Health Sciences

Major Depressive Disorder

For one to be identified with the Major Depressive Disorder condition, he or she need to exhibit the symptoms of this condition on daily basis for at least a fort night. Also, the symptoms of this condition seem to surpass our day to day fluctuations especially in our mood. In this case study it is evident that the patient had displayed the symptoms of this condition for almost a year that is since the death of her father. 

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It is evident that Kathie admitted herself to the hospital after she had developed suicidal thoughts. She had decided to end her life by taking an overdose of medicine. However, she sought help from 911 before executing her plan. During her assessment at the hospital, Kathie describes how she misses her father and how she has overtime become sad. Moreover, she also narrates that since the death of her father she has lost interest in most of life activities and thus becoming a social misfit. Also she mentioned that she experiences hopelessness and emptiness. The patient also suffers from loss of sleep and she has significantly added weight. Also the patient losses concentration easily. The above mentioned symptoms are in line with DSM-V criteria for major depressive disorder. Therefore, Kathie qualifies to be suffering from this condition.

Bulimia Nervosa 

Kathie has been able to show a number of signs and symptoms that indicates that she may be suffering from Bulimia Nervosa. Most of the symptoms are as it is described in DSM-V. In this case, Kathie has been binge eating recurrently. From her own explanation, she notes that she eats until she feel uncomfortable. Mostly Kathie eats in excess at night when she feels that she is unable to sleep. Her eating conditions can be noted as being a compensatory behavior for the lack of sleep. Kathie has noted that she has gained weight excessively and that she is concerned about the aspect of weight gain. The above description can be used to diagnose Kathie with Bulimia Nervosa.


From the case study it is clear that Kathie has been suffering from Insomnia for several years. Also she has been takin sleeping pills and Ambien to help her fall asleep. Interestingly the patient the patient usually takes three to four hours before she can fall asleep after going to bed. Also she sleeps an average of four and a half hours at most. According to the DSM-V criteria for Insomnia, Kathie’s condition could be as a result of major depressive disorder. The major depressive disorder condition highly influences the chances of developing insomnia and thus the condition can be described as a predisposing factor. The fact that Kathie losses concentration can also be attribute to the fact that she does not get adequate sleep at night and thus interfering with her cognitive abilities. 



In Kathie’s case, there are a number of differentials to be considered, however these conditions can also be ruled out in order to develop an accurate clinical impression. The differential diagnosis I this case include; Adjustment disorder with depressed mood, bipolar disorder, grief reaction for major depressive disorder. Secondly there is binge eating disorder for bulimia nervosa and lastly depression for insomnia.

  1. Differentials for Major Depressive Disorder

Adjustment Disorder with Depressed Mood

Adjustment disorder with depressed mood may lead to functioning impairment. From the case study Kathie has not been experiencing any impairment in her functioning. Moreover, the condition is also as a result of escalating mental health conditions. From the assessment, it is evident that Kathie does not suffer from any mental abnormalities and therefore the patient could be suffering from adjustment disorder with depressed mood.

Bipolar Disorder

From the case study Kathie has shown signs related to bipolar disorder and they include lack of sleep and low self-esteem. However, there are other major symptoms of the condition that she has not been able to bring out. One major symptom is increased energy. In the case of Kathie she has lost interest in the normal day to day activities and this is an indicator that her energy levels are low. The fact that her energy levels are low rules out the fact that she may be suffering from the condition.

Grief Reaction

Grief has under many occasions been confused with major depressive disorder, his confusion has been because the two conditions have a lot symptoms in common. However, it is evident that grief reaction is an emotional condition that is caused by the loss of an important aspect in one’s life. In the case of Kathie she lost her father, with whom they had lived together for a long period of time. However, the symptoms exhibited by Kathie are beyond grief, this shows that Kathie is not suffering from grief.

  1. Differential Diagnosis for Bulimia Nervosa

Binge Eating Disorder

Binge eating disorder is mainly characterized by the consumption of food in discrete time patterns. Also, one is unable to control his or her eating habits. From Kathie’s case it is evident that she has a number of symptoms that are common in people with binge eating disorder. However, in the case of Kathie she only eats at night when she is unable to sleep. On the other hand binge eating occurs periodically that is once or twice a week. The argument presented rules out that Kathie is not suffering from binge eating disorder.

  1. Differential Diagnosis for Insomnia


Kathie has for a long period of time experienced lack of sleep at night. The condition has made her to use sleeping pills and other forms of medication to help her sleep at night. Mostly she sleeps for four to five hours and she has to stay in bed for four hours before she can fall asleep. These characteristics may be a red flag that she is suffering from depression. However, from her symptoms it is evident that she is suffering from insomnia due to the fact that she has not shown various signs of depression.

Q).3 Psychosocial and Environmental Problems

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