Psychiatric Illness, Neurological Disorder, or Both?
The patient is a 44-year-old male, diagnosed with bipolar disorder, type II and generalized anxiety disorder. He has a long history of mood swings, depression, and anxiety. Since age 18, he attempted work at over 200 different jobs but couldn’t stay employed for more than a few months before his depression rendered him unable to continue. Treatment with medications and therapy has been sub optimal; with the patient never reaching any significant reduction in symptoms.
Due to antipsychotic medications for over twenty years, the patient develops tardive dyskinesia.
After treatment for a year in my clinic, his wife reports he has a family history of Huntington’s Disease. They decide to pursue genetic testing, and he is positive for the disease. He is seen by neurology, who confirms the HD diagnosis and the TD diagnosis.
This complex patient with longstanding psychiatric and neurological conditions received treatment for bipolar disorder, anxiety disorder, Huntington’s Disease, and tardive dyskinesia with four medications. He has remained stable for the last five years with only mild seasonal depressive symptoms and he has not yet displayed any chorea movements.
