1. Read these case studies:

Case 1

Elizabeth is a 25 y/o female who was taken to the E.D. by her family after they noticed she has been acting "differently" lately. In the past 2 months, family reports that she has been isolating at home and has been reluctant to take care of herself. Her hygiene is poor, and she looks disheveled. During the interview, patient had poor eye contact, she endorsed feeling "down", "fatigued", "no motivation to spend time with family as I used to" hopeless, and helpless. Her mood was described as "really depressed". Her affect was restricted. She decided to stop since she could not concentrate in her work duties. At one point of the interview she stated: "I just want to end it all," my life is worthless. All these symptoms have occurred for the last 6 weeks and it is causing a significant burden to her family.

Case 2

John is a 20 y/o College student who presented to the school's counseling center based on the recommendation from a professor. John claims that he is a junior student, but his time in College has been "sad". He describes his mood as "low most of the time". These feelings started especially at the beginning of the freshman year. In High school, he enjoyed playing sports, and socializing with his friends. During his time at the College, he has not been able to make friends. He feels ashamed, and gave up on trying to make friends because he felt that he would feel rejected. He isolates in his dorm at least one day of the week. When he comes out to his classes, he feels different than his classmates stating: "I feel worthless" compared to them. His grades and performance at the school have been ok during the past year. He claims that this is due to his fatigue, low energy, inability to fully concentrate on his courses, and assignments, but he still manages to do well. He has difficulty sleeping at night which occurs several nights during the week. He looks disheveled. He denies suicidal ideation.

Provide an overview of the case, main diagnosis, differential diagnosis, target symptoms, appropriate laboratory or diagnostic test,and treatment plan.

2. Answer these questions:

• Differentiate between bipolar depression and bipolar mania.
• Select a screening or diagnostic tool relevant to bipolar disorders.
• Indicate recommended treatment for bipolar depression or bipolar mania using clinical guidelines.