Making a Psychiatric Diagnosis - Assignment Example

Making a Psychiatric Diagnosis Affiliation Making a diagnosis Psychiatric conditions are conditions that affect the brain functioning. These conditions arise from occurrences in a person’s life that have long-time effects. The effects sometimes take long to become a healthy problem but most eventually develop to a clinical case. Psychiatric conditions are manifested by disturbances in various spheres of life including behavioral issues, thought process and thought content problems and even the relationship with others. A combination of symptoms is necessary for making a correct diagnosis. Moreover, any diagnosis must take into account the health and social history of the client and relate their experiences to the current situation. This is because most of the psychiatric conditions result from past experiences that have been suppressed and only come to surface and cause problems later in life (Krystal & State, 2014). The case studies evaluated below represent the findings from nine patients with psychological problems. Their diagnoses are reached at through evaluation of their cases. Jenny From the first case of Jenny, the clinical and social history and manifestation leads to a diagnosis of depressive mood disorder. Depression is a mental condition that is marked by changes in the general mood, thought and behavior. It is common among people of all ages, races and social classes. However, the most common age bracket is 24 to 44. This is the age bracket that has the young adults in their productive age and at a time when there are life responsibilities and coping with demands of life. Depression is different from normal expression of a bad mood in that it lasts longer, usually for more than two weeks and significantly interferes with the normal functioning and activities of life (Yager, 2006). The following symptoms of depression are present in this case. First, Jenny is anhedonic. She does not find pleasure in the activities that previously interested her. Secondly, she can no longer concentrate at work and is sometimes losing focus in her activities. Thirdly, Jenny has insomnia that has lasted for several weeks and was interfering with her life and work. She lacks motivation in life and is always fatigued. Lastly, she reports a significantly reduced appetite that has been there for long enough to result to weight loss. These are among the many symptoms of depression, and they, therefore, lead to the diagnosis. To probably dig deeper into the case and ascertain the diagnosis, it would be necessary to enquire whether the feeling of displeasure has anytime resulted to the client feeling worthless or wanting to harm himself or herself in any way. It would also be necessary to ask about the relationship with other people the siblings, at work or in the neighborhood. Does the client feel easily irritated, angered or indifference. It would also be necessary to consider relating the current health status with experiences and familial background. Fred The second case describes a client Fred. From the description given, Fred is suffering from post-traumatic stress disorder. This disorder is one of the anxiety disorders that affect people. It occurs as a sudden occurrence of intense fear and panic when the body experiences a sudden rush of physical and psychological symptoms. Fear, apprehension and anxiety are the main psychological symptoms. The physical symptoms include nausea, palpitations, trembling and sweating. The condition occurs because of being overwhelmingly distressed by a frightening event that occurred in the past. In Fred’s case, this disorder occurs after he is attacked and robbed in the subway while from work. After this incidence, although he feels it did not affect him much, he has had several episodes of panic attack and loss of control. Post-traumatic stress disorder is closely related to incidences in life that have had a psychological impact to cause a mental problem, and in most cases the current trigger is not the main problem. For Fred, he must have felt that the incidence was not enough to cause panic. However, the social life that exist in his case may have resulted to mental distress that only required a slight trigger to manifest (Law, Wong, & Yip, 2010). His complicated personality and relationship with family could be the main problem in Fred’s life. However, in as much as this remains the case, the current diagnosis is post-traumatic stress disorder. Having a psychotherapy session to explore Fred’s feelings about his life, and how it is affecting his relationship with his family, especially the mother and younger brother would assist in exploring the problem deeper and providing better care. Sally Sally’s case is more complicated that the above two. Her problem involves obsession with the thought that her writing work is what will make her rich and famous. The diagnosis in Sally’s case is mild delusional disorders. Sally is delusional that her book will make her famous once published. Although this thought and her obsession for it does not significantly interfere with her functioning at work and her socialization, when it comes to writing, which is her subject of delusion she demonstrate bizarre behavior which include breaking of items in the room and reportedly failure to sleep which are disrupting her life. She is however in denial and believes that she does not have a problem. Her delusional status has even made her blame the parents for selling the farm, she feels that the farm could have been a perfect place to write her book. She is irritated by any person or event that seems to affect her success in writing. To support this diagnosis, more information needs to be gathered concerning her relationship with people in the workplace and how she perceives the job in general. It is also important to look for the source of the delusion and obsession and if it is related to any experience. John The fourth case represents the story of John, a pharmacist who has had episodes of suicidal attempts and ideations. Despite these attempts, he is embarrassed and feels that he should not have done it. He has a complicated relationship with the parents and regards them with negativity. He is suffering from borderline personality disorder. This is a cluster B personality disorder. John struggles to regulate feelings and has common swings of positive and negative views of those close to him. He sometimes thinks that Megan is his soul mate and even attempts suicide when Megan tries to date other men. However, after counselling, he now consider her a wrong choice and only meant to hurt him. These swings lead to the unpredictable events in his life and the suicidal attempts that are a manifestation of borderline personality disorder. Borderline personality disorder presents with emotional instability those results to impulses of unexplained and unpredictable impulses of self-harm and unstable interpersonal relationship. It results from a combination of both genetic and environmental factors that determines psychological strength and interpersonal relationships. More information is required to explore the cause of the emotional instability affecting John. A possible focus could be the relational problems with his father and mother whom he consider with negativity. The history of suicidal ideations and attempts in the family should also be explored. Sam Sam’s condition is distressing. He appears to be relatively unsociable but believes he has no problem. His behaviors however display a different story. He acts out based on thoughts that another person is out to harm him. Sam’s diagnosis is paranoid personality disorder. This disorder is characterized by long-standing patterns of interpersonal distrust and feelings that other people mean harm. This suspiciousness of others often leads to acting out to relate or unrelated incidences. Sam interprets the presence of a dead dog as a sign from his neighbor and acts out. People with paranoid personality disorder often have feelings that other people will exploit or harm them (Yager, 2006). As is Sam’s case, they have episodes of hallucinations and paranoia. They take these feelings to extremes, making up stories that appear to give evidence to the existence of danger from others. They, therefore, have problems establishing and maintaining relationships. Sam’s condition is however complicating to manifest as a psychotic problem where his paranoid state is affecting his close relations and normal functioning such as concern about personal hygiene and isolation. Most of the personality disorders are manifested when there is an underlying mental health issue. In this case, there is a need to explore deeper in the familial history of Sam and the reasons behind his paranoia. He could have had a troubled or abused past that makes him paranoid and unable to trust anybody. The reasons behind his living with the uncle should also be considered as having something to do with his complicated personality. Ben The sixth case is that of Ben, a 21 years old male who is in distress. Bens distress results from the terrible news that have indicated that he will be charged in a court of law following his past incidences of burglary and breaking of law which are a violation of his probation on a domestic violence charge. He definitely is in trouble because he is now an adult and can handle a jail term, which in this case looks inevitable. He reports being distressed and having visual hallucinations. He otherwise looks normal. There is no clinical diagnosis in this case. Ben is distressed because of what might happen to him, his level of distress is a normal psychological manifestation. His reporting of being “crazy” and having visual hallucinations are an attempt to propose that he is having a mental problem. Further, his mother reports that he had vowed to do all he could to make sure he does not go to jail. Based on this information, it is clear that Ben wants to appear to have a mental problem, which will be supported by his distress and the objective signs of visual hallucinations. He hopes that the therapist will be convinced and admit him as he proposes. This will keep him out of jail. A mental status assessment should be done to ascertain this and anxiolytics given to relieve distress. Admitting Ben is an uncalled for approach. Alex Alex is in his teenage years. His behavior involves lack of attention in the classroom and at home and reduced control of his behavior leading to over activity. This over activity causes him to get angry easily and overreact even more. His manifestations are confirmatory of attention-deficit hyperactivity disorder. It is a common disorder starting in late childhood and extending to the adolescent stage. As manifested by Alex, people with this disorder have difficulties in establishing and maintaining attention to duties and activities. They cannot remain focused on issues and activities and are always late to perform duties of fail to perform them altogether. They also have trouble controlling their own behavior and often get irritated and over-react. This affects their relationship with others and performance in school. Further exploration into the condition should be done to ascertain the diagnosis and come up with the possible cause of the condition. The familial history of irritability and over-reaction should be enquired. Other related factors such as a difficult childhood, smoking and drug abuse should also be explored. Other environmental factors such as a possible recent head injury should be enquired. This is because the condition may result from brain injuries related to drug abuse or physical injury that sometimes goes unreported in adolescents. Maggie Maggie is an elderly woman aged 75 years. Besides her problems with age, she has recently shown signs of mental illness. These manifestations are related to old age, and she seems depressed. In as much as mental deterioration occurs more often in old age, Maggie’s sudden changes are related to a diagnosis of dementia. This is a degenerative mental condition associated with old age. However, the manifestations of dementia are more serious than normal aging mental health issues. As manifested by Maggie, the condition leads to hallucinations, loss of control of self. Further, the patient has problems performing activities that were previously not a problem and had trouble concentrating. Dementia affects the normal functions of a person through interference with the thought process memory and reasoning. This, together with the visual, auditory and tactile hallucination affects the life of a person. Sometimes, early onset of the condition is associated with childhood or earlier life experiences that come to resurface later in life. The meeting between Maggie and her siblings at her mother’s funeral may have caused resurfacing of these experiences leading to the sudden onset. Maggie’s condition may have been triggered by the recent losses of her mother and her husband and a change of environment. However, to support this diagnosis more information regarding the client’s mental health and relationship history should be sought. These will be important in explaining the sudden onset of the problem and its relationship with the siblings’ visits and the re-union. Phil Phil’s ‘stressed’ condition results from the difficulty to hold a job or to keep a family. These difficulties are related to his personality and behavior. Phil appears to be obsessed with neatness and cleanliness. He suffers from a personality disorder called obsessive-compulsive disorder. The manifestation of this disorder is evident in his life. First, in his first job he felt that working in a restaurant is messy. He would spend hours trying to wash out the smell of food from his body and be never satisfied that he was successful. His obsession with cleanliness also caused the break-up of his one-year old marriage. He could exercise undue control of the cleanliness even in the kitchen and do not seem to appreciate what his wife was doing. He had to do it himself. In his just terminated employment at the clothes shop, he was obsessed with neatness of the display. He did this perfectly that he gained an appreciation from the manager who promoted him. However, he could not perform well in his new responsibilities and was obsessed with folding of the clothes more than the supervisory duties. He was terminated as a result. These manifestations represent an activity that Phil is obsessed with, cleaning and neatness. He happens to put so much focus on cleanliness that he has ritualized it. He does not appear to have enough of it. Further information related to the onset time of the behaviors and his childhood behaviors should be enquired to support the diagnosis. Similarly, the self-treatment of the condition and the activities that Phil does to avoid the behavior should be addressed. However, in this case, the client does not seem to recognize what could be his problem. Therefore, an explanation is necessary as part of therapy. The above cases represent instances where manifestations of mental illnesses are sometimes difficult to identify and come up with a diagnosis. The diagnoses given in each is based on the manifestations at the instant. The review of these symptoms directs the making of a diagnosis. It is also important to note that some conditions share manifestations and therefore there is a risk of misdiagnosis. Further, the history of the patient, both health and social history can be used to support a diagnosis (Krystal & State, 2014). For instance, some clients may impose a symptom that lead to a certain diagnosis having a different motive. If the therapist is not careful, misdiagnosis is unavoidable and hence, mistreatment may result. References Krystal, J. H., & State, M. W. (2014). Psychiatric disorders: Diagnosis to therapy. Cell. Law, Y., Wong, P. W. C., & Yip, P. S. F. (2010). Suicide with psychiatric diagnosis and without utilization of psychiatric service. BMC Public Health, 10, 431. Yager, J. (2006). Values and Psychiatric Diagnosis. The Journal of Clinical Psychiatry. doi:10.4088/JCP.v67n0722a Read More