Attention deficit hyperactivity disorder (ADHD) is the primary diagnosis for this
case. This is a behavioral illness that makes it difficult to focus on daily activities and routines.
ADHD people frequently struggle with becoming organized, keeping focused, creating realistic
plans, and thinking before acting. They may be agitated, restless, and unable to adapt to new
circumstances. ADHD patients may be stubborn, socially awkward, or aggressive. Harold has
met the criteria of Inattention, hyperactivity, and impulsivity the major symptoms of ADHD. For
inattention: Harold has difficulty sustaining attention and has trouble listening to lectures or
conversations. He is easily distracted by things around him and has trouble completing tasks
(Pallanti & Salerno, 2020). He is also disorganized and forgetful, which impacts his ability to
function both at home and work. For Hyperactivity: Harold also displays signs of hyperactivity,
as he is often restless and has trouble sitting still. He also has a history of talking out of turn and
being disruptive in class. Impulsivity: Harold has trouble controlling his impulses, as evidenced
by his impulsive behavior at work (e.g. studying the Italian tile floor when he was supposed to be
designing gutters). He also has a history of making impulsive decisions, such as neglecting to
pay his bills on time, which has resulted in penalties. Harold's symptoms have also caused him
significant impairment in both his academic and professional life. He has a history of poor
academic performance and has been in trouble at work for his disruptive and impulsive behavior.
Anxiety disorders are also a possible differential case for this case. Anxiety disorders are
a group of disorders where the individual central organizing theme of emotional state is featured
with fear, worry, or excessive apprehension. The patient has met the criteria for anxiety disorders
because he has reported difficulty concentrating, making silly mistakes, feeling like he is not
pulling his weight, and having difficulty sitting and listening. He has also reported feeling messy
and disorganized and has difficulty paying bills on time. He also has a history of angina (ches
pain) a common symptom in severe anxiety disorders. The patient has not met the criteria for
anxiety disorders because they have not experienced anxiety or fear in response to a specific
trigger (Manoli et al., 2020). Additionally, the patient has not experienced any of the other
symptoms associated with anxiety disorders, such as difficulty breathing, sweating, or a racing
heart.
Major depression is also another differential in this case. Depression is a mood disorder
that causes a persistent feeling of sadness and loss of interest in once-enjoyed activities. The
DSM5 criteria of depression require one to present in about two weeks a minimum of five
symptoms are either a sad mood, a lack of interest or pleasure, difficulty in sleeping, appetite
difficulties, suicide ideation, and altered concentration (Karrouri et al., 2021). There are several
things that makes depression a differential in this case. Harold has difficulty concentrating,
making silly mistakes, and has lost interest in things he used to enjoy. He also feels like he is not
pulling his weight at work and is anxious about his performance. However, the patient has not
met all of the DSM-5 criteria for depression. For example, he has not lost weight or appetite,
does not have insomnia or hypersomnia, does not have fatigue, and does not have feelings of
worthlessness or excessive guilt
Harold's diet and sleep habits are contributing to his problems with concentration, and
whether he is getting enough exercise to help him relieve stress. From a legal and ethical
perspective, it is important to make sure that Harold understands the confidentiality of our
conversations and the limits to that confidentiality. I would also want to make sure that he
understands his right to refuse treatment and to stop treatment at any time. I would also want to
make sure that Harold understands the risks and benefits of any treatment recommendations I
make. From a health promotion and disease prevention perspective, it is important to encourage
Harold to eat a healthy diet and to get regular exercise. I would also want to encourage him to
quit smoking, and to limit his alcohol intake to no more than one drink per day.
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