Differential Diagnosis
- Single Most Likely Diagnosis
- Borderline Personality Disorder (BPD): The patient's history of impulsive behavior (overdose after relationship breakup), situational mood swings, and constant thoughts about getting the relationship back are all consistent with BPD. The patient has also been told they have borderline traits, which further supports this diagnosis.
- Other Likely Diagnoses
- Major Depressive Disorder (MDD): The patient is moderately depressed, has gained weight from overeating, is unmotivated, and has difficulty concentrating, all of which are symptoms of MDD. The patient's history of prior suicide attempt and current suicidal ideation (as evidenced by the impulsive overdose) also support this diagnosis.
- Adjustment Disorder with Mixed Emotional Features: The patient's mood swings and depressive symptoms are triggered by a specific stressor (the relationship breakup), which is consistent with an adjustment disorder.
- Post-Traumatic Stress Disorder (PTSD): The patient's history of prior trauma (the relationship breakup and possible prior traumatic events) and current symptoms of hypervigilance (calling friends in the middle of the night) and intrusive thoughts (constantly thinking about getting the relationship back) may suggest PTSD.
- Do Not Miss Diagnoses
- Bipolar Disorder: The patient's mood swings and impulsive behavior could be indicative of a bipolar disorder, particularly if the patient has a history of manic or hypomanic episodes. Missing this diagnosis could lead to inappropriate treatment and worsening of symptoms.
- Suicidal Ideation: The patient's history of prior suicide attempt and current impulsive behavior necessitate careful evaluation for suicidal ideation and intent.
- Substance Use Disorder: The patient's history of overdose and possible substance use (although not explicitly stated) requires evaluation for a substance use disorder.
- Rare Diagnoses
- Cyclothymic Disorder: The patient's mood swings and depressive symptoms could be indicative of a cyclothymic disorder, although this diagnosis is less likely given the patient's lack of clear hypomanic episodes.
- Depressive Disorder Due to Another Medical Condition: The patient's depressive symptoms could be due to an underlying medical condition, such as hypothyroidism or chronic fatigue syndrome, although there is no clear evidence to support this diagnosis.
- Factitious Disorder: The patient's history of prior hospitalization for a suicide attempt and current symptoms could be indicative of a factitious disorder, although this diagnosis is unlikely and would require further evaluation.