Tre is a 23 year old male that presents to the clinic with c…
Tre is a 23 year old male that presents to the clinic with concerns regarding his mood. For the last two and a half years he has felt depressed. He does not note any time period within the last two and a half years that he has been happy for greater than two weeks. He is not sure what has triggered this and it has been hard for him to manage. His energy is low, he is sleeping 12 hours a day, he is overeating and he has feelings of hopelessness. He denies any manic or hypomanic symptoms in his life. He is not on any medications at this time and his lab work at his last physical (TSH, CBC, CMP, B12, Vit D and Folate) were normal. His PHQ-9 is 20 and GAD-7 is 5. When thinking about this presentation what is the best DSM-5-TR diagnosis with his current symptoms:
Read DetailsYou have a 23 year old female that comes into your clinic an…
You have a 23 year old female that comes into your clinic and was on lamotrigine for bipolar II. She would like to wean off the lamotrigine during her pregnancy while she is monitored for a hypomania. You do wean her off and two months later she comes in and states she is feeling depressed and she has a family member on fluoxetine and she inquires about going on fluoxetine. What is your best response with what you know about her bipolar II diagnosis:
Read DetailsA 16 year old client returns for follow-up appointment 3 wee…
A 16 year old client returns for follow-up appointment 3 weeks after starting on fluoxetine 20 mg daily. During the appointment you notice that her speech is a little rapid, in marked contrast to the psychomotor retardation and paucity of spontaneous speech she displayed on her first visit. Instead of looking at the floor, she now makes normal eye contact. Her affect has one from constricted to expansive. She continues to have difficulty sleeping, but her energy has improved and she states she feels “so much better.” She also has not been eating as much since she feels like she does not have time to eat since she is so much busier now that she is feeling better. What should you conclude about the shift in the client’s presentation?
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