The Analysis of the Cyclothymic Disorder - Case Study Example

? Case Diagnosis number Publish James Part I: Multi Axial Diagnosis Axis I: Diagnosis: Cyclothymic Disorder Code: 301.13 Rationale: James has been experiencing episodes of depression and hypomania alternatively but his state cannot be characterised by a Major Depressive Episode due to the presence of manic activity. Moreover, the duration of the disorder has been three years as reported by James’ wife without the presence of a Mixed Episode, Manic Episode or Major Depressive Episode. The symptoms presented by James cannot be accounted for by Schizophrenia, Schizophreniform Disorder, Delusional Disorder or other Psychotic Disorders since James is not hallucinating or behaving as required by the aforementioned disorders. The problems that James is experiencing are not being caused by any form of substance abuse but do cause an impairment of James’ social and occupational functions. James also displays hypersomnia (327.15) related to Cyclothymic Disorder (301.13) and insomnia (307.42) related to Cyclothymic Disorder (301.13) alternatively. Axis II: Diagnosis: Schizoid Personality Disorder Code: ­­­­­­­­­­­­­­­­­­­­­­301.20 Rationale: James is detached from social experiences most of the time given his excessive sleeping routines and his refusal to meet other people. Additionally, James has little interest in sexual activities when he experiences depressive symptoms. James has no relationship beyond first degree relatives and friends that he has known for most of his life. He is reluctant in socialising with new people that support the idea that he has a schizoid personality disorder. James tends not to enjoy most activities when in a depressive state and provides an emotional detachment from people close to him including his wife. Since James is not involved in any substance abuse and is not using any forms of medication, it would be reasonable to deduce that James has a schizoid personality disorder. Axis III: hypersomnia related to another disorder and insomnia related to another disorder Rationale: James does not come out of his bed for around 14 hours a day when experiencing a depressive state. This in turn tends to aggravate his current state of affairs since it limits his time to socialise with other people or to carry out any forms of activities. Consequently, James’ depressive symptoms are aggravated further and this tends to constitute an Axis III disorder. Moreover, James also tends to display manic behaviour at other times when his total sleeping time is around 4 hours each day. During such periods, James’ body does not receive the amount of sleep required by an average human being and hence tends to affect his daily functioning including social and occupational functions. The presence of insomnia in James tends to aggravate his manic state and eventually forces him to slip into another depressive state of affairs. Axis IV: Unemployment Rationale: James does not have any problems with his primary support group since his wife fully takes care of him and his children cause him little trouble since they live on their own. Similarly, James does not have any problems in his social environment since he is not facing bereavement, acculturation or other adjustment related problems in life. However, James is facing occupational trouble since he has recently been fired from his job. This could be taken as the real cause behind his feeling of worthlessness and hence his suicidal tendencies. James has begun to picture himself as being irrelevant to the life of his family and friends and hence sees himself as being extraneous to his circumstances. Otherwise James does not present any symptoms or causes that could be categorised under Axis IV such as housing, healthcare, economic or other such problems. Axis V: 45 Rationale: James has some serious symptoms including his suicidal tendencies at times. His current state has affected his social and occupational functioning severely to the point where effective functioning is under question. Moreover, James has lost his job which presents occupational difficulties for him. On the other hand, it must also be kept in mind that James’ behaviour is depressive at time and is manic at other times. Moreover, his behaviour does not reflect any hallucinations or other such allied symptoms which means that James’ GAF should not be lowered anymore than 41. Part II: Biopsychosocial Risk and Resilience Assessment Table 1: Biopsychosocial Risk and Resilience Assessment for the onset of the disorder Risk Influences Protective Influences Biological Genetic disposition to disorder; Hypersomnia and insomnia may cause other disorders. James is still in good health and is able to function. Psychological James may fall deeper into psychotic disorders and may begin to hallucinate as his defence mechanism trigger to re-establish his self worth. James is currently not hallucinating or displaying paranoid, schizophrenic, delusional or other forms of behaviour which could be taken as a measure of sanity; James’ current state allows for him to recover better since he is able to communicate and understand effectively and this enhances his chances of recovery. Social James does not want to socialise which forces him to deal with people he is already familiar with. This in turn could cause problems when James is forced to socialise with a therapist. James has a close primary care giver in the form of his wife who has chosen not to abandon him; James’ children and close friends may be able to break him out of his isolation by encouraging him to be more socially interactive. What Techniques could you use to elicit additional strengths in this client? James’ situation can be improved considerably by allowing James to interact more with other people. The current situation is conducive to taking James out of his self imposed isolation since he has close support groups that can provide round the clock supervision and care. Moreover, additional information would be required from James’ wife, children and friends to discern the onset of his symptoms including any physcosocial disturbances in the recent past. James’ family history would require inquiry too in order to see if his family carries genetic disposition to James’ current problems. In case that James has a family history with mental disorders, it would provide insight into treatment methods as well as expected patterns of behaviour on James’ part. Read More