Bipolar due to health problem is the second diagnosis considered for Fernando's case. Bipolar due to health problem is considered due to Fernando's work activity, his apparent need for reduced sleep, as well as his excessive involvement in activities that have a high potential for painful consequences such as his diet , his alcohol consumption and cigarette consumption which lasted well over a week. These considerations meet criteria A and B. However, criterion C does not correspond because Fernando did not have disruptions in his social or professional functioning or hospitalizations due to these behaviors. Due to the lack of adjustment criteria, bipolar due to a health problem is currently excluded (American Psychiatric Association, 2013). A third consideration is a mental disorder due to a health problem. This diagnosis is used when there is evidence of impairment due to another medical condition. It appears that Fernando's behaviors began after he was diagnosed with type I diabetes. However, little information is known about Fernando's behavior before the diagnosis. His current behaviors are maladaptive and negatively impact his physical health, but the direction of this relationship is unclear. In other words, does his state of health have an impact on his mental health or does his mental health have an impact on his state of health and is it the cause of his behavior. Due to uncertainty, a mental disorder due to a health problem is currently excluded (American Psychiatric Association, 2013). An adjustment disorder is considered because an immediate decline in recommendations and poor health behavior began directly after the onset of a known stressor. and had a significant impact on Fernando's life... middle of paper ...... if his treatment goals were met, discontinuation could be considered. Although this treatment may take some time, it is unlikely that Fernando will need services for more than several months. Certain additions to the treatment would be recommended. The first is a complete check-up with a doctor since Fernando has not been seen for over a year and a half. This initial assessment would identify whether medications need to be added to Fernando's regimen as well as whether he is healthy enough to engage in later goals such as exercise. A second recommendation would be for Fernando to begin working with a registered dietitian who is trained and experienced in developing meal plans for people with diabetes. These two additional services could take place alongside the mental health services Fernando would receive without interrupting treatment..