Unit 2 Assignment 1 – Molly Case Study
1. Case Summary
Molly is a 29-year-old woman unemployed, living with her parents. She presents to the therapist looking sad, stark and exhausted with lethargic movements. She expresses concerns with feeling down for 2 ½ years after a job loss from an exciting IT career. She is unmarried and currently using marijuana regularly and moderate amounts of alcohol to cope with her sadness. She can no longer find pleasure in things, her mood can be described as depressed, and she has poor sleep hygiene, difficulties with concentration, no appetite, and no interest in sex. She also has concerns about feeling irritable and nervous. She has recently unintentionally lost 15lbs. While talking with the therapist she frequently is tearful. This is her first experience with a
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Moderate
305.00 (F10.10) Alcohol use Disorder mild
305.20(F12.10) Cannabis Use Disorder mild
OTHER FACTORS:
V60.9 Z59.9 Unspecified housing or economic problem
Other factors would include, her job loss and inability to maintain gainful employment, dependency on her parents, and lack of confidence.
3. Recommendations
Molly would benefit from cognitive behavioral therapy to help her change her mood pattern. Her initial situation devastated her and she did not have coping skills to help her through this trauma. Although her situation was largely self-induced, the result changed the course of her career and life. She needs person-centered therapy to process these thoughts and build her confidence. I would also recommend her see her physician, just to double check that she is not be challenged by an undelaying medical condition that has not yet be identified. I would also recommend a healthy diet and regular exercise. I believe with an empathic, congruent, and accepting therapist, Molly should have a positive outcome.
4. Questions
What other kinds of information would you like to know about
Helen recurrent mood episodes and suicidal ideation needs to be addressed immediately. Her moods episodes
Lester is a 40-year-old man referred to me for counselling by his doctor. He is currently married and lives with his wife, Carolyn, and their 16-year-old daughter Jane. He is employed as a fast food attendant (Cohen, Jinks & Mendes, 1999). At the initial examination Lester dresses untidily and unshaven, and avoids eye contact. Lester reports an overall feeling of unhappiness (Cohen, Jinks & Mendes, 1999). He stated that he has become reckless and self-destructive and worried about some of his recent life decisions.
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.
A major depressive episode is not a disorder in itself, but rather more of a description or symptoms of part of a disorder most often depressive disorder or bipolar. A person suffering from a major depressive episode must have a depressed mood or a loss of interest in daily activities consistently for a minimum of a two-week time span (Psych Central, 2013). In diagnosing the mood must reflect a change from the person’s normal mood. A person’s daily activities and functions, such as work, social routines and friends, education, family, and relationships must also have been negatively impacted by the change in their mood. A major depressive episode is also identified by presence of five or more of the following symptoms. The patient can show signs of significant weight loss or weight gain even not dieting or trying to lose or gain weight. The patient will also display a change in appetite almost everyday, either with an increase or a decrease in their normal eating habits. The weight change is typically set at an increase or decrease in weight of more than 5% per month. The patient will display a depressed mood almost the entire day and this sadness, emptiness, loneliness, crying, and distant is observed by others or indicted by the patient, is typically
John was diagnosed with depression shortly after being prescribed insulin to control his diabetes. Although depression is considered to be a long term condition itself, it is often noted to accompany other LTC’s suggests Carrier (2009). John has a wife and a daughter of 20 months and often feels unable to enjoy a normal relationship with them due to his low mood and feelings of anxiety. Before John’s diagnosis of
Donald is a fifty-four-year-old male with a wife, children, and several grandchildren. Donald’s symptoms started approximately thirty years ago and have been increasing in severity. Documenting the critical issues, diagnostic impressions, and treatment recommendations are imperative to successfully helping the client deal with the issues and possibly minimize the risk of future relapse in recovery. Addressing the biological, psychological, social, and spiritual aspects will help to guide the therapist through developing the most accurate treatment model for the patient.
this situation include economic factors, health factors, and legal factors. Economic factors, such as her ex-
history of depression, ADHD, substance abuse and anxiety disorder on both sides of her family.
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.
The Sarah self-referred for assessment at am outpatient clinic. She subsequently requested a referral to a psychologist in Chicago, IL. Sarah is a 24-year-old adult Caucasian female who identified as a lesbian. She reported a history of depressive symptoms that have worsened in the last few months. She is seeking treatment for these intensified depressive symptoms. She described having “depression” many years ago, but became evasive when asked to clarify. In addition, she noted a concern with experiencing anger and hostility towards others; she stated that these emotions are “uncomfortable” for her. She clarified that in the past three months she has perceived herself as “grumpier than usual.” She reported having experienced anhedonia, fatigue, and insomnia.
296.32 (F33.1) Major Depressive Disorder, recurrent episode, moderate severity, with anxious distress. Ms. Client meets eight of the nine diagnostic criteria for Major Depressive Disorder (MDD). Specifically, during several periods of time she experienced depressed mood, diminished interest in things she enjoyed to do, hypersomnia, psychomotor agitation, fatigue, feelings of worthlessness, decreased concentration, and suicidal thoughts without intent. Additionally, as Ms. Client expressed, these symptoms are source of continuing distress and interfere with her academics and social functioning. Also, her symptoms started four years prior to the psychological assessment and persisted intermittently since then, lasting for several weeks to several months, with the most recent period of extended length (enduring two weeks) approximately one year ago. Since the last episode she has experienced these symptoms for two to three days at a time. Although the last episode that met the criterion of two weeks duration occurred approximately a year ago, the symptoms have not disappeared, but they occur periodically since then and when they do, they cause considerable distress and impairment in functioning. Thus, the disorder cannot be coded as ‘in partial or full remission’. The specifier ‘with anxious distress’ was given, because Ms. Client reports feelings of difficulty in concentration because of worry and restlessness.
Ms. Miller is 29 years old, white, divorced mom. At her last appointment, she stressed to her doctor that she was sad, tired, stressed all of the time, and cries easily. She also expressed how irritated she gets with her daughter and boyfriend over nothing. She states she have feel this way for the past six months.
There is no indication she has had a manic or hypomanic episode. Her depression may be complicated by grief due to her father’s death one year ago. Her symptoms seem to get worse after his passing.
Of course I changed the name of the client to Anna. Anna is a white, married, 29 year old female with three children. She high is her highest level of education. Anna was 6, when her father tried to kill her. Anna was in a serious car accident when she was 16 years old and shared that it heightens her sense of awareness. Anna shared that her first husband was physically abusive to her and has one child with him. Anna shared depression symptoms since she found out her second husband affair, while she was pregnant. Her symptoms include feeling down, sad, and eat less. She shared that she has two or three anxiety attack daily (i.e. hard to breath, gets sweaty, shaky, and heart races). She shares that she experiences muscle tension and easily
Mei Ling had seen her general practitioner (GP) for lack of energy and vague gastrointestinal symptoms. But her medical examination result found no physical cause. Through discussion with the GP discovered she has been feelings of depression for the past four months. Mei Ling’s GP suggested her to seek counselling.