Differential Diagnosis for Tessa

Single Most Likely Diagnosis

• Major Depressive Disorder (MDD): Tessa's current symptoms, including depressed mood, anhedonia, fatigue, irritability, and poor concentration, are consistent with a major depressive episode. Her history of suicidal attempts and hospitalizations also supports this diagnosis.

Other Likely Diagnoses

• Attention Deficit Hyperactivity Disorder (ADHD): Tessa's self-reported symptoms of inattention, distractibility, and disorganization are consistent with ADHD. Her difficulty with task organization and forgetfulness also support this diagnosis.
• Anxiety Disorder: Tessa's reports of increased anxiety, feeling tightness in the chest, racing thoughts, and shakiness are consistent with an anxiety disorder, possibly generalized anxiety disorder or social anxiety disorder.
• Post-Traumatic Stress Disorder (PTSD): Tessa's history of traumatic experiences, including a difficult childhood, adoption, and homelessness, may contribute to the development of PTSD. Her symptoms of anxiety and depression could be related to underlying PTSD.

Do Not Miss Diagnoses

• Bipolar Disorder: Although Tessa doubts her previous diagnosis of bipolar 2, her history of suicidal attempts, hospitalizations, and mood instability cannot be ignored. It is essential to carefully evaluate her mood symptoms and consider the possibility of bipolar disorder, particularly given her previous diagnosis and treatment with mood stabilizers.
• Borderline Personality Disorder: Tessa's history of suicidal attempts, self-reported impulsivity, and emotional dysregulation may be indicative of borderline personality disorder. This diagnosis requires careful consideration, as it can have significant implications for treatment and management.

Rare Diagnoses

• Cyclothymic Disorder: Although less likely, Tessa's history of mood instability and previous diagnosis of bipolar 2 could also suggest cyclothymic disorder, a rare mood disorder characterized by periods of hypomanic and depressive symptoms.
• Trauma- and Stressor-Related Disorder: Tessa's history of traumatic experiences and current symptoms of anxiety and depression could be related to a trauma- and stressor-related disorder, such as adjustment disorder or acute stress disorder. However, these diagnoses are less likely given the complexity of her symptoms and history.