Trichotillomania Onset Pregnancy

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

The patient, a thirty-three year old female singer, is having difficulty sleeping, simple activities like getting groceries tire the patient easy, complains of neck pain, and cannot concentrate. The patient experiences worry and anxiety. However, when asked about what specifically, many things were brought up but none were more important than the other.

On 7/30/2015, client walk in the social service office and CM completed Bi-Weekly ILP Review. In the meeting client appears she appeared her stated age and in good physical health. She was satisfactorily groomed & dressed. She constantly throb her forehead, she most of time space out and her affect is flat.

Obsessive-Compulsive disorder is a type of severe anxiety disorder that impacts an individual’s entire life and way of functioning. Obsessions are considered intrusive and recurrent thoughts or impulses that cannot be removed through reasoning. Compulsions are the repetitive and ritualistic behaviors and actions that associate with the obsessions. These compulsions are to be performed according to specific rules or methods and are thought to prevent or reduce stress and feared situations. Both compulsions and obsessions cause disabling levels of anxiety. The individual affected is often able to recognize the behavior as excessive and irrational, but is unable to control or stop the behaviors without intervention.

The following is an overview about Obsessive-Compulsive Disorder (OCD), one of the most difficult psychiatric illness to be understood. The way of doing certain behaviors, thoughts or routines repeatedly is the essential condition of a person with OCD. In general, it is known and described by someone who is extremely perfectionist and meticulous. Unfortunately, they do realize those habits and be able to stop doing it. Common behaviors are such as checking locks, doors, stove bottoms, and lights, hand washing, counting things, or having recurrent intrusive thoughts of hurting oneself or somebody else.

1. Client demonstrates excessive and sometimes unrealistic worry that has been occurring more days than not for past seven months. Client has been affected by physical issues due to anxiety; such as, nausea, diarrhea, lack of sleep and trouble falling asleep, excessive crying, discourse at home, and hypervigilance.

Nervous habits also identified as body focused repetitive behaviors (BFRBs) are behaviors that occur repeatedly across situations and consist of undesired repetitive, manipulative, problematic and or destructive behaviors directed toward the body such as hand-to-head (e.g., hair pulling, hair twirling), hand-to-mouth (e.g., nail biting, thumb sucking), hand-to-body (e.g., skin picking, skin scratching), and oral behaviors (e.g., teeth grinding, mouth biting) and are often seen to play a role in emotion regulation and can arise during periods of heightened tension (Miltenberger,2005 ; Roberts, O’Connor, Bélanger, 2013; Woods & Miltenberger, 1995). The Diagnostic and Statistical Manual of Mental Disorders, fifth edition, does

She seems to have good insight into her behaviors and recognizes that they are irrational, as she describes them as “stupid and not making sense”, but reports that she feels the need to continue to participate in the behaviors. She reports feeling fearful that something bad would happen to her family if she did not participate in the behaviors or ritual, particularly that her grandmother may become sick. She reports being preoccupied with germs, which leads her to spend hours, over six hours of her day in ritualistic behaviors including shaking out her clothing for a half an hour and washing her hands with rubbing alcohol. As a result, her hands have become bloody and painful, as well as her personal hygiene has become neglected, as she is not brushing her hair or eating breakfast. She has missed out on fun things as a result of being unable to leave the house in a timely manner as a result of her obsessions and compulsive behaviors. She also reports a preoccupation with numbers and words and in her mind needs to add these numbers together. She seems to have good insight, as previously stated, as she is said to be “sensible”, recognizes that her behaviors are not normal, and is able to make the connection of her childhood surroundings with her current obsessions and

Client is a 35 year old African American female with an 12th grade education level who presented with signs and symptoms of forgetfulness, depression, severe anxiety, stress, uncontrollable mood swings and difficulty making decisions. During the assessment, the client struggled with bouts of crying triggered by memories of her past. The client was recently hospitalized at VCU Hospital for signs and symptoms related to a panic attack. The client has been given the diagnosis of Major Depressive and Anxiety. The client has been prescribed Prozac. Currently the client does not have a PCP or psychiatrist.

The anxiety (nervousness) of this disorder causes the individual to feel the urgent need to perform certain routines or rituals (compulsion) (Chakraburtty, 2009). For example, a person who has an unreasonable germ fear constantly washes their hands (Chakraburtty, 2009). The rituals are performed in an attempt to prevent or make the obsessive thoughts go away (Chakraburtty, 2009). The rituals that are performed are temporarily the person will perform the rituals again once his or her obsessive thoughts return (Chakraburtty, 2009).

Psychiatric- patient is a little anxious about these new symptoms and their significance. We discussed her situation and I offered her psychologic services, she refused for now.

Trichotillomania, also known as trichotillosis or hair pulling disorder, is defined as an impulse control disorder characterized by the compulsive urge for people to pull out their own hair (Weiss, 2015). Trichotillomania occurs in two forms, conscious and unconscious hair pulling. According to information gathered from the most recent and accurate study for statistics of Trichotillomania, which was performed by group of TrichStop staff in 2013, two and a half million people who live in the United States of America have been affected by trichotillomania at some point in their life (TrichStop, 2013). The hair pulling disorder has many causes as well as several effects that occur to a person during and after the hair pulling disorder is active.

"OCD patients have a pattern of distressing and senseless thoughts or ideas- obsessions- that repeatedly well up in their minds. To quell the distressing thoughts, specific patterns of odd behaviors- compulsions- develop." (Gee & Telew, 1999)

Obsessive compulsive disorder (OCD) is a disorder that causes someone to have unwanted and troubling thoughts and repetitive behaviors (Lack, 2012). People may self-diagnose themselves to be obsessive compulsive. But people with obsessive compulsive disorder need to spend at least 1 hour daily on obsessive thoughts and rituals (Ellyson, 2014). This disorder is broken into two parts. The first part is obsessions, thoughts or images, and the second part is compulsions, the repetitive behaviors caused by the obsessions (Brakoulias, 2015). An example of obsessive compulsive disorder would be someone checking the locked door multiple times to reduce anxiety about forgetting to lock the door. On average 5% of the population has subclinical symptoms which are considered to be symptoms that are not disruptive enough to meet criteria to be diagnosed obsessive compulsive (Lack, 2012). Dropping what you’re doing to go back and check if your curling iron is unplugged is an example of a subclinical symptom. This paper will discuss what obsessive compulsive disorder is and provide a brief history. It will also include current treatments, suggestions on how to treat the disorder, and a summary.

Hannah, a 25 year old Caucasian female, presented as alert, tense, and oriented 3x. Hannah is well groomed and appropriately dressed. Her affect was blunted flat. While client was cooperative, she presented as guarded, which may be due to her anxiety. She was calm, but displays signs of anxiety by posture, shuffling hands, lip biting, and eye movement.