Introduction To The Client Interview : Helen Stonewall

Patient lives with her husband of 10 years and 3 children in Denver, Colorado. Patient denies any spousal abuse. She also denies smoking, alcohol, or drug use during her pregnancy. Patient completed middle school, and currently works as a house wife. Patient is of low economic status.

Helen was previously at a bar. Which means that at most bars dancing and drinking is tolerated. So she was at the correct place to engage in those activity’s. It wasn’t until she stood on the table and started talking loudly before she was escorted out of the bar. She then commuted to the street from the bar to continue dancing, but she did this in the middle of the street. Helen was in the correct atmosphere to engage in the activities she did at first, she just had a hard time knowing when enough was enough. Similar to being over confident, which was a contributing factor to her arrest. The gentlemen that she was with could have played a role in the environment factor because they could have encouraged her to behave in a disruptive matter.

82)This emphasizes the book’s point of saying that some criteria are “abnormally increased activity or energy,” and “flight of ideas or subjective impression that thoughts are racing,” (Kring et al. 2016, p. 140). She mentions that during these episodes that her friends would tell her to slow down (Jamison 1995, p. 37). This can also be considered as the symptom characterized by unusual talkativeness and rapid speech (Kring et al. 2016, p. 140). According to the textbook, a decreased need for sleep also characterizes mania, which Jamison often refers to, saying that “Decreased sleep is both a symptom of mania and a cause,” (Jamison 1995, p. 69). During her manic episodes, Jamison also had a tendency to dress provocatively and overspend money, which the DSM-5 characterizes as “excessive involvement in activities that are likely to have painful consequences, such as reckless spending, sexual indiscretions, or unwise business investments,” (Kring et al. 2016, p. 140). She also mentions that during one of her manias, she bought snakebite kits because “God had chose me, and apparently only me, to alert the world to the wild proliferation of killer snakes in the Promised Land,” (Jamison 1995, p. 76), which can be classified as the DSM-5 criteria “increased self-esteem; belief that one has special talents, powers, or abilities,” (Kring et al. 2016, p. 140). As for her depressive

Felicia, a 41-year-old wife and mother, shows signs of Major Depressive Disorder with severe anxious distress, mood-congruent, and catatonia features. Most of the time, Felicia is overpowered by emptiness, sadness and despair. These feelings caused a change in her previous functioning resulting in emotional, physical and social complications. As depression progresses, the individual becomes more socially withdrawn. She reveals that she spends countless hours alone, avoids her children and occasionally sees her friend. The guilt of not saving her mother, troubles Felicia, causing her to battle with insomnia. Not only does she struggles with falling asleep, Felicia has a difficult time staying asleep. She reports that dealing with the guilt of her mother’s death has her on the bathroom floor, shivering to avoid disturbing her husband. Felicia is observed picking at sores on her arms, which is another symptom of MDD. This motion is known as psychomotor agitation and is also a sign of anxiety. Felicia’s thoughts and actions are slow, a result of psychomotor retardation. She struggles handling certain responsibilities. Her husband hired a housekeeper because Felicia can no longer take care of her family on a regular basis. She states that

The subject is then sent to our Clinic Physician to make certain that no other physical reasons may exist for her symptoms. A full physical exam along with a blood test or (CBC) will be required to rule out any thyroid problem or history of substance abuse. The subject is asked to come back the following week for the findings of the treatment team. The results of the test are gathered and taken to the treatment team for evaluation. A Multiaxial Evaluation is used which classifies the criteria from the DSM-IV. The first is Axis I which includes clinical disorders, most V-codes and conditions that need clinical attention. In this case the subjects

Helen has reported that she has mood swing and that she has suicidal ideation as well having feeling uncontrollable over her own body. She denies and audio or visual hallucinations. Helen is showing signs of bipolar disorder DSM 296.62.

Lori Schiller met all of the criterion for a Schizoaffective Disorder, bipolar type, with multiple acute episodes. Her symptoms either appeared during the same two week time period or lasted for longer than two weeks (American Psychiatric Association, 2013, p. 105.), (Schiller and Bennett).

Patient reports that five months ago she got angry with her children and stayed in bed for two days. She was feeling suicidal, mad at herself and mad at her children for not caring enough to come and get her. Patient stated that she was unsure how to leave the bedroom. This incident began this depression episode.

There is also a diagnostic possibility of Double Depression. It is essentially a major depressive episode superimposed on Dysthymia. This psychological condition would require that Ms. NS had a low-grade chronic depression and her current major depressive episode overlap each other. However, as stated earlier, the duration of her

Rachel has gone through a very traumatic and stressful year which seems to have caused her to experience depression. Symptoms such as loss of appetite, fatigue, and hypersomnia are being seen within her as well one of the major indicators looked for when diagnosing depression, loss of interest or pleasure in activities or other areas of life. (chapter 7, pg 146)

A 24 year old Native American male presented with periods of high mania followed by periods of low depression has come to us for help. The patient experienced mood swings that sometimes were comingled with elation and major depression at the same times. Major depression according to ( ) can be defined as having a very low mood for a period of at least two weeks or more for an individual.His sadness would last for periods of a several weeks or more that could not be explained with long bouts of staying in bed unable to get up except for absolute necessities. These periods of sadness were extremely intense and were constant throughout the week’s long periods. During this period sleeping and eating was excessive and all activities including house cleaning, personal hygiene, and job were neglected. After this period of depression the client reported a follow up period of high energy or mania where he reported that he felt more like himself including bursts of high energy and restlessness that could not be contained. Mania can be defined as periods of high excitement and euphoria that can be accompanied with delusions.

The major criteria are consistently elevated or irritated mood for the majority of 4 days, and, as in manic episodes, the individuals may experience a wide range of symptoms related to increased energy, self-confidence, impulsivity, and risk-taking. Besides a slightly shorter duration of symptoms, the main differentiating factor between hypomania and mania is the degree of impairment. In both states, the level of functioning must be uncharacteristic, and evident to others, but social and work functioning is not markedly impaired in a hypomanic episode. The presence of psychotic symptoms automatically excludes the definition of hypomania, as does an attributable medication or

Over the course of last six months, I have seen Ms. Grierson on a weekly basis, more often than any of my other patients. The task of relating to her abnormal behavior and damaged psyche proved to be difficult and at times unbearable. I’ve come across a multitude of patients throughout my diverse career. Frankly, I cannot for the life of me enter into her mind as I do with my other patients. Taking all of my therapeutic views and knowledge aside, she would certain be seen as a bizarre person. The reason that her counseling proved so difficult was due to how late Ms. Grierson had decided to seek help. Nevertheless, I have done a diagnosis and specified certain medications which will furthermore assist to her recovery along with the therapy sessions. Here is the information that I have gathered in the wake of Emily Grierson’s evaluation:

In beginning of a her career she is a licensed physical therapist in ROHC and provided physical therapy treatment and her goal is to prevent work related musculoskeletal injuries. She is experienced over 15 years in treating orthopedic injuries caused by occupation. As a Pilates instructor she used to train rehabilitation professionals. She is expert in using neck and back stabilizing techniques on patients and ergonomic clients. She is now Director of Physical Therapy department at Nova Pain and Rehabilitation. Her quest in field of ergonomics made her to establish an ergonomic evaluating office Ergo-RX and provides custom furnishings to the clients. As an ergonomist and physical therapist, Jeannie incorporates her physical therapy treatment and prevention of injuries to the clients and patients she is serving

In the description of the client, she does not state that she does not abuse alcohol or substances, Although, by confronting Kesha about this question, you can unfold some past history Kesha never acknowledged