Olivia Jacobs, a 22-year-old graduate student, was referred for a psychiatric consultation after telling her roommate she was suicidal. She had a history of bipolar II disorder and her depressive symptoms had returned after moving to a new city for school. She was having frequent suicidal thoughts and searching online for ways to purchase a gun. Upon evaluation, she appeared depressed and tearful with psychomotor slowing. She reported hopelessness, poor concentration, and guilt. She was diagnosed with bipolar II disorder.

1. Case Study*
“Olivia Jacobs, a 22 year old graduate student in architecture,
was referred for an urgent psychiatric consultation after she told
her roommate that she was suicidal. Ms. Jacobs had a history of
mood symptoms that had been under good control with lithium
and sertraline, but her depressive symptoms had returned soon
after she had arrived in a new city for school, 3 months earlier.
She had become preoccupied with ways in which she might kill
herself without inconveniencing others. Her dominant suicidal
thoughts involved shooting herself in the head while leaning out
the window, so as not to cause a mess in the dorm. Although
she did not have access to a gun, she spent time searching the
Web for places where she might purchase one.
Ms. Jacobs’s psychiatric history began at age 15, when the
began to regularly drink alcohol and smoke marijuana, usually
when out a t dance clubs with friends. Both of these substances
calmed her, and she denied that either had become problematic.
She had used neither alcohol nor marijuana since starting
graduate school.
Around age 17, she began experiencing brief, intensive
depressive episodes, marked by tearfulness, feelings of guilt,
anhedonia, hopelessness, low energy, and poor concentration.
She would sleep more than 12 hours a day and neglect
responsibilities at school and home.
These depressive episodes would generally shift after a few
weeks into periods of increased energy, pressured speech, and
unusual creativity. She would stay up most of the night working
on projects and building architectural models. These revved-up
episodes lasted about 5 days and were punctuated by feelings

2. that her friends had turned against herald that there were not
really friends at all. Worried especially about the par anoia, her
family brought her to a psychiatrist, who diagnosed her as
having bipolar II disorder and prescribed lithium and sertraline.
Although Ms. Jacobs’s moods did not completely stabilize on
this regimen, she did well enough at a local university to be
accepted into a prestigious program far from home. At that
point the depression returned, and she became intensely
suicidal for the first time.
Upon evaluation, the patient was visibly depressed and tearful,
and had psychomotor slowing. She said it was very difficult to
get out of bed and she was not attending class most days. She
reported hopelessness, poor concentration, and guilt about
spending family money for school when she was not able to
perform. She stated that she thought about suicide most of the
time and that she had found nothing to distract her. She
denied recent drinking or smoking marijuana, stating she did to
feel like “partying.” She acknowledged profound feelings of
emptiness, and indicated that she had occasionally cut her ar ms
superficially to “see what it would feel like.” She stated that
she knew that cutting herself this way would not kill her. She
reported depersonalization and occasional panic attacks. She
denied having mood instability, derealization, problems with
impulsivity, concerns about her identity, and fears of
abandonment.”
*Oquendo, M.A. In Barnhill, J.W. (Ed.) 2014.
There are 2 assignments; all assignments will be submitted
through safe assign for plagiarism
Assignment 1: APA format

3. This assignment requires that you find 3 to 5 professional
sources that address more common/less common treatment
settings (ie: in patient etc.), and the contiuum of care for
psychiatric/mental health disorders. Generally speaking, care
ranges from the "least restrictive" to the "most restrictive."
Report your findings in a 3 page, double spaced paper.
Your paper should include very specific information you find
about many related aspects of these topics, ie: the history of
treatment/treatment settings, the cost, the duration of treatment
and so on.
Assignment 2:
Please see attachment for case study Olivia Jacobs; at least 1-2
pages not including title and reference page; APA format; cite
relevant sourcesCase Study Format
You want your case to be well organized and well written to be
sure that information you include is easily identified and
followed by your reader. The following can be used as section
headings to help you organize the paper:
· Brief overview of relevant symptoms from case
· Olivia Jacobs, 22 year old graduate student in architecture;
psychiatric history began at age 15;
· Suicidal thoughts of shooting self in the head
· History of mood symptoms
· Depressive symptoms returned
· Regularly smoked weed and drunk alcohol but stopped when
started graduate school
· Ate 17 begin experiencing brief, intensive depressive
episodes, marked by tearfulness, feelings of guilt, anhedonia,
hopelessness, low energy, and poor concentration
· Sleep more than 12 hours a day neglecting responsibilities at
school or home
· Depressive episodes shifted after a few weeks into periods of
increased energy, pressured speech, and unusual creativity;
stayed up most the night working on projects and building

4. architectural models
· Revved- up episodes lasted about 5 days and punctuate d by
feels that her friends had turned against her
· Paranoia
· Depressed, tearful, and psychomotor slowing
· Struggled to get out bed
· Reported hopelessness, poor concentration, and guilt about
spending family money for school
· Denial of recent drug and alcohol use
· Feel empty
· Occasional self harm by cutting her arms
· Depersonalization and panic attacks
· List Diagnosis 1: (ICD & DSM diagnoses)
· Bipolar II disorder, current episode depressed
· Diagnosis 1 Reasoning/Evidence
· Thoughts of suicide and self harm-suicidal thoughts of
shooting herself in the head and self harm herself by cutting her
arms
· Lack of focus- was unable to concentrate
· Excessively energetic-when her depressive episodes shifted
she would have increased energy, pressured speech, and unusual
creativity. She stayed up all night working on projects.
· Depressive episodes- were marked by her feeling tearfulness,
feelings of guilt, anhedonia, hopelessness, low energy, and poor
concentration. At times she was unable to get out the bed,
unable to keep up with school and home responsibilities, and
felt guilty about spending her family money for school.
· Paranoia- she felt that her friends were turning against her.