Read the following vignette, keeping in mind the importance of knowing symptoms and their duration and severity:
Christina is a 25-year-old Mexican-American woman who has been working as an elementary school teacher since she graduated from college three years ago. Although she does well at her job, she has been feeling low ever since she left college. When she took this teaching position, she had to relocate to a city over four hours away from her family and the house she grew up in. Even though she has made some new friends, Christina still feels disconnected and lonely. She is also concerned about her mother, who has been diagnosed with a serious health condition.
For the past month, Christina has felt much worse. She reports feeling very sad and tired most of the time and is having difficulty concentrating at work. She says that she does not have enough energy to accomplish the things she would like to do. She admits to overeating to “unwind” after school, and is concerned she is sleeping too much on the weekends. She also has very low self-esteem, despite being well-liked at her school and receiving good performance evaluations.
Christina describes her life as “heading nowhere” and says that lately she has felt extremely hopeless. She wonders if she will ever feel as happy as she did when she was in college. She does not have a history of ever feeling worse than this, and is in good health.
Based on the information presented, address the following questions in your discussion post using headings to match content in each bullet point:
1. What diagnosis would you consider assigning to Christina? Describe the process you used for making this decision, including “Differential Diagnosis by the Trees” from the DSM-5 Handbook of Differential Diagnosis or Section II of your text, Desk Reference to the Diagnostic Criteria From DSM-5®.
2. What Z code or codes would you consider for Christina? How would including these systemic considerations help you understand Christina’s presenting symptoms and consider your treatment approach?
