Steven is a 33 year old married male who was referred to you by a past client of yours. He enters into therapy looking sad and slightly disheveled. He makes little eye contact and is somewhat slow moving. When discussing his life, Steven reports feeling hopeless and uninterested in most things. He struggles to identify activities he finds fun and reports that his recent fatigue and lack of motivation has resulted in his gaining 20 pounds over the last month. Although he is not currently wanting to commit suicide, he does report wishing he had never been born or that he’d never wake up.

You talk with him further and hear that these feelings are even more upsetting to Steven because he is used to having lots of energy. He reports often having 3 to 4 projects going at one time, sleeping very little, and has found it difficult in the past to sit still for any length of time. “My mind gets going so fast that I just have to go and try the many things that pop into my head. I almost lost my house during the last business venture breeding ferrets.” Steven also reports that his friends have found it difficult to communicate with him during this time because, “he talks way too fast and gets off topic easily.” He also reports “crashing” into a more deflated mood after being “so up for so long.” When he is “up” he sleeps only 2 hours a night, and frequently believes he is “superhuman.”

What is Steven’s Diagnosis?

What symptoms support your diagnosis?