Differential Diagnosis for Gavin's Symptoms
Single Most Likely Diagnosis
- Major Depressive Disorder (MDD): Gavin's symptoms of extreme self-loathing, negative self-image, depressed mood, loss of interest in activities, guilt, anger, low energy, disturbed sleep, and insufficient appetite are all consistent with MDD. The presence of suicidal thoughts, although without intent or plan, further supports this diagnosis.
Other Likely Diagnoses
- Post-Traumatic Stress Disorder (PTSD): Gavin's history of trauma from their father and stepbrother, along with symptoms of guilt, anger, and paranoid feelings, suggest PTSD as a possible diagnosis.
- Substance Use Disorder: Gavin's frequent use of marijuana and occasional use of alcohol, which they believe helps maintain a medium mood level, indicates a potential substance use disorder.
- Borderline Personality Disorder: Gavin's self-loathing, negative self-image, and history of trauma, along with their use of substances to cope with emotions, may suggest borderline personality disorder.
Do Not Miss Diagnoses
- Bipolar Disorder: Although Gavin mentions some elevation in mood attributed to substance use, it is essential to rule out bipolar disorder, as untreated bipolar disorder can lead to severe consequences.
- Psychotic Disorder: Gavin's reports of internal monologues and occasional visual disturbances, as well as paranoid feelings, necessitate consideration of a psychotic disorder, such as schizophrenia or a schizoaffective disorder.
- Trauma- and Stressor-Related Disorder: Given Gavin's history of trauma, it is crucial to consider other trauma-related disorders, such as acute stress disorder or adjustment disorder.
Rare Diagnoses
- Schizotypal Personality Disorder: Gavin's occasional visual disturbances and paranoid feelings might suggest schizotypal personality disorder, although this is less likely given the prominent depressive symptoms.
- Dissociative Disorder: Although not directly mentioned, Gavin's history of trauma and reports of internal monologues could potentially indicate a dissociative disorder, such as dissociative identity disorder or depersonalization disorder.