El Supremo's Psychiatric Evaluation

Now I have promised that I would attempt to do some long distance diagnosing of El Supremo. Based on his public behavior and anecdotal evidence I think he potentially has Bipolar disorder. Now we must remember that this diagnosis or any other psychiatric diagnosis is never done without a full medical evaluation. It is also impossible to make a psychiatric diagnosis without ruling out substance abuse. In the case of El Supremo we have to add the necessary personality disorders which are sometimes difficult to discern from some of the Bipolar disorder manifestations. As I define Bipolar disorder I will place + by signs that we know to be true or have suspicion that are true. Please feel free to add some which I could have missed. Since El supreme has a bunch a “yes sir” around him they are unlikely to point this out to him. Ultimately this is to his disadvantage. This is done for the benefit of El Supremo and his health. The definitions given can be found anywhere and the ultimate source for diagnostic criteria for psychiatric illnesses is the DSM-IV.

Now for some definitions and potential findings:

Bipolar disorder is an illness characterized by a period of sustained disruption of mood, associated with distortions of perception and somatic functioning, and impairment in social functioning. A distinct period of abnormally and persistently elevated, expansive, or irritable mood that last at least one week.

During the period of mood disturbance, at least three or more of the following symptoms are present: inflated self esteem(++) or grandiosity(+++); decreased need for sleep(++); more talkative than usual(+++); racing thoughts or flight of ideas(++); distractibility(++); increase in goal-directed activity(+); and excessive involvement in pleasurable activities that have a high potential for painful consequences(+++), such as spending money or sexual indiscretions.

Now there are at 2 types of Bipolar disorders. Type I is very disruptive to normal life, so he does not have this since he is functional. The last statement is true despite whatever anti-chavistas say. He is likely to have bipolar II disorder have a history of at least one episode of major depression and at least one hypomanic episode. The latter is characterized by a mood elevation that is abnormal for the individual but does not seriously impair functioning or require hospitalization.

Now we have to consider an array of other possible diagnosis that include but it is not restricted to:

A- Psychiatric and substance abuse: Schizophrenia, schizoaffective disorder, posttraumatic stress disorder, abuse of alcohol, cocaine, PCP, amphetamines, and personality disorders such as narcissistic, borderline and histrionic personalities may mimic bipolar disorder, and at times coexist with the illness.

B- Medical: thyrotoxicosis, partial complex seizures, systemic lupus erythematosus, cerebrovascular accident, human immunodeficiency virus, tertiary syphilis, or steroid-induced mood symptoms ( you may add this under substance abuse also)

Now the good news for El Supremo. We can test and treat most of the medical illness. If he is high on something, it is time to stop. We also have treatments for most psychiatric disorders. Since he probably has Bipolar I will say that we have an array of therapies to stabilize his mood. May advice is Lithium with psycho therapy. For any further advice please contact me at this blog.