Answer

Major Depressive Disorder

            No, I would not change Alejandro’s diagnosis. Alejandro is possibly suffering from major depressive disorder. He meets criteria including depressed mood, loss of interest/apathy, and fatigue. He should be evaluated for other criteria such as sleep disturbances, appetite/weight changes, psychomotor agitation/retardation, guilt/worthlessness, executive dysfunction, and suicidal ideation since they have not been taken into consideration in the current diagnosis. He should present with either a depressed mood or loss of interest/apathy (or both) is required as well as four or more of other listed symptoms to diagnose Alejandro of a major depressive disorder (Culpepper, Muskin, & Stahl, 2015).  Another comorbid psychiatric diagnosis that the patient might be having is bipolar disorder I or II. The criteria that Alejandro meets for bipolar I disorder include major depressive episodes, mood disturbances, and the major depressive disorder is not attributable to the effects of a substance such as medication, other treatments, or drugs or other medical conditions. However, the unmet bipolar I disorder criteria include manic episodes, elevated mood and increased activity or energy. On the other hand, Alejandro meets certain criteria for bipolar II disorder including an episode of major depressive disorder, and absence of a manic episode. In addition, in this case, major depressive episodes and hypomanic episodes cannot be explained by schizophreniform disorder, schizoaffective disorder, delusional disorder, other psychotic disorder, unspecified or other specified schizophrenia. However, Alejandro does not meet one criterion for bipolar II disorder, which is unpredictability that is caused by recurrent alternation between periods of hypomania and depression (American Psychiatric Association, 2013).