Ms. Psaras: A Case Study

She had feelings of confusion, fear, guilt, anger, and fatigue. She also had a low energy level, which made her ability to think clearly and make decisions difficult. My mother had become disengaged; she was depressed and often isolated herself in her bedroom only coming out to use the bathroom. She had no appetite, did not want to see anyone and wanted to be left alone. Consequently, her eldest daughter took on the responsibility of caring for her youngest brother, which was very difficult for Dawn. Additionally, my mother could not return to work due to severe depression and subsequently went on disability.

Depression and anxiety. She is being followed by Dr. Lidstrom. She is really struggling of late since the passing of her father-in-law and dealing with her mother-in-law and the emotions surrounding this change in their life and I am pleased that she is going to counseling as I think that would be very useful for her. She will continue her follow up with them and continue with her current medications.

31 y/o AA male patient seen today for psychiatric-mental health assessment. He is awake, alert and oriented x4. He is calm, cooperative and follows commands during assessment. The patient reports he is depressed, difficulty sleeping and nightmares at night. The patient explained his depression is as a result of deep thinking from a news he received two days ago from his elder brother that his mother is ill. Stressors identified by the patient include losing his job a week ago before the news about his mother; his wife is 6-months pregnant with their first child, who currently works part-time at her present job; patient relates difficulty paying monthly bills and inability to provide adequately for his family as a man. The patient denies mood swings, suicidal/homicidal thoughts and ideation. Patient reports his spouse is at work at the moment and he does not want to put stress on his wife due to her current condition. Patient denies been hospitalized for depression or psychiatric illness; and denies family history of mental illness. Patient reports he is seeking help because he does not like feeling this way using terms of “helpless and loss of worth from his spouse”. Patient reports he needs help with his depression and nightmares before his current condition get out of hands and ruined his marriage.

Per grandmother, the client’s pregnancy, and delivery were normal. The grandmother recalls that Keisha’s developmental milestones were reached appropriately, including basic motor skills such as crawling, walking and fine motor skills such as writing. According to the client, she experienced an accident when she was nine years old. The accident affected her brain causing her to experience a coma for more than a month. It took her several months of rehabilitation to be able to return back to school. Keisha reports fatigue and/or loss of energy very often. Even after sleeping for more than twelve hours per day she feels tired every morning. She has been feeling this way for more than three years. Furthermore, the client reports that she has poor appetite, eating one or two meals per day. Due to her decrease in appetite the client reports that she lost about ten pounds since last year. Keisha mentions that her appetite has decreased since she started high school. Per client, her father abused drugs when he was younger, which included heroin and crack. She is unaware if father continues abusing drugs. Per client, her mother did not abuse any drugs while she was alive. The client reports no allergies, traumas or chronic diseases affecting her

Sharon is a 17 year old young women, her mother noticed that Sharon had lost a significant amount of weight, and she looked pale and had dark circles under her eyes. Sharon was complaining of severe diarrhea, stomach cramps, and after battling this for weeks she was extremely tired. Her doctor conducted a standard physical exam, and interviewed Sharon about her general health, diet, family history, and environment.

Her symptoms started small. She exercised, but slowly it came more extreme. She counted every calorie of every meal. Sally stopped eating her favorite food, like ice-cream and cake. Her family did not understand the seriousness of what was happening. Her menstrual cycle was thrown off, and did not come for some months. Her hair fell out, whether it was from stress or the disorder, it was unsure yet.

Pt mother describes the pt seems to be in a “trance state” when he is in an anger episode. Pt mother stated that the pt have punched holes in the walls. Pt mother stated pt became assaultive towards pregnant sister who has M.S. Pt mother stated she feels unsafe with the pt in home due to is impulsive anger outburst.

The patient moved from Troy, New York a few months ago after getting married. She is living in Barrington and working in Northwood. They moved because her husband's job. The patient would like to talk about depression. She tells me that she has had anxiety her whole life. She was never evaluated by a physician for this, as her parents reportedly did not believe in any medication. She says that she struggled with her anxiety throughout her teen years and went to counseling in college, but never saw a physician at that time. She is no longer in counseling. In addition to feeling anxious, she feels depressed. She says

Rationale: Jennifer has been presenting with symptoms for unspecified amount of time. Jennifer meets six of the criteria for symptoms being present during the same 2-week period and represents a change from previous functioning. Jennifer is depressed most of the day, nearly every day, has diminished interest in all or almost all activities most of the days, nearly every day, has fatigue or loss of energy nearly every day, feelings of worthlessness, and diminished ability to think or concentrate, is having recurrent thoughts of death, recurrent suicidal ideation without a specific plan. The symptoms have cause clinically significant distress or impairment in social, occupational, and other functioning areas. There is no know substance or medical condition and occurrence is not better explained by Schizophrenia Spectrum or Psychotic Disorders. Jennifer has never had a manic episode or a hypomanic episode. Possible family history of depression - mother.

She reported no exposure to mental health professional, she denies any family history of mental health or substance problems in biologically related family

Looking at the symptoms such as anxiety attacks, overeating, fear of accomplishment, fear of abandonment, and so forth—can be interpreted as outward manifestations of unconscious conflicts that have their origins in childhood experiences and defensive reaction to these experiences that are necessary to her as a child.

Anna’s main passion was child psychology, where she dedicated her time and energy to studying and analyzing children suffering from the impact of war. Many of these children were predisposed to enduring traumas, many were handicapped or blind. Her father had concentrated entirely on adults, which sorted through childhood recollections instead of present events. Anna desired to work with children suffering from present traumas to prevent psychological complications in adulthood. She observed children and their own environment and became an authoritative therapist to deal with the transference problem. She was reported as being a caring adult that was not a substitute parent or new playmate

4. What is the focus on her therapy sessions. Also, is she working on some coping skills with her therapist?

Dr. Fein reported that she is currently teaching and functioning. She indicated that her father had a history of depression after brain surgery. Her mother was severely depressed after her sister died. She indicated that she is aware that her father’s brother is diagnosed as bipolar. Dr. Fein reported that her brother is also diagnosed with

Psychosocial: Admits she is in good mood most times. Denies unusual stress, depression or anxiety. No suicidal ideation