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Meredith Cavour
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MENTAL HEALTH CASE STUDY
Abstract
This mental health case study focuses on a 22-year-old male who suffers from major
depression disorder with suicidal ideation, anxiety and dependent personality disorder. He came
to St. Elizabeth’s voluntarily after falling into a deep depression and considered taking his life.
This case study will delve into different aspects such as his mental health background, family
history, medications/treatments and therapy. Different nursing diagnosis will be discussed as well
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MENTAL HEALTH CASE STUDY
Objective Data:
R.S. is a 22-year-old Caucasian male. He was admitted to Mercy St. Elizabeth’s Main
Campus - Youngstown on February 19, 2019 and the date of care was February 21, 2019. He
The patient was admitted with the diagnoses of major depression with suicidal ideation,
anxiety and dependent personality disorder. He has no history of sexual or physical abuse in
childhood or adulthood. The patient was under hospital observation for three days with standard
observation and precautions for someone admitted with his diagnosis of depression with suicidal
ideation. Staff will continue to assess suicide risk on a regular basis as part of ongoing clinical
procedures.
According to the DSM IV-TR, Axis I through V, patient R.S. psychiatric diagnosis’s fit
into the axis I with his diagnosis of major depression with suicidal ideation, as well axis II with
his diagnosis of dependent personality disorder. The patient suffers from frequent exacerbations
of irritable bowel syndrome. Therefore, according to axis III, the onset of these IBS symptoms
could aggravate the patient’s psychiatric illnesses. In reference to axis IV, the patient has a
somewhat unstable home environment. He moved around from one place to another frequently
and has been unemployed for a few months since a serious car accident while on the job as a
pizza delivery driver. Patient R.S. also has a history of unstable relationships with family
member and significant others. In relation to axis V, I would say the patient is either at level 41-
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MENTAL HEALTH CASE STUDY
mood.
On day of admittance to the psych ward at St. Elizabeth’s, the patient was exhibiting
signs of wanting to hurt himself, major anxiety and crying. The day of care patient R.S.
exhibited behaviors such as anxiety, restlessness and inability to focus for long periods of time.
The patient’s treatment included being under 24-hour observation at a medical facility
specializing in psychiatric illness, group therapy, lab work and medications. The medications the
patient wad prescribed were Zoloft/sertraline (25 mg daily) which is an SSRI (selective serotonin
reuptake inhibitor) which is an atypical antidepressant used as a first line treatment for
antipsychotic typically prescribe for schizophrenia, depression and bipolar disorder. In addition
medication and used to treat extrapyramidal side effects (EPS). The patient’s prn medications
include Haldol/haloperidol (10 mg) which is used to help certain mental disorders and anxiety,
Vistaril/hydroxyzine (50 mg) which is an antihistamine that can be used for anxiety and tension
and Trazodone (50 mg) which is a sedative and antidepressant that can be ordered to help
Summarize
interferes with concentration, motivation, and many other aspects of everyday functioning. It is a
complex disorder, involving many systems of the body, including the immune system, either as a
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MENTAL HEALTH CASE STUDY
and such things as genetics and diet play a part in one’s susceptibility to it. In most cases,
depression is typically very treatable with things such as medication and therapy. It is often
cyclical with periods of no symptoms and episodes where there are varying degrees of indicators.
worthlessness, loss of interest in things that were once pleasurable, insomnia and fatigue,
changes in appetite with it going either way: eating too much or too little and thoughts of suicide.
(Depression, 2019)
an extreme and at time inappropriate manner. (Dependent personality disorder, 2018) “This
condition results in submissive and clingy behavior, a fear of separation, and difficulty making
decisions without reassurance from others. Dependent personality disorder may be caused by a
overprotective parenting styles, chronic physical illness, or separation anxiety during childhood
may be more likely to develop dependent personality traits.” (Dependent personality disorder,
paragraph 1-2) A major goal of treatment for dependent personality disorder is to help the patient
increase their self-esteem and self-confidence in their own decision-making process and help
them develop a sense of independence. Behavioral health is the primary treatment for dependent
happens over otherwise common things or events, it is difficult for the individual to control, is
excessive, and lasts at least 6 months.” (Torpy, paragraph 1) Signs and symptoms of generalized
anxiety disorder include tachycardia or fast or irregular heartbeat, sweating excessively for no
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MENTAL HEALTH CASE STUDY
physical reason, headaches and muscle tension, insomnia and fatigue, lack or loss of appetite and
increase of appetite, gastrointestinal symptoms such as nausea, diarrhea and vomiting. (Torpy,
2011)
Identify
The patient recently broke up with his girlfriend of 5-years. He was very dependent on
that relationship to make him happy and to fulfill him in different ways such as giving him a
sense of self and an emotional connection. He said he also recently lost his job as a pizza
delivery driver because he totaled his car while on the job. He said he felt loss without his
relationship with his girlfriend and didn’t know how he could be happy without her in his life. In
addition to that, his job loss caused him to also feel a loss of self and loss of sense of purpose and
responsibility. He said he felt like a loser with no reason to go on in this world. This led him to
become very anxious and depressed and he said he felt there was no reason to live without her
and being unemployed on top of everything else that was happening to him.
The patient said this caused him to go to his ex-girlfriend’s home to say “good bye” one
last time. The patient then then planned to go out to the woods to shoot himself in the head with
a gun. He didn’t share this information with his ex-girlfriend but the patient’s ex realized
something was terribly wrong with his behavior and contacted the patient’s father and let him
know she thought his son was planning to hurt himself. The father was able to reach his son
before he did anything drastic and talked him into going to St. Elizabeth’s psychiatric unit for
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MENTAL HEALTH CASE STUDY
Discuss
The patient has a family history of depression and bipolar disorder. He said his mother walked
out on the family when he was young and he no longer has a relationship with her. He said he
thinks his anxiety stems from when his parents would have huge fights with each other. He said
he doesn’t remember a time when they weren’t yelling at each other and fighting all the time. He
said the fights were very rough and got very scary at times because he thought his parents were
going to physically hurt each other at times. Ever since then he had issues with anxiety and then
the depression came when he was a teenager. He believes he developed a dependent personality
because his father was very overbearing at times and was extremely controlling and negative
towards him. He says his father did eventually receive therapy and their relationship is better but
Describe
The patient’s treatment at St. Elizabeth’s psychiatric ward includes activities such as 24-hour
care by a professional staff of nurses and doctors trained in the care and treatment of people with
mental health disorders, medications such as Zoloft, Abilify, Haldol, Vistaril, Cogentin and
Trazodone and group therapy to discuss his emotions, feeling and to learn different coping
techniques.
Analyze
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MENTAL HEALTH CASE STUDY
The patient didn’t really mention or focus on any cultural aspects of his background. He claims
he is not religious but is spiritual and believes in god. He says that his friends are everything to
him and that they are a great support system to him since he doesn’t always have the most
supportive and loving relationship with his family at times. Though the patient claims his
relationship with his father has improved over the past few years since he got therapy as well and
is starting to work on dealing with his negative feelings and emotions towards his son. He also
says he is good friends with his ex-girlfriend though he is still finding it difficult to accept that
Evaluate
When I spoke with patient R.S. he was still experience feelings of anxiety though he
couldn’t really explain why he was feeling anxious. He however said that his feelings of
depression had subsided somewhat and that he no longer had any desire to hurt or kill himself.
He was feeling positive and looking forward to the future. He felt that the medications he was on
were working for him and that he was learning a lot from group therapy and ways to cope with
Summarize
Patient R.S. said the he thought he was planning to be at St. Elizabeth’s psychiatric unit a
total of 3-5 days but that he thought he has ready to go home that day. However, he was going to
respect what the doctors thought he should do and figured they knew better. He claimed he
planned to stay on his medications after getting discharged because he knows they were working
for him in a positive manner. He also said he was going to be very dedicated to going to therapy
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MENTAL HEALTH CASE STUDY
as often as is recommended. The patient said he plans on moving back home with his father and
stepmother since their relationship has gotten better in recent years. He then wants to figure out
his next steps in life. He wasn’t sure whether that would be going back to college or getting
another job or possibly both eventually. He said his main priority is getting to a better place
mentally and emotionally and then he will move forward from there.
1.) Risk for suicide: At risk for self-inflected, life-threatening injury related to feelings of
hopelessness/helplessness.
2.) Ineffective individual coping: Inability to form a valid appraisal of the stressors,
3.) Anxiety related to changes in the environment and routines, threat to socio economic
status.
Conclusion
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MENTAL HEALTH CASE STUDY
Speaking to patient R.S. was a very educational experience regarding mental health
disorders such major depression with suicidal ideation, anxiety and dependent personality
disorder. He was very open about his situation and did not hold back any emotion. It was very
eye-opening to hear extensively about his mental illness and his background information
regarding it. It’s just one of the many experiences I’ve had in my Mental Health clinical that
really affirmed to me that mental illness disorders have such a broad spectrum of symptoms,
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References
https://my.clevelandclinic.org/health/diseases/9783-dependent-personality-
disorder/management-and-treatment?view=print on 4/3/2019.
https://www.psychologytoday.com/us/basics/depression on 4/3/2019.
Torpy, J.M. (2011, February 2). Generalized Anxiety Disorder. Retrieved from
http://jamanetwork.com/ on 4/3/2019.
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