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Wendy is a 30-year-old, unemployed white female. She is no stranger to therapy, having seen counselors for most of her teen and adult years. Her friends would describe her as a “wild woman” who takes no crap from anyone. She has held various part-time jobs for the last few years because she usually gets angry at her boss or coworkers and quits. While she has had a string of boyfriends over the years, she has been seeing one man for the last year or so. He too is unemployed and has both an alcohol and methamphetamine problem. She describes the relationship as “addictive and dysfunctional, yet exciting and hot.” Wendy is back in treatment at the urging of her parents, who describe her behavior as erratic and unpredictable. They also claim that she has periods where she “sleeps little and parties lots.” There were also several occasions in the last five years when she was so depressed she didn’t eat or want to leave the house. Her father also admits to periods of depression, and Trisha’s grandfather was diagnosed with manic depression, resulting in numerous hospitalizations in the 1950s and 1960s. Wendy’s only brother died in a car accident several years ago. He was drunk at the time, but she claims he had a long history of depression. Recently Trisha was arrested for disorderly conduct at a friend’s party. She had not slept for nearly 24 hours and was drunk and combative. When she was first approached by police, she solicited them for sex. They report that she was rather hyperverbal and hyperactive. They later had to investigate a complaint from local storeowners for bad checks she wrote in excess of $7,000.

• Summarize the clinical case.
• Create a list of the patient’s problems and prioritize them.
• Which diagnosis should be considered/ Depressive disorder with manic episodes
• What is your rationale for the diagnosis
• What differential diagnosis should be considered/ MDD, Bipolar I Disorder, Bipolar II Disorder
• What test or screening tools should be considered to help identify the correct diagnosis/Mood Disorder Questionnaire (MDQ)/Young Mania Rating Scale (YMRS):
• What treatment would you prescribe and what is the rationale (consider psychopharmacology, diagnostics tests, referrals, psychotherapy, psychoeducation) Combination of medication and psychotherapy. /Mood stabilizers, such as lithium or anticonvulsant medications like valproate or lamotrigine, are often prescribed to manage manic symptoms. Antidepressants may also be prescribed for the depressive symptoms, but caution is needed as they can potentially trigger or worsen manic episodes. Psychotherapy: Different forms of psychotherapy can be beneficial for individuals with MDD and mania.CBT, IPT.
• What standard guidelines would you use to assess or treat this patient

Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.

Submission Instructions

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 evidence-based sources.