Don`s Multiple Diagnosis


Don’s Multiple Diagnosis

Don represents with multiple complications. The behavior he exhibitsis imperative in making conclusions about the illnesses ailing him.Although there is previous diagnosis by the psychiatrist, it ispossible to pick certain manifests ion of his behavior and use theDSM criteria to conform the diagnosis.

First, Don presents with a drug use problem. The nurse refers to hisurine as a “trash can” meaning that he tested positive formultiple drugs. He confirms spending between $200 and $400 every dayto procure heroin and he injects himself at least six times everyday. According to the DSM criteria, an individual with a substancedisorder develops tolerance to a given drug or o multiple drugs, andthey strive to get a given dose to achieve a given feeling (AmericanPsychiatric Association, 2013). According to the nurse, Don alwayspushed for a higher dose of benzodiazepines.

Don also confirms engaging in dangerous drinking that always lead toblackouts. Also, he is aware of the danger lurking in his heavyintravenous drug use. The two characteristics depict the risky use ofdrugs. Due to the use of drugs, Don always finds himself engaging inanti-social behaviors that always land him in jail. It depicts andeffect on his social behavior setting to social impairment. Accordingto the DSM criteria, an individual diagnosed with substance disordermust have two primary characteristics (Yatham et al.,2013). Donexhibits three of them including social impairment, risky use, andtolerance.

His behavior also depicts the presence of psychosis. The DSM criteriaindicate that drug use is a possible cause of psychosis (Galanter etal., 2013). The condition is exhibited by hallucinations, poorinterpersonal relationships, and social dysfunction. During theprevious meeting with the psychiatrist, the nurse confirmed that Donhad been violent depicting a poor interpersonal relationship. Thepatients also report having auditory hallucinations although ruledout by the psychiatrist. The anti social behavior explained by theDSM criteria is present in Don, and he confirms engaging in recklessactivities that always lands hind in jail. Don has also lost hishouse, upcoming legal charges and lack of social support and theseconfirm his social dysfunction.

The primary diagnosis for his condition is bipolar. Don has all thesymptoms to satisfy the threshold explained by DSM criteria. Donexhibits an improved level of self-confidence (Yatham et al., 2013).Instead of feeling guilty of his drug use he is confident inexplaining his drug ordeal and even the amount that he spends onthem. The DSM criteria indicate that individuals with bipolar exhibithigh levels of confidence and self-esteem (Society for BipolarDisorders,2013). He is also talkative, and he confirms his state ofinsomnia. The stressors have also led him to have suicidal thoughtsalthough he has not attempted it.

His bipolar condition is only mild. Mild bipolar condition manifestswith thoughts of suicide without the attempting (Society for BipolarDisorders,2013). However, if t s not managed through the differenttreatment options, it can easily slip into being severe. Drug use isa major cause of bipolar disorder (Society for BipolarDisorders,2013). Don developed this condition mainly to his heavydrug use. Although his substance disorder is severe, his bipolarcondition exhibited by increased recklessness, increasedtalkativeness, lack of sleep and impaired judgment. Don is in need ofsupport to avoid his relapsing behavior. A continued use of drugs mayworsen the condition of bipolar and psychosis.


American PsychiatricAssociation. (2013). Diagnostic and statistical manual of mentaldisorders (DSM-5®). Arlington: American Psychiatric Pub.

Galanter, M.,Kleber, H. D., &amp Brady, K. (Eds.). (2014). The AmericanPsychiatric Publishing textbook of substance abuse treatment.Arlington: American Psychiatric Pub.

Yatham, L. N.,Kennedy, S. H., Parikh, S. V., Schaffer, A., Beaulieu, S., Alda, M.,&amp Ravindran, A. (2013). Canadian Network for Mood and AnxietyTreatments (CANMAT) and International Society for Bipolar Disorders(ISBD) collaborative update of CANMAT guidelines for the managementof patients with bipolar disorder: update 2013. Bipolar disorders,15(1), 1-44.