Case Study
Leo (Age 8): Leo finds it difficult to make eye contact and struggles to understand jokes or sarcasm. He rarely initiates social interactions and seems more comfortable playing alone. He has an intense fascination with train schedules and can recite them verbatim. He becomes extremely distressed if his daily routine is altered, such as taking a different route to school. His language development was slightly delayed, and while he speaks fluently now, his tone is often described as flat or robotic.
* What is the most likely diagnosis?
ASD
Distinct period of abnormally and persistently elevated, expansive, or irritable mood and persistently increased goal-directed activity or energy. Symptoms include inflated self-esteem/grandiosity, decreased need for sleep, more talkative than usual/pressured speech, flight of ideas/racing thoughts, distractibility, increase in goal-directed activity or psychomotor agitation, excessive involvement in risky activities.
Mania as seen in Bipolar 1
Used for anxiety disorders, involves gradual exposure to feared situations to reduce anxiety.
Exposure Therapy:
Name 3 symptoms of mania
Elevated, expansive, or irritable mood
Increased energy and activity levels
Decreased need for sleep (e.g., feeling rested after only 3 hours of sleep)
More talkative than usual or pressure to keep talking
Racing thoughts or flight of ideas
Increased goal-directed activity or physical restlessness
Excessive involvement in risky activities (e.g., spending sprees, sexual indiscretions)
Inflated self-esteem or grandiosity
More outgoing, increased sociability, or sexual indiscretions.
Used to treat depression and can also sometimes help with anxiety.
Antidepressants
Ben (Age 40): Ben rarely leaves his house anymore. He experiences intense fear and anxiety about being in situations where escape might be difficult or help might not be available if he were to have panic-like symptoms. He specifically avoids public transportation, being in crowds, standing in lines, and being in open spaces like parking lots. The thought of being trapped in these situations causes him significant distress.
* What is the most likely diagnosis?
Agoraphobia
Excessive anxiety and worry about various events or activities, occurring more days than not for at least 6 months. Difficulty controlling the worry. Associated symptoms like restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance.
GAD
Focuses on identifying and changing negative thought patterns and behaviors.
Cognitive Behavioral Therapy (CBT)
A mental state characterized by a disconnection from reality is called
Psychosis
Used to treat psychotic disorders like schizophrenia.
Antipsychotics
Richard (Age 42): Richard is a junior executive who firmly believes he is destined for greatness and possesses unique talents that others don't appreciate enough. He constantly seeks admiration and expects special treatment from everyone. He talks at length about his achievements (often exaggerating them) and shows little interest in the experiences or feelings of others unless they relate directly to him. He reacts with anger or dismissiveness when criticized and feels envious of others' successes, believing they don't deserve them as much as he does. He has a history of exploiting colleagues to get ahead.
* What is the most likely diagnosis?
Narcissistic Personality Disorder
Recurrent, unexpected panic attacks (abrupt surge of intense fear/discomfort peaking within minutes, including symptoms like palpitations, sweating, trembling, shortness of breath, feeling of choking, chest pain, nausea, dizziness, chills/heat, numbness/tingling, derealization/depersonalization, fear of losing control, fear of dying).
Panic Disorder
Behavioral technique that pairs unwanted behaviors with unpleasant stimuli to reduce or eliminate those behaviors by creating a negative association.
Aversion therapy
Cluster B disorders
Antisocial Personality Disorder
Borderline Personality Disorder
Histrionic Personality Disorders
Narcissistic Personality Disorders
Medications like lithium help regulate mood swings and prevent manic and depressive episodes in bipolar disorder.
Mood stabilizers
Thomas (Age 27): Thomas works in a solitary role because he is terrified of criticism or rejection from colleagues. He avoids social gatherings and turns down promotions that would require more teamwork. Although he longs for close relationships, he is unwilling to get involved with people unless he is certain of being liked. He views himself as socially inept, personally unappealing, and inferior to others. He is extremely reluctant to take personal risks or engage in new activities because they might prove embarrassing.
* What is the most likely diagnosis?
Avoidant Personality Disorder
Marked, persistent, and excessive fear or anxiety about a specific object or situation (e.g., flying, heights, animals, injections, blood).
Specific Phobia Disorder
Therapy that uses principles of learning and conditioning to improve specific behaviors, such as social skills, communication, and academic performance, through systematic interventions and reinforcement strategies.
Applied Behavior Analysis
Difference between Persistent Depressive disorder and Major depressive disorder
MDD is characterized by more severe symptoms that last for at least two weeks. PDD, on the other hand, is defined by less severe but longer-lasting symptoms, typically persisting for at least two years. Essentially, PDD is a chronic, low-level form of depression, while MDD is characterized by more intense, episodic depression.
Benzodiazepines, like alprazolam, and other anxiolytics are used to quickly reduce anxiety symptoms, including panic attacks.
Anti-Anxiety Medications
Daniel (Age 21): Daniel is plagued by persistent, intrusive thoughts about germs and contamination. He worries constantly about becoming sick from touching everyday objects. To reduce his anxiety, he feels compelled to wash his hands excessively, sometimes up to 50 times a day, until they are raw and chapped. He also follows rigid cleaning rituals in his apartment. These thoughts and behaviors consume several hours each day and cause him significant distress.
* What is the most likely diagnosis?
OCD
Inability to recall important autobiographical information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting. May involve dissociative fugue: apparently purposeful travel or bewildered wandering associated with amnesia for identity or other important autobiographical information.
Dissociative Amnesia
Helps individuals manage intense emotions, cope with stress, and improve relationships, often used for borderline personality disorder.
Dialectical Behavior Therapy (DBT)
Difference between Bipolar 1 and Bipolar 2
Bipolar 1 involves more severe manic episodes that can last for several days or weeks, while bipolar 2 has less severe hypomanic episodes that typically last for a shorter duration.
This is a potential side effect of long-term use of antipsychotic medications, characterized by repetitive, involuntary movements, such as grimacing, tongue movements, and jerking of the limbs.
Tardive Dyskinesia