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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Could Be Diagnosed From The Symptoms Of Sleeplessness And Weight Loss?

I have this friend his name is Larry Larry is a 23-year-old law student. He is in his second year of law school and typically receives excellent grades. Recently, however, Larry has been having some trouble. Although he feels tired, he has a difficult time getting to sleep. He lies awake for hours, or sometimes just sits and stares out the window. He feels exhausted all day long. Academically Larry has been having problems lately. He failed an important exam in contract law, and he says that he cannot seem to stay focused on the legal cases or other work for more than twenty minutes at a time. Even when he does manage to complete an assigned reading, he can hardly remember the details later. After a visit home, his parents expressed concern over his obvious weight loss and thin appearance. Larry did not call any of his friends or his brother while he was home. He spent most of the weekend in his room or watching TV. Larry’s girlfriend got angry with him for not wanting to spend any time with her. She is threatening to break up with him. Three months ago Larry was arrested at the recreation center at the University for creating a disturbance in the weight room. He was talking a mile a minute. His face was stubbly as he had not shaved in three days, nor had he slept. He had been walking around taunting people about their bodies and athletic abilities. A fight broke out when he tried to challenge another man to a “strength contest” while the other guy was using free weights. Larry said he could prove he was stronger and a better athlete. Two days later the other student decided to drop his charges against Larry following Larry’s apology. Larry said he had no idea why he had behaved that way, and he just wasn’t feeling like himself. What would you most likely from his symptoms diagnose him with?
Mon, 4 Jul 2016
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Psychiatrist 's  Response
Hi there, thanks for writing in. Welcome to the forum. A psychiatric disorder seems likely - most likely a primarily psychotic disorder or depression with psychotic symptoms. But we will need to rule out underlying medical conditions. A complete hemogram, RBS, RFT, LFT, electrolytes, TSH, ECG and Chest X ray should reveal any major systemic problems. If these are normal, one should go ahead and treat it along the lines of a psychiatric condition. Effective medications are available and he should get better. What is a matter of concern at present is his nutritional status. It appears that several days of self neglect has lapsed and may have taken a toll on his physical health even if the primary disorder was psychiatric in nature.
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What Could Be Diagnosed From The Symptoms Of Sleeplessness And Weight Loss?

Hi there, thanks for writing in. Welcome to the forum. A psychiatric disorder seems likely - most likely a primarily psychotic disorder or depression with psychotic symptoms. But we will need to rule out underlying medical conditions. A complete hemogram, RBS, RFT, LFT, electrolytes, TSH, ECG and Chest X ray should reveal any major systemic problems. If these are normal, one should go ahead and treat it along the lines of a psychiatric condition. Effective medications are available and he should get better. What is a matter of concern at present is his nutritional status. It appears that several days of self neglect has lapsed and may have taken a toll on his physical health even if the primary disorder was psychiatric in nature.