Question

A 39 year-old woman comes in for a check-up regarding previous diagnoses of hypertension and elevated cholesterol. She admits that there have been days that she had not taken her medications. She also states that she is unmotivated and isolates herself at home. She reports that she sleeps a lot but still feels tired, that doing anything takes a lot of effort, and says “nothing is fun anymore”. She also describes feelings of sadness and hopelessness. She becomes tearful and admits that in recent weeks she has been having feelings of not wanting to live, and this scares her. These feelings have been going on for the past six weeks following the death of her mother. In the last three weeks they have gotten worse, and last week she missed work twice. What are the 3 most important things you need to assess to determine whether she suffers from Major Depressive Disorder, Bipolar I or Acute Depression? What additional information (if any) do you need?

Answer 1

Three things that one needs to assess in context of MDD acute depression or bipolar is low mood that persists over a span of more than two weeks, loss of pleasure or anhedonia, and excessive lethargy.

Additional information required would be the magnitude over the time, which would help in gauging the advancement of the disorder and hence thwart the danger that the individual could pose for others and self.

A brief family history, cause for mothers death would also aid in comprehending thr patients mental status.