Daryl Owen Rachal Psych 445, Abnormal Psychology Instructor: Kevin Murray Case Study Assignment #1 Due Date:

2/24/2014 Case Study #1: Derek Derek (42) is currently suffering from a Depressive Episode, judging from his presentation of a number of depressive symptoms. Although not enough history is available to determine if this is Dereks first episode or the most recent in a series of recurrent episodes, or how long he has been suffering from these symptoms, the severity of the symptoms seems to suggest Major Depressive Disorder, rather than Chronic Depressive Disorder. According to the information available, Derek presents with a fairly consistently dysphoric mood that includes feelings of worthlessness (particularly with regards to his profession), possibly unwarranted fears of employment termination, ruminating thoughts of excessive guilt and failure over a poor demonstration of job performance ten years previous, and recurrent thoughts of his own violent death. Derek exhibits difficulty concentrating, particularly in the morning, which he attributes to his markedly disturbed sleep. Although there is no indication of psychomotor retardation or agitation, a change in appetite or weight, or a specific complaint of lethargy and loss of energy, Derek does complain of a number of physical aches and pains unexplained by any known somatic ailment, yet causing him to spend additional time resting in bed and possibly impacting dietary behaviors. Further information about his weight, eating behaviors and subjective feelings of energy would be necessary to evaluate these criteria. As a result of his symptoms, Derek experiences significant distress and dysfunction. His ruminative thoughts of past and present career disappointments, his physical discomfort, fear of termination, poor sleep and fantasies of violent death are both causes and effects of great psychological suffering, possibly accompanied by an inability to experience pleasure or joy, as indicated by his affectionless marriage and no mention of positive feelings associated with his children or any other outside interest. The additional rest required by his stomach cramps and headaches prevent Derek from participating in his family life, and his difficulty concentrating interfere with job performance almost certainly increasing the likelihood of failure in both of these areas, and the additional time in bed likely perpetuates his sleep disturbance, further perpetuating the cycle of Dereks distress and dysfunction. While no direct indication of danger is evident from the case study, Dereks recurrent thoughts of death may indicate hidden suicidal ideations or may ultimately culminate in suicidal behavior, and the Major Depressive Diagnosis is associated with an increase in all-cause mortality, emphasizing the urgency of treatment.

Case Study #2: Rodney Rodney (38) meets the diagnostic criteria for Bipolar I Disorder. He is currently experiencing a Manic Episode, evidenced by his marked departure from baseline behavior, in the form of suddenly intense irritability, abnormally high activity and energy levels, increase in goal-related activity, decreased need for sleep, and excessive involvement in activities likely to have undesirable consequences. Due to the subjective nature of distress, it is unclear if Rodney currently experiences much distress from his symptoms, although significant dysfunction is evident and future distress post-episode seems assured. His marriage has been negatively impacted by his threats of leaving his wife for another woman, reckless sale of shared valuables, excessive partying and socializing with strangers, reckless spending on his swimming pool construction project, public opening of the completed swimming pool and the decision to sell concessions at the pool. Aside from the wear and tear of a weeks worth of 18-hour manual labor sessions and little sleep, there is no indication of physically dangerous behavior from the case study. However, clearly uninhibited behavior and lack of insight, leading to impaired decision-making, is evident, which could easily lead to physically dangerous situations for Rodney or others, and the financial safety of Rodney and his wife is clearly in danger. Some social deviance is evident in the decision to run a commercial swimming pool and concession stand out of a private residence.