Mary Altered Mood Case Study
Background :
Mary is a 41 year old female who lives with her husband and three children, 17, 14 and 10 years respectively. Mary holds down a responsible position in a large organisation and loves the work she does. Her husband is supportive and they have been married for 18 years. Mary has moments of extreme energy. While this is good at some level, she finds herself exhausted, and at times her thoughts are too accelerated for her concentrate on any one thing. For instance when feeling like this, she often forgets to eat or undertake tasks required in the workplace and at home. Sometimes Mary has feelings of euphoria where she enjoys spending money however this can get out of hand. For example, she has recently had one shopping spree where she bought 23 red lipsticks because she liked the colour and believed there was a special meaning related to the number of lipsticks and the colour.
Mary also describes moments of despair where she is tearful and has little or no energy to even move from her bed. At these times, she lacks motivation to complete simple activities such as eating and dressing. Mary’s husband reports that Mary often talks of feeling worthless and hopeless on these occasions and has made comments in the past that she can’t see how she will manage to get through another day.
Relevant Information
? Lives with her husband and 3 children ( John 17; Philip 14 and Sarah 10)
? Married 18 years. Husband supportive.
? Works for large organisation as an accounts manager.
? Belongs to the local church and attends weekly.
? Physically well with no known medical history.
? Diagnosed with bipolar disorder at the age of 26 after a manic phase. Hospitalised for 5 weeks but has had no further admissions.
? Self-administers Lithium ( a mood stabiliser) 900mg daily
? Appropriate developmental milestones achieved.
? No alcohol, smoking or drug history.
? Care is self-managed in collaboration with her GP.
? Attends GP’s for regular blood test to monitor lithium levels.
? Her own mother has lived with depression for 35 years.
3. Tania Eating Disorder Case Study Background :
Tania is a 23 year old female who is studying to be a lawyer. She lives in the metro area with her parents who are both ‘busy’ doctors and her younger brother who she describes as outgoing and popular and who is studying law.
The family describe themselves as very close and loving despite both parents working long hours. Tania started preparing meals for the family 12 months ago but now refuses to eat with them. Her weight has dropped from 66kg to 40kg in the past year. During the same period she has grown from 160cm to 164cm tall.
The parents have several concerns such as Tania’s weight loss, her food restrictions and excessive exercising over the last six months. Tania denies vomiting or laxative abuse but believes she needs to continue losing weight as she is fat. She believes her parents are making a fuss over nothing and cannot understand their concerns. She believes they are interfering in her life and it is causing disharmony and arguments between the family members.
Relevant Information
• Lives with parents and younger sibling ( Pete 21years old studying law)
• Studying to be a lawyer
• Appropriate developmental milestones achieved.
• No alcohol, smoking or drug history.
• No prescribed medication
• Appropriate developmental milestones achieved.
• No known psychiatric history
• Has a history of dieting since the age of 14.
• Has been seen by the family GP over the last 2 months for gastrointestinal disturbances (feeling bloated and constipated) and feeling faint on some occasions. Was advised to eat more fibre and to have an ECG. A referral was made to a cardiology department.
• No family psychiatric history
1. Tom Altered Perception Case Study
Background :
Tom is a 19 year old man who resides in a remote community about 5 hours travel from Adelaide. He lives with his mum and four younger siblings. His father died when he was 15 years old.
Tom left high school in Year 9 and has had a disrupted employment history though successfully started work 12 months ago for a local mechanic. After working for a few months, Tom began to hear voices that told him he was no good. He also began to believe that his boss was planting small video cameras in the cars to catch him making mistakes. Tom became increasingly agitated at work, particularly during busy times, and began “talking strangely” to customers. For example, one customer asked when his car would be available and Tom indicated that that it may not be available because had “surveillance photos of him that were being reviewed by the CIA”.
A few weeks ago Tom quit his job, after yelling at his boss that he couldn’t take the constant abuse of being watched by all the TV screens in the car yard and even at his home. Tom has become increasingly confused and agitated. His behaviour has recently become more disorganised and his mum and aunty have been concerned about his erratic and volatile behaviour. They are particularly concerned over the increase in his alcohol and cannabis use.
Relevant Information
? Lives with mother and 4 younger siblings.
? Father died 4 years ago.
? Has a few close friends he socialises with each evening.
? Currently unemployed. Past employment includes farm hand and car mechanic apprentice.
? Known cannabis and alcohol use
? Physically well with no known medical history
? No prescribed medication
? Appropriate developmental milestones achieved.
? No known psychiatric history.
? No family psychiatric history though has had 2 friends complete suicide in the last 3 years.
Develop an essay focusing on the chosen case study.

You are required to address all three discussion points in relation to the chosen case study.

Required discussion pointS for the essay

These following three (3) points are to be clearly addressed and linked to the chosen case study.

A comprehensive understanding of mental health, mental illness and the principles of recovery.

The nexus between mental health with physical health.
Recognising and responding to the mental health needs of the identified person, i.e. our essay must include implications for practice for you as a health professional.

Discussion themes

Below is a list of 10 possible areas to help guide the essay development. You will need to identify, explore and critically analyse a maximum of three of the following themes to add depth to the essay. Each theme must be linked to the above discussion points and the chosen case study.

1 Discuss the common presentations of the mental illness related to the case study and the stigma or attitudes that can impact on care.

2 Discuss the process and significance of a mental health assessment and possible findings from the case study for the purpose of treatment and recovery.

3 Discuss the required interventions and management of the mental, physical social and cultural issues for the chosen case study.

4 Discuss the quality of life effects for the person in the case study and their carers within a recovery framework.

5 Discuss specific issues relating to the case study, e.g. safety issues, multidisciplinary involvement, consumer and carer education and community resources.

6 Discuss likely outcomes and best practice recommendations for managing the care of the person experiencing mental illness. In the chosen case study.

7 Discuss contemporary issues in providing care such as access to services, consumer and carer perspectives, indigenous mental health.

8 Discuss the use of communication strategies and other therapeutic modalities in stabilising a therapeutic relationship with the person in the chosen case study.

9. Discuss the responsibilities of registered nurses to the person in the case study experiencing mental illness.

10 Discuss the resources and barriers that may impact on service delivery for the chosen case study.