Mental Disorder

ABSTRACT

This paper aims to present relevant disorders that are “socially” significant because they are present in all socioeconomic levels and has an alarming increasing prevalence worldwide. I chose to focus on eating and gender identity disorders, creating a story about an adolescent male. This is so because I have several friends who have these disorders. The purpose of the paper is to show how they evolve to their present selves.  

Mr. X is an 18 year old, Filipino, male, stowaway, who was brought to the emergency room by the police. He was taken into custody after a drug raid in Malate, Manila where he was taking marijuana. Mr. X is an extremely thin individual, pale, dressed simply in a t-shirt and jeans. He has a pronounced feminine voice inflection. His feminine gestures were exaggerations of an effeminate, swishy gait and arm movements. He sits with his legs crossed very effeminately and his arms folded. The interview session that followed was marked by temporary unawareness of surroundings and visual hallucinations lasting for 2-3 hours. He was admitted and put on sedation.

Next day Mr. X was much more approachable. He began to talk about his life. His role model was his maternal grandmother who used to “dress him up and raise him as a girl” died before his 5th birthday with alcoholism. His father, in his adolescent years also drank and dabbled in drugs and he died in a work accident. His mother, a very abusive woman, had four marriages in and Mr. X had 5 half-brothers and 2 half-sisters. After her 4th failed marriage, Mr. X’s mother stopped working and began drinking and smoking cannabis. At this time, he was 7 years old, and had to stop schooling to take care of his younger siblings. His only solace back then was his friends, who, like him, were very preoccupied with “thoughts of boys” and their weight. When he was 14 years old he started inducing vomiting and thereon, had up to 10 episodes of bingeing and vomiting weekly, and had a stable pattern of persistent food restriction. To lose more weight, he also experimented with cannabis (i.e., he swears that his mother never eats because of it) and also started smoking.

By the time he was 16, he was using cannabis several times a day and smokes 2 packs of cigarettes/day. Sessions of inhalation might last a few seconds, or up to half an hour. They ended when the craving and euphoria ended. He had often tried to stop or cut down but ended with failure. At this time, he ran away from home.

He stayed in a friend’s house and started working as a beautician. He tried to decrease his marijuana intake for a number of reasons: he wanted to take care of his younger brothers and sisters, and felt that he was at a point in his life where he needed to become more serious-minded. But his friends, continue to influence him, “It was a vicious cycle.”

The physical exam had determined that his sexual status was normal prepubertal male with a normal 46XY male karyotype.  Physical and laboratory examinations showed extensive dental caries, malnutrition, ulcer, and iron deficiency anemia. Current GAF is 40 and past GAF is 70.

Let us start from Axis I. Axis I pertains to Clinical Disorders, most V Codes, and conditions that need Clinical attention. In this case, the patient has Bulimia Nervosa, Gender Identity disorder, adolescent, cannabis dependent and nicotine dependent. In this case we can say that his being bulimic is a result of his gender identity. This condition is also the cause why he has dental caries (Gastric acids, as a result of induced vomiting, reach the oral cavity and may cause a deterioration of tooth enamel) iron deficiency anemia, and malnutrition (food that he takes does not get digested and thus nutrients are not absorbed in the body). Treatment of this disorder includes psychotherapy with or without the aid of pharmacologic intevention. Halgin & Whitbourne (1994) states that Cognitive-behavioral therapy principally involves a systematic series of interventions aimed at addressing the cognitive aspects of bulimia nervosa, such as the preoccupation with body, weight and food, perfectionism, dichotomous thinking and low self-esteem. This therapy also addresses the behavioral components of the illness, such as disturbed eating habits, binge eating, purging, and dieting. Patients typically record their food intake and feelings. They then receive extensive feedback concerning their meal plan, symptom triggers, caloric intake and nutritional balance. Patients are also instructed in cognitive methods for challenging rigid thought patterns, methods for improving self-esteem, assertiveness training, and the identification and appropriate expression of feelings. If there is a need for pharmacologic intervention, the physician may use tricyclic antidepressants, monoamine oxidase inhibitors, and selective serotonin reuptake inhibitors. By treating this problem, we are also modifying his eating behavior thus slowly reversing the malnutrition, and iron deficiency anemia. The ulcer can be healed through pharmacologic intervention.

With regards to the gender identity disorder, In typical cases, the treatment is conservative because gender identity development can rapidly and unexpectedly evolve. Teenagers, like Mr. X should be provided psychotherapeutic support, educated about gender options, and encouraged to pay attention to other aspects of their social, intellectual, vocational, and interpersonal development.

            For substance dependence (cannabis and nicotine), Astolfi, Leonard & Morris (1998) had stated that dependence does not require treatment because the withdrawal syndrome is so mild and most users can cease their use without assistance. However, if all else fails, psychotherapy is needed and involves brief advice, assisted cessation of cannabis use together with education about its acute and chronic effects, assistance with withdrawal symptoms and being involved in self help groups. We should also note that much of this therapy depends on Mr.X’s control and resolve. Second level of diagnosis is the Axis II.  Axis II, V71.09 means that there is no mental Retardation nor personality disorders. Axis III diagnoses: Malnutrition; vitamin deficiencies; ulcer, has already been discussed concomitant with bulimia.

Axis IV: School difficulties, ran away from home. We must consider that he had lost his father at an early age, had an abusive mother, and several siblings whom he took care of at an early age (which is the reason why he left school). These could have led to his “running away from home.” Metaphorically we could say that this person is running away from his responsibilities. Again, through psychotherapy, Mr. X could be persuaded to go back to school and home after dealing with his drug dependence and eating disorder. Axis V: GAF-40 current/ GAF-70 past. Halgin & Whitbourne (1994) defines GAF as Global Assessment of Functioning Scale. Having a GAF of  70 means that there are some mild symptoms or some difficulty in social, occupational, or school functioning, but generally functioning pretty well and has some meaningful interpersonal relationships. A GAF of 40 means that there is some impairment in reality testing or communication or major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood. From here we can conclude that Mr. X’s mental state is deteriorating and needs to be treated but only as an outpatient.

            In conclusion, I can say that Mr. X is a victim of circumstances like all patients with mental disorders. However, through continuous follow-up and psychotherapy there might still be a chance for him to bring back something he lost. Recovering fragments of himself might be helpful so that he can truly identify who he is and what he must do to overcome the obstacles that life will bring to his path.

References :

Astolfi, H., Leonard, L., & Morris, D. (2000). Cannabis Treatment and Dependence.

Retrieved from August 22, 2007

from http://www.health.nsw.gov.au/public-health/dpb/supplements/supp10.pdf

Halgin, R. P., & Whitbourne, S. K. (1994). Abnormal Psychology: TheHuman

Experience of Psychological Disorders. Dubuque, USA: Brown & Benchmark.

“When we meet real tragedy in life, we can react in two ways-either by losing hope and falling into self destructive habits or by using the challenge to find our inner strengths”- Dali Lama. I have witnessed and encountered many tragedies in my life and are going share the trials and tribulations that I have endured and how life has made me a stronger Individual today.

The point of this story Is not to upset those who have witness tragedies as well or frustrate those who are going through something UT to show that anyone can come out stronger through tragedies they’ve witnessed, instead of faltering into a distressful state of mind. My story begins at just the age of 8, we Just had moved to a South Texas town, Counted, this town had about 2,000 to 3,000 people residing in It. My parents had decided this was the perfect place to raise me and my brother who Is two years older than me.

I TLD understand much then, but from what I can remember the only problems I had was what flavor of Ice cream I wanted when my father took me to the ice cream shop and which Disney Handel show was on. But then, as I thought things were Just fine, On one summer night I heard noises in my parents’ bedroom and I overheard my favorite hero crying in the bedroom and saying he needed to tell us something terrible had happened. As he sat me down on his lap and told me that grandfather had passed away. My grandfather had been diagnosed with lung cancer shortly after he came from India to America too visit us.

My father had to take him back to India when they found out he diagnosed. I sat there not understanding what had happened and hearing my ere in tears for the first time. It was one of first of many forms of tragedy I have had to witness as I thought nothing could shake my father but at this moment I realized I was wrong and got scared, this moment had changed my whole perspective on anything can happen at any moment. But what really stood out to me was my father’s ability to go through the tough times and soul be strong for everyone else. This tragedy I witnessed taught me how to be strong and not to take things or people for granted.

I was able to be an emotional support for my parents. Tragedies can come n several deferent ways in different parts of our lives. In relation to this I witnessed my father face his second tragedy in life, his pride and Joy was his business but, in 2001 when the markets slowed, the hotel my father owned, which was about a 12 room property, slowed down to a point where he could not afford to keep it open anymore. We had days we TLD have electricity, and It got so bad that my dad to give up his car too. After about two years of hoping it would regain business, it lead us to a disappointment.

My dad had given up, had to give the hotel up to the bank. This was something that he had to face head-on and decided to go back to work again. Though his pride and Joy were lost, he developed a sense of motivation which would bring him back to one day owning a business again. I didn’t really understand the direct impact on my life. This is an example of a tragedy that I witnessed and was able to learn that though you might fall, you always have to get back up stronger and even more motivated then you were before. Later at the age of 14, I witnessed prejudice towards my mother because of her disability.

My mother was diagnosed severe bipolar disorder along with chronic schizophrenia. She had unpredictable days of outburst of anger, frustration, along violent actions. But she had days when she would be completely normal. As a family we felt completely helpless at times. Most of my mom’s side of the family were not there to support us and ignored the situation. In the community that my parents and I lived, primarily Indo-Asian, did not accept people with disabilities, and were often times excluded in events, gatherings and have caused them to lose their Jobs.

Being witness to this type of scenario and the idea that we as a society think time has improved our “backwards way of thinking” has caused me to rethink how far we have actually come and how far we still need to go. As a observer, I was in disbelief that people be the way they were to my mother who has one of the most open minded and honest soul. Some of the verbal language that was thrown at her as I heard as a child left me with a bitter taste and sometimes vivid scenes from the past. The taunts such as “she’s crazy’ and “she needs to be sent to a mental hospitals.

Tragedies can not only effect the primary individual but the individuals around them, as I was an example in this case being Judged as my mom. I now am able to voice to injustice for my mom. I have been able to help provide my mom and much more acceptable environment and give her that happiness she deserves. Her condition has given me the motivation to show people that despite her health she was able to raise a responsible daughter. Misfortunes that have been overcome can be described as triumphs.

A primary example of this can be said about my father going through his fife with a several different tragedies, but following every tragedy, he has made it to overcome those and created triumphs. For example, after he lost his business he had to start from the bottom of the hotel industry. As I witnessed him move from one Job to another I saw him learn from every opportunity he had and then carried that up the ladder. Triumphs can be created through small or big steps following tragedies. Being a witness to tragedies can really set yourself up to realize that you have them in your own life too and those triumphs keeps you going.

In my life I have seen my ether go through many obstacles that were tragedies too me. Being a witness to huge life events of the closest people in your life can lead to many lessons and those lessons can teach you how to work through your own tragedies. In conclusion I have witness many tragedies and I have also witness many triumphs, The examples I have given above about my grandfather passing away, about my father losing his business and having to get through the problems of prejudice with my mom and the community we lived in, shows that tragedies can be overcome despite the obstacles.

I eave witnessed many triumphs watching my father having his through the hotel industry, in his career and his personal life. Every step he took to get to the triumph was another step forward . Let’s all about having building blocks and overcoming obstacles to get there. Being a witness to these, personally, has made me a stronger, thriving and motivated individual. It’s all about learning through other people’s problems or learn how to deal with them when I have my own. Today, I have built my foundation from overcoming these problems, and has made me understanding and a responsible person.

The debate over whether or not social media is beneficial or harmful to kids has become a rising argument in the past few years. This is due to the increase of children possessing smart phones and having frequent access to the internet. It is estimated that more than sixty percent of kids ages thirteen to seventeen have a social networking profile of some sort (AACAP, 2013). Social media is harmful to kids because it exposes them to situations and content they are not emotionally and mentally capable of handling, allows room for cyber bullying, and can cause them to form detrimental habits.

Technology is an extension of what goes on in the real world. Bullying was around before the Internet, but cyber bullying makes it easier,” explained Dr. Brian Primack, an assistant professor of medicine and pediatrics at the University Of Pittsburgh School Of Medicine. Although bullying is nothing new; when it takes place in the digital world, the public humiliation can shatter young lives. Photos, cruel comments, taunts and threats can travel in an instant. These then can be seen, revisited, reposted, and linked to a huge audience.

Cyber bullying is using digital ommunications, like social media, to make another person feel angry, sad, or scared. Many experts agree that intent and context are important as well (AACAP, 2013). If the behavior was intentional, that’s clearly cyber bullying and there should be consequences. However, if a kid inadvertently hurts another kid, then he or she may just need to learn better online behavior. Online messages can be more confusing or scarier than in-person communication because there are no face-to-face cues to help you understand people’s intentions.

Helping kids recognize bullying will help them earn to better deal with it. Kids may be apt to use more hurtful and extreme language online than offline. It’s not uncommon for cyber bullies to say things like “l wish you would die,” “You’re ugly,” or “Everybody hates you. ” If a kid said these things out loud in public, a teacher, a parent, or even another kid would probably overhear and intervene. Cyber bullying can happen anytime, whereas regular bullying generally stops when kids go home.

A child could get a text, or see posts on Facebook at any moment. Cyber bullying is very public, which can add to the harmful effects it can have on children. Posts can spread rather quickly to a large, invisible audience due to the nature of how information travels online. Daily overuse of media and technology has been proven to have a negative effect on the health of children, preteens, and teenagers by making them more prone to anxiety, depression, and other psychological disorders, as well as by making them more susceptible to future health problems.

A review of research from the past decade has found that adolescents who demonstrated Internet addiction scored higher for obsessive-compulsive behavior, depression, generalized and social anxiety, ttention deficit hyperactivity disorder, introversion, and other maladaptive behaviors (AAP, 2013). There is also considerable debate within the mental-health field about whether dependence on technology is a true addiction, like alcohol, drugs, or gambling.

In fact, the American Psychiatric Association, which produces the Diagnostic and Statistical Manual, decided not to include Internet Addiction in their latest revision. Some experts in the tield argue that the unhealthy dependence on technology may be a symptom of some more fundamental pathology, such as depression or anxiety. To underdeveloped minds, these affects can be extremely harmful and can affect them later in life. However, not all usage of social media can be totally harmful.

In Why Social Networks Are Good for the Kids,’ by Sara Lacy, argues that social networking can make people more empathetic, and that ‘sites like Facebook and Twitter are more about extending your real identity and relationships online. ” Indeed, we get actual ‘endorphin rushes”(Lacy, 2013) from connecting with friends and staying in touch with people we don’t see or interact with daily. Social media usage can be a door to echnological literacy as well; which could help children prepare for their future professional lives.

A 2008 study by the MacArthur Foundation suggested that social sites led some kids to learn to adjust software code in the video games they played, edit video games, or fix computers; and in an ever-advancing technological world, these skills could be helpful. As with everything, balance is the key. Parents should take care to educate their children as much as possible on the dangers of too much social media use, as well as encourage use for educational and socializing purposes. Taken as a whole, social networking impacts children in ways that most people would expect it to.

The biggest questions are: How different is virtual empathy from real life empathy? And how is the development of virtual feelings different from the development of real feelings in general? Parents should be aware of the appropriateness of their child’s activities on social networking portals, as well as talk about removing unacceptable content or connections to people who may be a bad influence. Parents play a large role in helping maintain kids’ online safety.

Case Study: Wealthy Widow

DSM-IV Multiaxial Evaluation

Axis I              Moderate Mood Disorder NOS with single Hypomanic Episode (current)

Axis II            No formal diagnosis, frequent use of denial

Axis III           None

Axis IV           Problems with primary support group

Axis V            GAF = 60 (current)

            The client is a 72-year-old female, referred to psychiatrist against her will by her children. She is alert and oriented, although uncooperative and does not present with any signs or symptoms of dementia or psychotic behavior. In addition, no medical conditions or disabilities were reported, and the client denied the use of substances. The client currently meets DSM-IV diagnostic criteria for Moderate Mood Disorder Not Otherwise Specified with a single Hypomanic Episode, as she does not have a history of emotional disturbance or prior psychiatric diagnoses (American Psychiatric Assoc, 2000). However, her levels of functioning are sufficient to warrant a score of 60 on the Global Assessment of Functioning Scale.

The client was brought in by her sons because over the last three months her children have become concerned about significant changes in her behavior and her recent engagement to a 25-year-old male nurse she met while volunteering at a local hospital. The client’s husband is recently deceased, but client notes the bereavement was not severe and that she resumed her normal activities very shortly after the loss, which may indicate the use of denial of her feelings as a coping mechanism. Her children encouraged this behavior, but it would appear that her relationship with her sons has deteriorated since then, indicating problems with her primary support group. This is evidenced in her sons’ use of threats and intimidation to force their mother to accompany them to the psychiatrist’s office, and in the client’s assertions that they do not understand her and are only after her money. It is appropriate to note that the client is very wealthy, and most likely has complete management of her finances.

From what the client reported during the initial interview, she seems to be having a Hypomanic Episode. The DSM-IV defines a Hypomanic Episode as a period in which there is an abnormally and persistently elevated, expansive, or irritable mood lasting at least 4 days that is clearly different from the individual’s usual nondepressed mood (American Psychiatric Assoc, 2000). At the beginning of the interview, the client was very angry with her three sons and the psychiatrist, but later claimed that for the first time in her life she was feeling fulfilled and that her life was exciting. She reported no feelings that are typically associated with Major Depressive Disorder or Bereavement, and did not report or seem to be experiencing the delusions or hallucinations that would indicate a Manic Episode. In addition, the changes in the client’s mood and behavior are not severe enough to cause marked impairment in functioning, or to necessitate hospitalization, which assists in differentiating this from a Manic Episode.

The client also presented with at least five of the symptoms that must be present to indicate a Hypomanic Episode, including inflated self-esteem or grandiosity, as evidenced by her references to her ability to attract a much younger man. She refused to participate in formal testing and asserted that she will continue in her current behavior, seemingly regardless of her sons’ interference, which may be regarded as an increase in goal-oriented activity, another of the necessary symptoms. Her claims that she is finally doing something for herself instead of the men in her life may also be a form of coping, and a way of denying feelings of loss or abandonment related to her husband’s death. The client also indicated a decreased need for sleep, an excessive involvement in pleasurable activities that have a high potential for painful consequences, including her spending sprees and sexual activities, and displayed overly talkative behavior, all three of which are considered symptomatic of Hypomanic Episodes.

Despite these indications, there are several ethical concerns that the clinician must address when evaluating this case. The most obvious reason to confirm this diagnosis is to enable the client to move forward with treatment. The circumstances surrounding the changes in behavior and the relative lack of significant harm to the client or others indicates that this may be merely a reaction to underlying adjustment or bereavement issues, and therefore psychotherapy would most likely be successful in resolving the symptoms. In addition, this diagnosis may be useful in protecting the client’s finances. She indicated that she was planning to turn over her house and a large sum of money to her young fiancé, which is not necessarily problematic in itself, but the client’s age and circumstances make her vulnerable to being taken advantage of. Ethical concerns dictate that the clinician focus on what would be best for the client, and the prudent clinician would want to gain a clearer picture of the understanding between the client and her fiancé in order to assess whether the client is capable of managing her own finances.

However, the same ethical concerns regarding the client’s financial state could be applied to her children as well. The client expressed several times in the interview that she was merely asserting her freedom, having been the conventional wife and mother for most of her life, and seemed to understand how others viewed her behavior as unusual for her age and social position. Her sons’ claimed that they thought she was going “senile,” but this is clearly not the case, and the client’s statement that her children want her money must be explored. Because of the client’s age, it is possible that a diagnosis like this could be used to declare her unfit to manage her own finances at best, or to place her unnecessarily in a nursing home or retirement facility at worst. It is very possible that what the client declares about her own behavior is true, and that this change is something she actually desires and not a manifestation of a mood disorder. People are complex beings and must be looked at in context of their entire lives, not one small portion. In conclusion, psychotherapy and further evaluation should be considered in order to determine the true nature of the client’s behavior and to determine a course of action that will benefit the client, in either treating her for a Mood Disorder or helping her to make the transition to her new life and resolving some family conflict.

Reference

American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental

Disorders (4th ed., text revision). Arlington, VA: Author.

Interventions to Meet the Needs of Consumers with Mental Health and Add Issues. BY songster CHAMBER Provide interventions to meet the needs of consumers with mental health and ADD issues. Introduction Case study of Susan a female patient age 40 years old. Name change due to confidentially and I had been given consent to obtain and access her personal medical file for the purpose of my study. In her ass, Susan is beginning to experiencing bouts of unhappiness. She turned to alcohol. The trauma early in Suntan’s life, coupled with the subsequent health problems had placed Susan at risk or developing a serious psychiatric disorder as an adult.

Despite getting help for depression, her drinking gradually increased. Following the death of her mother in 2003, Suntan’s addiction escalated to the point that she could not start the day without a drink. It was in great emotional pain, and her drinking increased. At this point, she was never sober. Recently she had turned herself to cannabis smokers. Susan had identifying her first problem. She wanted to get well and be normal allowing her greater freedom from the horrible side-effects of alcohol. She was placed on an antidepressant medication to assist her in functioning better. Her family is very supportive.

She had a secure and stable family. Susan is fully aware of her mental state. She scored full in Mini mental state examination. Her speech is normal and calm. Therapeutic relationship Susan and I had a nurse-patient relationship that’s based on mutual trust and respect. I had been providing care in a manner that enables Susan to be an equal partner in achieving wellness. I had always make sure Susan has privacy when provide care and be sure that her basic needs are met, including relieving pain or there sources of discomfort. I too had actively listened to her to make sure I understand her concerns by restating what she has verbalized.

I had maintained professional boundaries like respecting differences in her cultures. We as nurses help Susan achieve harmony in mind, body, and spirit when engaging in a therapeutic relationship based on effective communication that incorporates caring behaviors. It’s a win-win situation in which the nurse and Susan can experience growth by sharing the moment with each other. Assessment We did assessment for Susan as the first part of the nursing process, and thus form he basis of the care plan. The essential requirement of accurate assessment is to view Suntan’s holistically and thus identify her real needs.

Through the use of a scoring formula identification of evidence to support decision making and practice. The assessment tool will assist nurses to both articulate and quantify the nursing contributions to care. Suntan’s chart provides information about his health status. It includes details about the current medical condition, treatment plan, related past medical history and other important data required to create a care plan. Vital Signs, jugular monitoring of a patient’s heart rate, blood pressure, temperature and evaluate a Suntan’s overall condition.

Abnormalities can indicate a variety of problems ranging from anxiety to heart failure. Suntan’s interview is the one of the most important assessment tools the patient herself. An initial detailed interview to get a full picture of Suntan’s physical and mental status. Patient Safety Plan There was a Patient Safety Plan for Susan. The purpose of the safety plan is to encourage Susan to identify calming strategies that may be of assistance to them while she is in hospital. This plan helps to list those things that can be assistance and encourage helping prevent a crisis developing that might place the patient and others at risk.

The plan helps to list Suntan’s activities and strategies that find helpful in keeping calm. For example Susan likes listening to slow and sentimental music and doing artwork to calm her nerves. She does not like noise and being bullied these will act as triggers and she will get angry. Risk Factors Alcohol abuse also can have serious repercussions on a person’s life, leading to financial and legal troubles, impaired thinking and Judgment, as well as marital tress. If we’re struggling with money or grappling with a failed relationship, we’re more likely to feel depressed.

A person’s home and social environment also can play a big role in determining whether they will develop both depression and a drinking problem. Children who have been abused or who were raised in poverty appear to be more likely to develop both conditions. Researchers have been searching for a common gene or genes that might lie behind both conditions. They have pinpointed at least one a variant of the gene CHARM that is involved in several important brain functions, including memory and attention. Variations in this gene might put people at risk for alcohol dependence and depression. Surveillance, R.

A Primer of Drug Action, Macmillan, 2005. J. Goldberg, 2012. Minimize social isolation We had suggested that Suntan’s family members and friends can also benefit from the hospital support group that they learn more about the disorder and become more constructively involved in recovery of Susan. Possible alternatives to traditional treatment. Here is some traditional treatment that Susan attends in her day activities in the day Centre in the hospital itself for relaxing. A number of essential oils are believed to be specially beneficial in the treatment of depression as they help to balance and relax the nervous system.

Aromatherapy can be helpful in alleviating mental disorders including depression. Aromatherapy is the use of essential oils to produce different emotional and physiological reactions. Some essential oils affect the nervous system, can help relieve tensions and anxieties, and even reduce blood pressure. Massage therapy is believed to be helpful for people with depression. Massage produces chemical changes in the brain that result . In a feeling of relaxation, calm and well- being. It also reduces levels of stress hormones – such as adrenalin, cortical and morphogenesis – which in some people can trigger depression.

Yoga breathing exercises are beneficial for depression. Yoga is an ancient Indian exercise philosophy that provides a gentle form of exercise and stress management. It consists of postures or ‘asana’ that are held for a short period of time and are often synchronized with the breathing. It is very helpful for reducing stress and anxiety which are often precursors to depression. We have given leaflets on acupuncture for traditional medicine China, Japan and other eastern countries. Acupuncture is based on the principle that stimulation of specific areas on the skin affects the functioning of certain organs of the body.

Fine needles are inserted into specific points called acupuncture points Just below the surface of the skin. It is believed that acupuncture can help to relieve depression, along with anxiety, nervous tension and stress. Other self-help measures include: Meditation, relaxation, diet, alcohol and drug avoidance and exercise. Withdrawal symptoms The common symptoms of alcohol intoxication include slurred speech, euphoria, impaired balance, loss of muscle coordination, lushes face, dehydration, vomiting, reddened eyes, and erratic behavior.

Which Susan does not have but she does not sleep well, not thinking clearly, irritability and loss of appetite. These symptoms are related to withdrawal from another drug as well Management of dependent drug intoxication and withdrawal Encourage and monitor diet and fluid. Reduce all environmental stimuli like providing single room with dim lights 4 hourly vital signs Administer medication prescribed by MO Consider assessment of breath or blood alcohol level where there is a concern of polycrystalline use. Report mental state and concerns, discuss with MO Referral to psychiatry.

Treatment her treatment includes Disappear, Thiamine, and multivitamin and foliate supplements. Mobility: Performs falls risk assessment on falls risk management tool (FROM) On going assessment and management Assessment of the patient’s risk and protective factors status at the current time. Provision of feedback on the patient’s risk level. Review of progress since the last towards achieving current goals. Identification of upcoming high-risk situations. Development and practice of coping responses Addressing any problems the patient may currently experience and Setting new oils for the time until the next.

For Susan the goal is to disrupt the cycle and reduce the risk of relapse. Treatment can include continuing care. We use intensive inpatient care based on 12-step principles. Followed by continuing care involving self-help groups, 12-step group counseling, and some individual therapies. Alternative approaches to enhance treatment retention in both initial and continuing care. The 12-step programs that provide a spiritual and behavioral guide to self improvement and offer social support for people seeking to achieve abstinence Each of these groups offers several hypes of meetings like speaker meetings.

With invited speakers such as discussion meetings in which all participants contribute to the discussion of a given topic or “12- step meetings” that discuss one of the 12 steps and participants are encouraged to attend all types of meetings. Cognitive-behavioral therapy begins with an analysis to identify beliefs, attitudes, and situations that contribute to the patient’s ADD use. Based on this analysis, coping responses that the patient can use are developed and practiced in high-risk situations to avoid relapse (Carroll 1998; Month et al. 1999). Monitoring of her sleep pattern.

Monitoring of her fluid and diet intake. Being The aim is addressing Suntan’s social care needs including possible triggers or substance misuse. To give her education in improving awareness of risks taking behavior and explaining how to find support. To give her treatment of mental health problems, drug treatment, psychosocial therapy and complementary therapies.

Reply to Response #4 I don’t think that Susan should give up on Mrs. Taylor. She has to convince her that Carl needs all the help he can get otherwise his behavior disorder might turn into something more destructive. He should be allowed to overcome his problem without the help of any prescription drugs. Mrs. Taylor and everybody in the faculty of the school should therefore exercise “maximum tolerance” in dealing with Carl.

Susan’s intervention plan would only work with the full cooperation of everybody else: Mrs. Taylor, Carl’s parents, Susan herself, and the other faculty members of the school. Reply to Response #5 You are absolutely right and I agree with you. Susan has definitely come up with the best plan given the available resources. I also believe that completely removing Carl from Mrs. Taylor’s class would do more harm than good. Carl is already feeling insecure after the divorce of his parents and subjecting him to such a humiliating experience might result to more violent reaction from the boy. The IEP meeting with the parents was also a great help for Susan.

It gave her a first hand knowledge of Carl’s predicament and could help her reach out to him. However, before Susan enlists the help of the shared psychologist, I think it would be better for her to arrange a one-on-one meeting with Carl after class first. If she could befriend Carl and gain his confidence by showing him that she is someone he could trust, Susan would be off to a good start. A psychologist, on the other hand, might have a negative reaction from Carl. Reply to Response #6 You’re probably right. I also think Carl’s mother wants to wash her hands of the entire problem.

She definitely showed that she did not care whether Carl is disciplined or not when she uttered the words “Do whatever you have to do. Give me the papers to sign, I have to get back to work. ” However, before I decide to transfer Carl to another class, I think it would be better if Mrs. Taylor should first be convinced to do more for Carl. A little more patience is what Carl needs. A little more sympathy would be even better. Moving Carl to another class might prove embarrassing for him and elicit an even more violent reaction.

Treatment of eating disorders can be challenging. Effective treatment must address the underlying emotional and mental health issues, which often date back to childhood and a person’s self perception and self image. Building strong therapeutic alliances with clients is imperative.

When working with a client who presents with an eating disorder it is fundamental that, as a counsellor, you do this in conjunction with a medical doctor and a nutritionist.

The first step when someone presents with an eating disorder is to insist on them receiving a medical from their GP. There are various reasons as to why this is important. Firstly, if the client has a Body Mass Index (BMI) of 17 or less, you cannot work with them. This is due to the effects that a very low weight can have on one’s brain. Furthermore, the need for a medical is important as someone who has engaged in the behaviour may have encountered serious health consequences and may need to be admitted to hospital, or in extreme circumstances, to a psychiatric ward.

It is important to work with both a doctor and a nutritionist so as you can focus on why the client may have an eating disorder and what maintains it. The other professionals then, focus on issues of weight and increasing this weight, if necessary. All treatment should be tailored to the individual and will vary according to both the severity of the disorder and the patients’ individual problems, needs and strengths.

Due to the psychological causes and effects of some eating disorders, talking therapy can play an important role in treatment. Cognitive Behavioural Therapy (CBT) is considered the treatment of choice for people presenting with eating disorders. CBT is a focused approach that enables a person with an eating disorder to understand how their thinking and negative self-talk and self-image can directly impact their eating and negative behaviours. CBT focuses on identifying and altering dysfunctional thought patterns, attitudes and beliefs which may trigger and perpetuate the clients’ eating disorder.

Nutritional counselling and advice can help your client to identify their fears about food and the physical consequences of not eating well. The initial aim of treatment is to re establish a healthy attitude toward food and a consistent pattern of eating. It is a necessary stage of treatment and should incorporate education about nutritional needs and planning for, and monitoring, rational choices of the individual patient.

There are a number of treatment approaches used for those with eating disorders, in which a combination may be offered. As a counsellor you must work in conjunction with a medical doctor and nutritionist, so as the most effective treatment approach can be put in place for your client.