applying differential diagnosis to depressive and bipolar disorders 1

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Depressive and Bipolar Disorders.

Alejandro is a fifty-three-year-old Hispanic male who complains of missing his family, who separated from him when he started behaving strangely. Alejandro has inconsistent feelings of good, lack of sleep, and social drinking (Plummer, 2013). He has had a good parental upbringing where he would spend time every Sunday with family and relatives. It is also clear that Alejandro never had an abnormal medical record from his childhood (Plummer, 2013). Most of his problems thus originate from his abnormal feeling of excitement, which at some point led him to punch the wall, and this scared his wife, and thus she had to leave for fear of being a victim of his acting out. This history, therefore, shows that Alejandro could be suffering from a bipolar related disorder and not a medical condition.


Alejandro has symptoms of bipolar disorder characterized by his inconsistency of feeling good, which does not last long, followed by his angry outburst and his actions of punching the wall. The ICD-10-cm code for the disorder is F31.2, and the 2019 edition of the coded started being effective on October first two thousand and eighteen (American Psychiatric Association 2013).


Alejandro has confessed that he misses his and wants them back. His actions of outburst anger and punching on the wall scared them for his wife says she feared to be a victim of his acting out. The other confirmation of his bipolar disorder is his extreme feeling of good, where he even spends a lot of money buying expensive items, his lack of sleep, and substituted with playing games. His social drinking also increases, and he reports to his wife that he feels great.


These symptoms are moderate, and they can be lowered further by bring back his wife and children and also encouraging him to seek psychiatric treatment and should not stop the treatment even when his behavior settles down. He should also make sure he has enough sleep and abandon social drinking (American Psychiatric Association 2013).

Medical Needs

There is a need for the social worker to find out what causes Alejandro to develop the inconsistent feelings of good and all over sudden the outburst anger.

The Diagnosis.

Alejandro has the symptoms of a bipolar related disorder, and the DSM-5 diagnosis criteria will involve a combination of various methods. Therefore, the initial diagnosis involves a personal assessment to detect if there are any bouts of sadness followed by extreme optimism and happiness (Morrison, 2014). Upon doing so, it would be important to see a doctor to perform any physical examination to rule out other conditions which could be suspected to cause extreme shifts. The other diagnosis will be made by a psychiatrist to assess the overall mental health by asking questions about the symptoms and how long they have occurred (Morrison, 2014).

Measurement Instrument.

The general behavior inventory is suitable for the validation of the diagnosis and assessment of outcome since its internal consistency is high and reliable (American Psychiatric Association 2013). This is because the method combines the scale length and items questioning related symptoms.

Treatment Recommendation.

Since the most significant cause of separation from his family is his inconsistent feelings of good, followed by acting out, the most effective treatment would be family therapy (American Psychiatric Association 2013). In that case, the social worker will get to inform him that his strange behavior scares his family members since they feared to be victims of the outburst anger and financial bankruptcy. I would also recommend Alejandro to resume his psychiatric treatment and never to abandon them even when his behavior is stable since his inconsistent feelings occur at any given time.


Morrison, J. (2014). Diagnosis made easier (2nd ed.). New York, NY: Guilford Press.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. BMC Med, 17, 133-137.

Plummer, S.-B., Makris, S., & Brocksen, S. (2013). Social work case studies: Concentration year. Baltimore, MD: Laureate Publishing.