Full Mania Case Studies

Ellen presents with symptoms and behaviors that are consistent with a DSM-5 diagnosis of F31.81 Bipolar II Disorder, current episode depressed, moderate severity, with panic attacks. Of the twelve diagnostic criteria for hypomania Ellen meets at least nine in addition to meeting eight out of eleven criteria for major depression (Diagnostic and Statistical Manual of Mental Disorders, 2013).

Differential Diagnosis Diagnostic criteria for other mood or depressive disorders were unmet and/or her symptoms were better explained by another disorder. For example, while she met five of the ten diagnostic criteria for full mania in Bipolar I Disorder, the full range of symptoms were better explained by this diagnosis. Additionally, the description of her acute panic attacks was insufficient to qualify for a panic disorder, so a specifier was added for a more complete diagnosis.

Biological, Family, and Cultural Considerations

Ellen is a 37 year old female, graduate student who lives alone and supports herself via work as a home health aide. She has been romantically involved with the same man for about six years, but he has been unwilling to commit as evidenced by his refusal to marry or cohabitate with Ellen. This has added to her depression and experience of acute panic attacks. Familial considerations include a history of strife in her parents’ marriage, emotional abuse by her parents, and alcohol abuse by her father. The possibility of additional biological and familial history should be assessed as “physical health and medical history, medications, family and personal history, and psychosocial stressors” (Beidel, Frueh & Hersen, 2014) could contribute to Ellen’s