GENERAL DATA Patient DE.JO., 26 years old, Female, Filipino, Born again christian, born on Nov 25, 1999, currently residing in Tungkil, deca homes, minglanilla, cebu city was seen for the first time in our institution on 15 july2026. SOURCE AND RELIABILITY Patient: 90% CHIEF COMPLAINT Patient: "I wanted to have a professional opinion about my mental health." HISTORY OF PRESENT ILLNESS 1 Years PTC, the patient was involved in a long-term romantic relationship that ended after she discovered her boyfriend had been unfaithful and was involved with another woman and washeart broken by it. Following the breakup, the friend of her ex-boyfriend's mistress repeatedly sent her threatening text messages, stating that they would "ruin her life" and "destroy her mental health." Despite the patient's attempts to avoid communication, the messages continued, causing her significant emotional distress. During this period, the patient began experiencing perceptual disturbances. She reported seeing a shadow-like figure, particularly when she was alone. She also stated that she would spend prolonged periods staring at herself in the mirror while talking to herself, sometimes lasting for several hours. Since April 2026, the patient reported recurrent self-harm behaviors. She described using a cable wire to strangle herself around the neck until she heard a "hissing" sound or until everything "went black." She admitted these episodes occurred repeatedly as a way of coping with overwhelming emotional distress. Three days PTC, the patient experienced another emotional breakdown characterized by uncontrollable crying related to her unresolved heartbreak. She cried continuously until she collapsed and briefly lost consciousness. She was subsequently brought to San Lucas Hospital, Minglanilla, where she was initially assessed for an anxiety attack. An ECG and further medical evaluation reportedly revealed no significant abnormalities, and she was discharged the following day. Despite discharge, the patient continued to experience persistent sadness, emotional instability, hallucinations, self-harm behaviors, and difficulty coping with the breakup. Hence, she sought psychiatric consultation at our institution. PAST PSYCHIATRIC HISTORY The patient has no prior psychiatric symptoms observed. Had no psychiatric consultations or hospitalizations. Patient had no history of suicidal or homicidal thoughts process in the past. SUBSTANCE USE HISTORY The patient denies any history of tobacco smoking, alcohol consumption, or illicit drug use. The patient also denies misuse of prescription medications, vaping, gambling, or gaming use. There is no history suggestive of substance use disorder or dependence. PAST MEDICAL HISTORY Patients denied previous Hospitalization or surgeries. The patient denied any chronic illness or taking maintenance medication. The patient has no hypertension, diabetes mellitus, bronchial asthma, thyroid or cancer issues. No known food and drug allergies noted. FAMILY HISTORY The patient currently lives with her parents. She reports having a good relationship with her family and resides in the same household with her parents, one older sister, and three nieces. Her mother is 56 years old and has a history of thyroid disease. Her father is 64 years old with no known chronic medical illnesses. She has one sister, aged 29 years. The patient denies any family history of psychiatric illness, suicide, or other heredo-familial psychiatric disorders. DEVELOPMENTAL AND SOCIAL HISTORY Prenatal, Natal, and Postnatal History: The patient was born to a 30-year-old G3P2 mother through normal spontaneous vaginal delivery without maternal or perinatal complications. She was breastfed during infancy. She could not recall whether her mother took prenatal vitamins during pregnancy. The patient's mother had one miscarriage prior to her birth. There was no reported maternal alcohol, tobacco, or illicit drug use during pregnancy, and no history of maternal medical or psychiatric illness during gestation. Early Childhood (0–3 years): The patient's primary caregivers were both of her parents. According to the patient, she was an extroverted, cheerful, and sociable child. She had no significant childhood illnesses or hospitalizations and completed her routine childhood immunizations. Middle Childhood (3–11 years): The patient started Grade 1 at six years of age and attended Padre Elementary School. She performed well academically and particularly enjoyed drawing. She actively participated in school-related extracurricular activities. She maintained a few close friendships and attended school regularly. She denied any history of bullying, absenteeism, or behavioral problems during this period. Later childhood to Adolescence (12 year or 18 year): The patient attended ACT High School, where she maintained good academic performance and received recognition for Best Research. She actively participated in basketball and other sports. She denied experiencing bullying, disciplinary problems, absenteeism, or romantic relationships during adolescence. She described this period as generally stable and enjoyable. Adulthood The patient pursued a college degree in Special Needs Education at the University of Cebu with the goal of becoming a teacher. Prior to the recent events surrounding the breakup of her long-term relationship, she described herself as emotionally stable and functioning well academically and socially. She reports that the relationship betrayal and subsequent harassment marked the onset of her significant emotional distress, hallucinations, and self-harming behaviors, which ultimately prompted her to seek psychiatric consultation. MENTAL STATUS EXAMINATION The patient is awake, alert, precise with his answers to questions throughout the interview. She is cooperative and speech is well modulated. She is fairly groomed and dressed appropriately for her age,she maintains good eye contact and she is anxious and her thoughts are goal directed and relevant. Px is aware of the environment and is oriented to 3 spheres with good calculation and memory intact. The patient has a good fund of knowledge with Insight level 5. PHYSICAL EXAMINATION BP: 110/70 mmHg RR: 18 cpm TEMP: 36.4 C HR: 76 bpm O2 sat: 99% at RA Ht: 148 cm Wt: 60 kg BMI: 27.4 kg/m2 PRIMARY IMPRESSION Bipolar 2 disorder, current episode depressed 2.) Borderline personality disorder DIFFERENTIAL DIAGNOSIS