Personality Disorder Assessment

The PMHNP is evaluating a patient who has presented for care repeatedly reporting that she is bipolar and has manic episodes. She has been medicated in the past with a number of mood stabilizers without any meaningful improvement. Today a more detailed history reports that what she is calling manic episodes are actually periods of dramatic responses to stressors. When she argues with her significant other, her mother, and even people at work she becomes very animated. In response to stressors she is very dramatic and defensive, will react in an erratic fashion, but then often within hours goes to extremes to try and explain her behavior and make amends. She clearly struggles with being alone.

Which of the following diagnoses should be explored for this patient?

A. Bipolar disorder with mixed episodes

B. Schizoaffective disorder

C. Adjustment disorder with anxiety features

D. Borderline personality disorder

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