Question

Post a diagnosis of the client in the case study. Then explain your rationale for assigning on the basis of the DSM. Finally, explain whether this person is at risk for suicide and how you might specifically assess them for suicide. Justify your response with client data and the current literature.

Depressive, Bipolar Disorders and Suicide Program Transcript

[MUSIC PLAYING] FEMALE SPEAKER: I wanted to reconcile. I begged him to come home. I begged him. He was the one that had the affair. He said he couldn't stand to be around me anymore.

The divorce was finalized six, seven weeks ago, and it's over. It's really over. But

I just don't know what happened. I thought everything was OK.

I guess that's why I started drinking again. I know, I know. More than I should. I'll bet you I've gained 15 pounds. You know what would make me feel better? A raise. A big, fat one. Going from two incomes to one is just killing me.

FEMALE SPEAKER: That must be really difficult for you.

FEMALE SPEAKER: You have no idea. I even lost my medical insurance in the divorce, so now I'm not taking my medications.

FEMALE SPEAKER: What medication?

FEMALE SPEAKER: I forget the name. I have a history of hyperthyroidism, so I know I'm not supposed to stop taking them, but I can't afford them.

FEMALE SPEAKER: Is there any way you can get insurance through your job?

FEMALE SPEAKER: They cut all medical benefits. Sliced that right along with my hours. I don't really, usually hate my job, but it's just all sort of mixed up right now. The people that I manage don't respect me, and the people I report to, they just take advantage of me, and it's just a nightmare there.

I work in a department store. I'm the assistant manager there.

FEMALE SPEAKER: That must be a very demanding job.

FEMALE SPEAKER: It's not what I want. I went to school for fashion design.

That's what I love. I want to be creative. But business so just so hard to break into. Apparently, I'm the only one who thinks I'm any good at it.

I just want to pull down the blinds and hide away from the world. I definitely feel myself going there again.

FEMALE SPEAKER: Going where again?

FEMALE SPEAKER: Feeling rejected, worthless, crying all the time.

FEMALE SPEAKER: So you've experienced something like this before, extreme feelings of sadness and depression?

FEMALE SPEAKER: You don't really talk about it in our family when I was growing up. You just keep things to yourself.

When I was a junior in college, I went to a frat party, and I got pretty wasted. I mean, I was gone, but not completely. Because, I remember there was this guy and this girl. And we were drinking all night together, and then they took advantage of me.

FEMALE SPEAKER: Did they rape you?

FEMALE SPEAKER: Yes. No. I don't really know. It just all got mixed up. I ended up in the hospital for what they called a depressive episode. I was in there for six days. 40 milligrams of Prozac every day for breakfast.

FEMALE SPEAKER: Sounds like it was incredibly difficult for you. And how long did your symptoms of depression last?

FEMALE SPEAKER: I don't think they ever really went away. That's what happened last--it's just really hard for me to talk.

FEMALE SPEAKER: That's OK.

FEMALE SPEAKER: I always thought I was a good girl. You know, going to church and all that. But just the fact that I was with a guy and a girl. I just feel like I don't know which way to turn, you know?

FEMALE SPEAKER: Are you talking about your sexual orientation?

FEMALE SPEAKER: Yes. And it never really went away. Even after I got married, my husband used to complain that I was never really there when we had sex. Real boost for the ego, right?

He wasn't wrong. I don't think I've ever really been there during sex. With anyone, even before college.

It's not like I avoided it. It's just that whenever I did, I think I just went somewhere else. Sometimes I think I'm just afraid that I can't handle really connecting with someone.

FEMALE SPEAKER: What is it you think you can't handle?

FEMALE SPEAKER: I don't know. I do have one thing figured out.

FEMALE SPEAKER: What's that?

FEMALE SPEAKER: Details of my suicide. I have all the details worked out. I have a stash of Ambien. I have like 60 of them. It's going to be quick and painless. The only thing I haven't figured out is what day I'm going to do it.

Answer 1

Case study

Name – unknown

Age- unknown

Gender- Female

Social History- The lady is divorced few weeks ago, she is addicted of alcohol, and working in departmental store. She is suffering from over active thyroid problem, she experienced depression and chronic anxiety during young age,

Interview and behaviour inspection- The lady is experiencing the post traumatic problems, she had experienced many stress and depression symptoms and also problematic in behaviour.

During the interview the lady seem to be confused and feeling lack of attention, she has used the word killing three times, the lady has sex disorientation which led her to some bad experiences with partner. She is not facing memory deficit but she did not memorise the medication due to personal concern, she could able to remind the disease as well as symptoms.

She is not completely willing to commit suicide, she just want to special attention and sympathy by people, she is still confused and not able to decide about her decision of suicide or harm to herself.

Symptomatic behaviour- the behaviour is not showing the clear image of suicide aggression but depression and lack of attention can be found by the assessment of behaviour.

Assessment- the client is showing some symptoms of partially suicidal behaviour and clear depression symptoms.

DSM IV TR, axis 1^st (Depression), axis 2^nd (Behavioural and Suicidal)

References- DSM IV, OCD 10, SCAN (WHO).