Reference no: EM133476509

Assignment

Lorna M. had been an excellent student in high school, valedictorian of her class and the editor of the school paper. She had been overly sensitive as a child and had difficulties as an adolescent making and keeping friends because she always felt rejected and unworthy. Her mother, who had gone through several bouts of depression herself, was no help in providing guidance. Her way of handling stress was to "take to her bed" whenever something bothered her.

For college, Lorna went away to a big state university. She studied hard the first year and got all A's.

Her sophomore year she dated a fellow student for 6 months, but halfway through the second semester she discovered that she was pregnant. Her boyfriend broke up with her and a month later she had a miscarriage.

Both events left her sad and lethargic. She had a hard time getting out of bed in the morning, and felt very heavy, as if she were walking through water. She couldn't seem to make even the simplest decisions, like what clothes to wear to class, so she stopped going altogether. After 10 days of staying in bed, she woke up one moring and burst into tears. All she could do was get in her car and drive the 3 hours home to her parents' house. Once there she stayed in bed for several days, tearfully telling her parents she didn't know what was wrong with her. Her parents sent her to their family physician who diagnosed major depressive disorder and gave her SSRIs.

Because she had missed so many classes, Lora dropped out of college and spent the next 6 months living with her parents. She was irritable and mean to everyone, and she wouldn't return calls from her friends at college. Her parents tried to cheer her up and would give her money to go shopping and buy herself new clothes.

At the end of the summer Lorna was feeling better and went back to college with a reduced classload.

She mostly kept to herself, and whenever she felt sad or anxious, she would go shopping to make herself feel better One time even though she had money in her purse to pay for the item, she shoplifted a new top and was caught. She returned the clothing and was not charged, but that night she went out and had so much to drink that two strangers had to help her get home.

Her roommates were worried and tried to talk to Lorna about her behavior; but she told them to mind their own business. Her parents came to visit, but she sent them away in anger. After several months of just getting by in school, and making herself feel better by partying and drinking, she smoked some weed that Was laced with PCP. Lorna became so paranoid that she thought she was going insane.

It seemed like she was spinning out of control. She couldn't tell her parents the truth. Her roommates didh't care. With no one left to turn to, she called a crisis line. The phone counselor was very supportive, and Lorna told her how sometimes she felt so down on herself that she just wanted to go to sleep and never wake up. But other times, for days at a time she would get dressed up and feel sexy and go out to the clubs where guys would buy her drinks and she would feel good about herself again. She would stay upall night doing her homework and still make it to class the next day. She felt like she did great work during those all-nighters. Then she would crash again, sleep until noon, miss class, hate herself, and go shopping to make herself feel better.

As a result of compulsive eating to reduce her stress, Lorna had gained 20 pounds and was once again having difficulty getting out of bed. She sought mental health treatment at the university health center, where, based on her family history, her prior major depressive episode (MDE), her current episodes altering between depression and elation, the irritability, weight gain, and continued participation in self-defeating behaviors, Lorna was diagnosed with bipolar II disorder- with atypical features.

Question I. List the signs and symptoms that point to a mental health diagnosis in the case.
Question II. Describe the other case details you would need to know for treatment planning and explain your reasoning.
Question III. List and describe the treatment interventions you would use for this case and explain your reasoning.