Dis-engagements make them withdrawn from their social environment. This withdrawal may be by choice or forced. If it is forced individual feels hopeless about future may develop depressive pathology.
Health-Perception & Health Management: 66 years old retired male contacted to the psychiatrist as an outpatient. Since last six months he was feeling unwell. His chief complaints were- feeling of sadness most of the time, palpitation, loss of appetite, unable to enjoy pleasurable activities, lack of sleep, depressed mood persist about half of the time, decreased will to share/ interact with almost every time.
Before consultation to psychiatric OPD (Out patient Door) the client has contacted physician and other specialists' viz., cardiologists, neurologists etc. He also has gone through different medical examination but except arthritis he has not having any organic dysfunction. When he became fade up with medications, he asked to his consultant doctor about his illness, the doctor advised/ suggested him to contact a psychiatrist and psychologist both for the betterment of his mental health. He admitted that his problem is more mental than physical, but due to social stigma initially he avoided to contact a mental health professional.
The client was puzzled about his illness as his problem was affecting his daily routine activities badly. He as well as the informant (his wife) was complaining that he is slowed up in his daily activities, can't be able to concentrate in most of his activities. He was feeling that life is not worth living. He was taking an antidepressant, but was unable to manage and follow the routine activities to maintain his health. No current history of alcohol use but use to enjoy beetle nut with tobacco.
Nutritional Metabolic Pattern: As described earlier that due to loss of appetite, his diet was poor. He used to take less diet, as he doesn't have the feeling of hunger. Since last six months gradually his diet deteriorated and very often he skip his meal.
Elimination Pattern: Initially he didn't complain any of the bowel/ bladder change. But in the second session he came with complain that he feels frequent urination as compare his early age. Due to this frequent urination he has to get up many times in night that obviously disturbs his sleep and make him worried about his health status. Till now he was not having any history of use of any devices/ aid for bladder pattern.
Activity / Exercise Pattern: As the patient was already complaining that he is overwhelmed with his routine activities, he was not able to correspond actively with his day-to-day activities. His wife said that even for brushing/ bathing she has to take some strict actions Otherwise he use to laid down on the bed saying "I'll do' Please leave me alone." Sometimes forcefully he use to do his exercises like: walking and deep breathing but not regularly.
Sleep/ Rest Pattern: His sleep pattern is also disturbed in comparison to normal days. Presently the patient actual need for sleep is decreased, and having disturbed sleep. When he was at work (before retirement) he was having a sound sleep. Although most of the time he feels to be on bed but complaining that he cannot sleep properly. His sleep is not refreshing enough. For his sleep initially he tried some relaxation exercise