You are meeting with Julia Marie Groffin, a 38-year-old woman who is visiting the clinic because of a chief complaint of “not able to pay attention and not sleeping.”
Julia Marie enters your office and you notice that she is well-dressed, and her hygiene is good.
Julia Marie starts talking even before you offer her a seat. “My office is somewhat similar.” As she is sitting down, she starts, “I am working on my MBA in finance. I have always been academically focused. You know my aim is to stay contemporary in my career and I enjoy going to school.
“Writing a romance novel energizes me, and that’s what I do for most of my weekend.” There is an incredible gush of joy as she is describing to you how she creates these fancy characters for her novel. “I imagine an ideal life for myself and then I create me as the main character in the novel. I design every situation and every character as picture perfect and I make this imaginative me in the novel enjoy the most desirable life. I really hope one day my romance novel will be made into a movie.
“Night school for MBA, writing romance novels on the weekends, all while working a full-time job as a certified public accountant! I have a busy life although I live by myself. I’ve had a lot of sexual partners recently, but I don’t want to get pregnant and so I take birth control pills.”
Julia Marie experiences periods of depression, where she says “at those times I think of hurting myself, but currently I don’t have any of those thoughts. But I get angry pretty easily.”
Julia Marie answers all your questions appropriately but is very distracted. However, you were able to engage her throughout the interview process.
Pick a screening tool that would be most appropriate for Julia Marie and score it the best you can based on the information provided. Based on the screening tool and score, what would the most likely diagnosis for Julia Marie be? Include the scored screening tool as an appendix.
What interviewing techniques would be best used for Julia?
What medication treatment would be best for Julia Marie? Please indicate the medication(s) you would start her on, the starting dose, and any patient education that you would need to do with these medications.
What type of therapy would work best for Julia Marie?
Identify what lab work you would order. Provide evidence to support your rationale.