Fictional Case of Ms. Jean Harlow Term Paper

Pages: 10 (3573 words)  ·  Bibliography Sources: 8  ·  File: .docx  ·  Level: Doctorate  ·  Topic: Psychology

¶ … fictional case of Ms. Jean Harlow and her need for a treatment plan. The beginning of the paper describes the case in detail of Ms. Harlow and her mental disorder. It describes the events that took place in her life that would lead her to seek the attention of a psychiatrist as well as a more in depth look in how someone with a mental disorder might behave in order to be able to observe and evaluate.

The treatment plan for her mental disorder involves antipsychotic medications as well as antidepressants. She demonstrated symptoms of Major Depressive Disorder with Mood-Incongruent Psychotic Features. This was evidenced by her hearing voices and feeling lethargy and disinterest in her daily life and social interactions.

In the later sections her reactions and responses to treatment will be discussed followed by the ways problems experienced by the patient can be solved and alleviated. The section titled: "Treatment Plan" is the short version that raps up the overall treatment phase. The latter will describe more of the process along with short- and long-term goals.

Ms. Harlow experienced a lot of mental health issues that are recurring and therefore this paper explains ways patients with recurring mental health problems can learn to better cope with their issues to effectively deal in the long run with mental stress and depression. Certain outcome measures will be assessed such as how the patient is able to function in a social setting and how she is able to deal with stress triggers to see just how far along in terms of progress she is making.

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As difficult as it is to manage mental health problems, the last section will explain how difficult or easy it was to help and treat the patient. There are certain strengths and weaknesses that can hinder or progress the overall tratment of a patient. The doctor patient relationship is important and trust must be established in order to effectively help the patient get better and stay in a form functioning that isn't destructive to the patient and the world around them.

Term Paper on Fictional Case of Ms. Jean Harlow and Assignment

Detailed Description of Case

Ms. Jean Harlow is a scrawny, messy 59-year-old overweight woman with a slight British accent. She was being treated at a medical clinic for an upset stomach when she mentioned briefly she had been hearing voices. This immediately prompted the doctor treating her to send her for a psychiatric evaluation. During the evaluation Jean expressed through a story what exactly happened to her that would prompt her to say she heard voices.

One day she invited her friend for coffee. She and her friend, a male, shared a plutonic friendship. Nevertheless they went to her house and while Jean was taking a nap, she felt as though her friend was on top of her. She opened her eyes, saw him on top of her and ran out of her house confused and worried. When she came back shortly after he was gone, she decided to call him to find out why he was on top of her and found out he never was. He left shortly after she took a nap. Was this a hallucination, she asked herself.

She always had problems with her weight and one day she heard someone call her a fatso. She brushed it off even though it upset her a little bit. Then when she was walking to the grocery store she heard of string of taunts saying she's fat, ugly, and even insulted her clothes. She looked around and didn't recognize any evidence that these words spoken were actually coming from people's mouths. She didn't know whether they were in her head or real, though it seems they were more so in her head. All of this happen within a one month span.

She became so paranoid, she genuinely believed everyone in her neighborhood thought she was a hideous beast. Jean was so rattled by this she decided to go to her mother for some guidance. Her mother simply stated it was all in her head and to pay no mind to it. During the evaluation as Jean is explaining all of this, she is still hearing those voices taunting her.

When describing her mood and how she felt, Jean said she felt crappy and "nervous, rattled." She doesn't admit to feeling depressed though exhibits signs of depression. These signs are: lack of interest in socially interacting with friends or participating in any sort of activity. She even stated her appetite has decreased and she has lost weight. At first she was excited to see the weightloss but now she states she feels weak and tired all the time. The one thing she says has stayed the same is her sleep habits.

She mentions she only really feels guilt when the voices are taunting her. Although she has no suicidal tendencies due to her religious beliefs, she expresses how better off she would be if she somehow stopped breathing. She mentions an episode like this happened to her 10 years ago. It was not to this extent, but she did hear voices and felt lethargic.

She went through outpatient treatment for 6 months and took medication though Jean cannot recall the name of the medication she took. She continued her job as a store manager at a GAP store. Her weight during this time fluctuated and eventually she gained so much weight that she was experiencing pain in her knees when she walked.

She has been with her live in boyfriend now for 11 years and has a 9-year-old son. Jean drives him to various sports activities. She spends a lot of her time with her son or at work. Her boyfriend works as a sales representative and puts in long hours.

One thing that Jean mentions is she has not had an alcoholic beverage or a cigarrette for 35 years. When her memory was evaluated she just said she sometimes forgot her keys or would leave the door to her home unlocked. Later the psychiatrist performing the evaluation wanted to interview her boyfriend to find out more information about her.

Her boyfriend mentioned to the psychiatrist that her episode prior was similar to this one now and that she was looking anxious and nervous for the past few days. He also mentioned she was and has always been very sensitive to remarks from others.

Her sensitivity was noted when observing the way she looked for approval as she was being evaluated. She wanted to know if she was a good listener. She also wanted to let it be known she is good at following directions and wanted very much to be liked.

Treatment Plan

The first step in creating a treatment plan is determining the appropriate diagnosis. The first diagnostic question to consider is whether or not the voices Jean hears are hallucinations or obsessions. The fact she described the "voices" as repetitive, and stereotypical suggests that they are most likely obsessions. The problem with this is that she perceives it as coming from other people, eventually everyone she interacts with or sees therefore pointing to the "voices" as being true hallucinations that are delusionally elaborated.

Could a Mood Disorder be at the root of the delusions and hallucinations? Her behavior points to that being the case. She said she experienced a decrease in mood and desire. Even her recurrent thoughts of death contribute to this being a Mood Disorder although she ruled out suicide. There are enough symptoms to classify this as a Major Depressive Disorder (DSM-IV-TR, p.376) Also what can be added is that it is recurrent since she experienced a similar episode 10 years ago.

Another facet of the diagnosis to acknowledge is her lack of guilt when experiencing the hallucinations and delusions. So in addition to the diagnosis would be with Mood-Incongruent Psychotic Features (DSM-IV-TR, p. 413) The preferred treatment would be for a prescription of antipsychotic medication on an inpatient unit. Thereshould be no antidepressent medication used until the voices disappear and the depressive symptoms worsen.

As the patient was treated with the above mentioned plan for four weeks, she was allowed to be treated on an outpatient basis. Although the patient was much improved she demonstrated Obsessive-Compulsive Disorder evidenced by the recurring requests for ressurance that she is not gaining weight and is not ruining her diet. New antidepressents were then applied that specifically helped with Obsessive-Compulsive Disorder. A year went by and Ms. Jean Harlow was free of her symptoms and was able to return to a baseline form of functioning.

Relevant Information

Major Depressive Disorder is a disorder that often is identified by a low mood associated generally with low self-esteem. This is followed by a loss of interest in normally enjoyed activities such as social gatherings and hobbies. This disorder affects a patient's work, family, and/or school life. Not only are the social areas of a person's life diminished in quality and connection but also there is an effect also in a patient's… [END OF PREVIEW] . . . READ MORE

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"Fictional Case of Ms. Jean Harlow."  Essaytown.com.  July 12, 2012.  Accessed September 28, 2020.
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