Differential Diagnosis for Chloe
- Single most likely diagnosis
- Major Depressive Disorder (MDD): This diagnosis is the most likely due to Chloe's persistent feelings of hopelessness, self-doubt, lack of motivation, and low mood most days. Her symptoms of waking up tired despite adequate sleep, using coffee to maintain energy, and struggling with concentration at work also align with MDD. The presence of thoughts of wishing to be dead, although without active suicidal ideation or planning, further supports this diagnosis.
- Other Likely diagnoses
- Generalized Anxiety Disorder (GAD): Chloe's description of constant worry about making mistakes or upsetting others is characteristic of GAD. The fact that her anxiety has been ongoing for approximately 10 years and has been exacerbated by the pandemic and her new job also supports this diagnosis.
- Adjustment Disorder with Mixed Anxiety and Depressed Mood: Given that Chloe's symptoms worsened after starting a full-time job, an adjustment disorder could be considered. However, the duration of her symptoms (approximately 10 years) makes this diagnosis less likely than MDD or GAD.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Bipolar Disorder: Although Chloe's symptoms are more indicative of depression and anxiety, it is essential to rule out bipolar disorder, particularly given her intense episode of dread and brief psychiatric evaluation in the ER. Bipolar disorder can be deadly if missed, as it may lead to suicidal ideation or poor treatment outcomes if treated solely with antidepressants.
- Post-Traumatic Stress Disorder (PTSD): Chloe's history is not explicitly mentioned, but given her symptoms of anxiety and depression, it is crucial to consider PTSD, especially if she has experienced any traumatic events. PTSD can be deadly if missed, as it may lead to suicidal ideation, substance abuse, or other high-risk behaviors.
- Substance Use Disorder: Although not explicitly mentioned, substance use disorders can contribute to or exacerbate symptoms of depression and anxiety. It is essential to assess for substance use, as it can be deadly if missed, particularly if Chloe is using substances to cope with her symptoms.
- Rare diagnoses
- Dysthymia (Persistent Depressive Disorder): Although Chloe's symptoms have been ongoing for approximately 10 years, dysthymia is a less likely diagnosis given the intensity of her symptoms and the presence of anxiety.
- Anxiety Disorder due to Another Medical Condition: This diagnosis would be considered if Chloe's anxiety symptoms were directly related to a medical condition. However, there is no indication of a underlying medical condition that would suggest this diagnosis.
- Depressive Disorder due to Another Medical Condition: Similarly, this diagnosis would be considered if Chloe's depressive symptoms were directly related to a medical condition. However, there is no indication of a underlying medical condition that would suggest this diagnosis.