Provide three differential diagnoses based on Janet’s subjective and objective data and discuss your reasoning for each.

Anxiety disorders can be characterized by excessive worry and fear that interfere with daily functioning, as well as physical symptoms such as sweating, trembling, and palpitations (DSM-5). Symptoms of a panic attack usually involve feelings of intense fear or terror that reach a peak within minutes. These feelings may be accompanied by physical symptoms such as shortness of breath and feeling dizzy or faint (Mayo Clinic). Based on the subjective data provided about Janet’s experience with anxiety throughout her life, it is likely that she could have an anxiety disorder such as generalized anxiety disorder or panic disorder.

Bipolar disorder is also a possible diagnosis due to its cyclic nature which includes periods of extreme mood swings between mania/hypomania and depression. The DSM-5 criteria for manic episodes include increased energy levels, reduced need for sleep, racing thoughts, distractibility, grandiosity in beliefs/behavior/speech patterns, lack of impulse control which can lead to reckless behavior (DSM-5). Moreover, the fact that Janet has stopped taking her antidepressants at a higher than prescribed dose is suggestive of this condition. This could be further evaluated through more appropriate tests like psychometric testing or interview questions from validated diagnostic scales like the Mini International Neuropsychiatric Interview (MINI).

In conclusion then these three conditions; anxiety disorders ,panic disorders ,and bipolar disorder should all be taken into consideration when trying to establish a diagnosis for Janet due to the relevant information available in both her subjective report and objective findings.