interest or pleasure in activities, significant weight loss or gain, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue, feelings of worthlessness or guilt, difficulty thinking, concentrating or making decisions and recurrent thoughts of death or suicide. Though it is not necessary for all of these symptoms to be present, they must cause clinically significant distress or impairment in social, occupational or other important areas of functioning. The symptoms must also not be better explained by another mental disorder, such as brief psychotic disorder, schizophrenia or a mood disorder due to a general medical condition.

Jenny complains of depressed mood in most part of the day which is with diminished pleasure and interest in almost all activities. Jenny has been experiencing significant weight loss due to the fact that she does not eat enough. Jenny has also been experiencing insomnia and loss of energy almost everyday. These symptoms led to significant impairment in occupation, and important areas of functioning. For instance, the symptoms have lasted for weeks and has interfered with her work, sleep and motivation.

Jenny has also been experiencing episodes of post traumatic disorder. Post traumatic stress disorder is a mental health illness that can develop after a person is exposed to a traumatic event. Jenny’s exposure to childhood trauma when she claims of being molested by her babysitter can cause post traumatic disorder. However, according to DSM-5, Jenny does not fit in post traumatic disorder criteria  because her symptoms show she is not exposed to sleep disturbance, negative changes in her thoughts, changes in reactivity, arousal, intrusion and avoidance.

Fred

Fred has been complaining of emotional distress due to the fact that his family does not support the fact that he is homosexual. He has also been experiencing panic attacks every time he is preparing for work or when leaving work at the end of the day. The panic attacks begun weeks after he was robbed at subway station. Panic attacks can result to unreasonable and sudden feelings of anxiety and fear which can lead to panic disorder which is a common form of generalized anxiety disorder. Generalized Anxiety disorder is a mental health issue which interferes with an individual’s ability to function (Stein and Sareen, 2015). Panic attacks cause sudden and intense episodes of fear that trigger several physical reactions. Fred is suffering from post traumatic stress disorder  due to the fear and  anxiety he experiences when thinking about the robbery incident and his sexual orientation. Post traumatic stress disorder is triggered by terrifying moments that either one has experienced or is witnessing. The symptoms include severe anxiety, nightmares or flashbacks and uncontrollable thoughts about an event.

According to DSM 5 criteria of post traumatic stress disorder, the individual must have been exposed to a traumatic event in which both of the following were present: the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others and the person’s response involved intense fear, helplessness, or horror. In addition, the individual must have at least one of the following symptoms: intrusive thoughts about the event, avoidance of things that remind him of the trauma, negative changes in mood and beliefs, or alterations in arousal and reactivity. Fred is experiencing severe anxiety, negative changes in his moods, avoidance and reactivity. For instance, he decided not to use subway anymore since he feels its too dangerous.

Fred does not if in generalized anxiety disorder which is a mental condition of excessive worry about daily situations and issues. According to DSM-5 criteria of Generalized anxiety disorder , an individual must experience at least six of the listed symptoms for a period of at least 6 months. The listed symptoms in DSM-5 include feeling restless, being easily fatigued, having difficulty concentrating or mind going blank, being irritable, having muscle tension or aches and having sleep disturbance. However, he does not have fatigue, poor concentration, irritability, muscle tension and sleep disturbance for a period of at least 6 months.

Sally

Sally’s parents are concerned with the behaviors of Sally which they suspect might have resulted from a mental health condition. They report of hearing Sally typing in her room for hours even during the wee hours of the night. Her mother is concern since Sally does not have enough sleep and once she is frustrated with her writing, she breaks things. Sally reports of being frustrated for her parents selling their farm 10 years ago since she feels that would be a perfect setting in which she would have some peace to focus on her writing. Sally displays some symptoms of Bipolar I disorder which is a mental health problem that results from extreme mood swings such as mania and depression. Bipolar I disorder is evident when a person experiences extreme increase in energy (Grande et al., 2016).

According to DSM-5 criteria of Bipolar I disorder, Sally should be experiencing at least one episode of mania in her life which she has not reported. To perceived as mania, a patient should have expansive, elevated and irritable moods that have to last for a week. The patient should also be displaying three or more of the following symptoms: inflated self-esteem, decreased need for sleep, grandiose plans, high energy level, increased risky behaviors. Since Sally has only reported symptoms of grandiose plans regarding her writing, risky behaviors, high energy level and decreased need for sleep, she meets the criteria for Bipolar I disorder and therefore can be diagnosed with it.

Sally does not fit in the criteria of Bipolar II disorder as she does not have any depressive episodes. She also does not have any mixed features as her symptoms do not include both manic and depressive at the same time. According to DSM criteria, Bipolar II disorder is a diagnosis given to individuals who experience depressive episodes and hypomanic episodes, but never full blown mania. Bipolar II disorder is milder form elevated mood which involves the episodes of milder hypomania which is alternate to the occurrences of severe depression.

Treatment of Jenny

Jenny is 35 years and was brought up in a middle class family. She has been in a relationship but has never been married. While she was young, she was sexually molested by her baby sitter but her parents were less concerned. Jenny has reported of insomnia which has occurred for several weeks. She is always fatigued during the day and lacks motivation or interest for life demands. She feels tired, never active like before and cannot concentrate on her work like before. Jenny is relatively thin and agrees to have lost weight since she has not been eating enough much lately due to lack of appetite. The DSM 5 criteria fits for Major Depressive Disorder fits with Jenny because she has most of the symptoms that are required for the diagnosis. She has lost interest in many activities, she has changes in her weight, she has insomnia, and she feels fatigue. She also has reported of feeling worthless and helpless. Carty Jr and Escalona (2016) focused on an overview of major depressive disorder for the primary care providers which is effective in diagnosing major depressive disorder. According to Carty Jr and Escalona (2016), the diagnosis of major depressive disorder should focus DSM-5 criteria which allows for sound decisions for treatment. Major depressive disorder is characterized by insomnia, significant weight loss, loss of reactivity and concentration which are evident in Jenny’s condition.

The most effective treatment for this mental health condition is cognitive behavioral therapy, which is a form of therapy that helps patients understand and change their negative thought patterns. Cognitive behavioral therapy has been shown to be effective in treating major depressive disorder, and it is often used in conjunction with medication. Hofmann et al., (2012) states that cognitive behavioral therapy is the gold standard therapy in the field of psychotherapy. Hofmann et al., (2012) conducted a comprehensive meta-analysis survey to examine the effectiveness of cognitive behavioral therapy for schizophrenia, substance use disorder, dysthymia and psychotics, anxiety disorder, insomnia and personality disorder. The study show a greater response rate in the mental health conditions. For instance, Cognitive behavior therapy show effectiveness than control treatments. The findings were consistent with the findings of other meta analysis that examined the efficacy of the intervention in the treatment of mental health condition.

An alternative treatment is antidepressant medication to help her manage her symptoms. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to treat major depressive disorder, and they can be effective in managing the symptoms of the condition. SSRIs work by increasing the levels of serotonin in the brain, which can help to improve mood and alleviate symptoms of depression.  Antidepressant medication can be an effective treatment for major depressive disorder, but it is important to discuss all of the potential risks and benefits of the medication.

Professional Behavior in the Field of Psychology

The field of psychology can rely on this article to inform professional behavior since it offers a detailed information on diagnosis and treatment of  major depressive disorder.  Carty Jr and Escalona (2016) offers recent and relevant information for practitioners to rely on. It is also useful for gaining a comprehensive understanding of the topic. Using the DSM-5 criteria for major depressive disorder, practitioners can arrive at a more accurate diagnosis and provide better treatment. The DSM-5 is important for diagnosing major depressive disorder because it provides concise and specific criteria that can be used to identify the disorder. The DSM-5 also offers guidance on how to assess and treat major depressive disorder. Practitioners who use the DSM-5 can provide more accurate and effective care for their patients.

References

Carty Jr, J. J., & Escalona, P. R. (2016). Brief Review of Major Depressive Disorder for Primary Care Providers. Federal Practitioner, 33(Suppl 2), 12S.

Grande, I., Berk, M., Birmaher, B., & Vieta, E. (2016). Bipolar disorder. The Lancet, 387(10027), 1561-1572.

Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive therapy and research, 36(5), 427-440.

Stein, M. B., & Sareen, J. (2015). Generalized anxiety disorder. New England Journal of Medicine, 373(21), 2059-2068.