SOCW6090 Walden Differential Diagnosis to Depressive & Bipolar Disorders Discussion
Question Description
Discussion: Applying Differential Diagnosis to Depressive and Bipolar Disorders: The Case of Sam
What is it truly like to have a mental illness? By considering clients’ lived experiences, a social worker becomes more empathetic and therefore better equipped to treat them. In this Discussion, you analyze a case study focused on a depressive disorder or bipolar disorder using the steps of differential diagnosis. You also describe lived experiences of depression.
To prepare: View the TED Talk “Depression, the Secret We Share” (TED Conferences, LLC, 2013) and compare the description of Andrew Solomon’s symptoms to the criteria for depressive disorders in the DSM-5. Next review the steps in diagnosis detailed in the Morrison (2014) reading, and then read “The Case of Sam,” considering Sam against the various DSM-5 criteria for depressive disorders and bipolar disorders.
By Day 3
Post a 300- to 500-word response in which you address the following:
Provide the full DSM-5 diagnosis for Sam. For any diagnosis that you choose, be sure to concisely explain how Sam fits that diagnostic criteria. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, medical needs, and the Z codes (other conditions that may be a focus of clinical attention). Keep in mind a diagnosis covers the most recent 12 months.
Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.
The Case of Sam
Sam is a 62-year-old, widowed, African American male. He is unemployed, receivesSocial Security benefits, and lives on his own in an apartment. Sam has minimal peerrelationships, choosing not to socialize with anyone except his daughter, with whom heis very close. Sam raised his daughter as a single father after his wife passed away.Melissa is 28 years old and works as an emergency medical technician (EMT). WhenSam was 7 years old, he was placed in foster care and has had very limited contact withhis extended family.Prior to September 11, 2001, Sam had a steady employment history in food servicesand retail. He had no psychiatric history before that time. Sam reported his religiousbackground is Catholic, but he is not affiliated with a congregation or church.Sam became depressed and psychotic sometime after 9/11 and had to be taken to anemergency room. He was hospitalized at that time for several weeks. His mental statusexam (MSE) and diagnostic interview showed no history of alcohol or substance abuseissues, and he had no criminal background or current legal issues. Sam was released tooutpatient care but was deemed unable to return to work. At that time, he had adiagnosis of major depression with psychotic features; he also has a history of highblood pressure and migraines. After several additional multiple psychiatrichospitalizations, he was gradually stabilized.Sam has been seeing a psychiatrist once a month for over a decade for medicationmanagement and is currently prescribed Depakote®, Abilify, and Wellbutrin®. Sam hasa positive history of medication and treatment compliance. He was treated by a socialworker at an outpatient program for about 2 years after his hospitalizations for hispsychosis and depression. He gradually stopped attending sessions with the socialworker after his symptoms stabilized, and his termination from the outpatient programwas deemed appropriate; he continued to see the psychiatrist monthly for medicationmanagement.After about 10 years of seeing only the psychiatrist, Sam scheduled a meeting with thissocial worker for increased feelings of depression. These feelings were brought on afterhis daughter moved out of the apartment they had shared for many years to live withher boyfriend. He reported difficulty adjusting to living alone and said he often feelslonely and anxious. He reported during sessions with his social worker that he speaks tohis daughter frequently, and although she only lives 10 blocks away, he misses herterribly.Our sessions for the last 3 months have focused on his mixed feelings around hisdaughter’s new life with her boyfriend. He said he is happy that she is happy but missesher very much. I emphasized his strengths and helped him reframe his situation byfocusing on the positive changes in her life as well as his own life. Our goals were tohelp him reduce his symptoms of anxiety and begin searching for new opportunities forsocialization outside of his daughter.During our last two sessions, I became concerned because Sam, who was normallyarticulate, had been appearing confused and slightly disorganized. I asked him if he hada recent medication change and if he had been compliant with his current medications,but he denied noncompliance or any recent medication adjustment.I asked Sam if he was experiencing any physical health problems. He denied anyongoing problems but mentioned that
