General Psychiatric Case Studies Term Paper

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¶ … Psychiatric Case Studies

This is a question of an individual getting worried and that is a problem that happens to most people. This as such is not a reason for any individual to start worrying, but the reaction from individual becomes a reason for worrying when the reaction is severe or the cause is not known. It may also lead to a situation when the person is only interested in worrying at the cost of everything else. When that happens, one has to go to a health provider to find out the real situation. Here the nurse is finding out a lady whose husband is undergoing an operation. There are various reasons which may exist for her worry like this may be the first time that someone in the family is going for operation in the family, or the operation may be really serious according to the doctors taking care of the patient, the lady may be feeling very lonely as she does not have anyone else around to support her, etc. These factors may exist and the first stage is to know what the lady is really suffering from. Then only can one judge whether the matter is a cause to worry in the lady. (Chronic Worry: What you can do if worry has taken over your life)

This can happen if the lady feels anxious nearly all the time, the lady cannot determine why she is feeling anxious, the lady has developed a habit of avoiding situations which give her tension, the lady is no longer able to enjoy many facilities that she once enjoyed due to worries, the worry develops to the level where it becomes impossible for the individual to work, etc. This is often accompanied by many different symbols like trouble in getting sleep, trembling, headaches, muscle tension, sweating, hot flashes or even lightheadedness. This type of people may be even called chronic worriers, and the mental reason behind this is that the person is always expecting the worst to happen. (Chronic Worry: What you can do if worry has taken over your life) the individual who is going through this cannot be helped in the matter over a few seconds that the nurse has at her disposal, but she should definitely try to calm the patient down as if the situation develops then the lady may herself end up causing a problem. She should be reassured that the husband will come out shortly, and that she would be permitted to see him then. This is of course under the impression that the real situation is on those lines.

Question

An attack of panic at certain times is not unusual at certain times and certain situations and this keeps on happening to all of us. Generally when there is a panic attack, individuals' concerned get into a very high level of anxiety and they may have all sorts of feelings like having a heart attack, going fully mad or even losing control that one has over his own functions. This is also accompanied by a shortness of breath, tingling sensations over the body, sounds of rings in the ears, a fear of very serious events that are about to happen, trembling or a sensation of choking, chest pain, sweating or some other similar conditions. These conditions often appear to individuals and doctors or nurses as if the patient is having medical problems. This requires the patient to be first taken to a doctor and he has to rule out medical troubles. When the patient comes to a nurse, this matter is to be first checked out through a medical doctor. Along with panic disorder many patients also have agoraphobia. (Panic disorder and agoraphobia?)

This is connecting the panic attack with places where such an attack may take place, and from where the patient may find it difficult to get out of. When the patients have agoraphobia they stop going out alone, or going to supermarkets, boarding trains, getting up on very tall buildings, getting into elevators or tunnels or though open fields. The extension of panic to everyday life keeps increasing and some feel panic when they are asleep. Panic attacks generally take place when the individuals have to get into stressful situations and these can be the need to leave home, conflicts in relationship with family members, finding out the need of going through surgery, getting into a situation where the person will have to take up new responsibilities or even simple physical illness. These individuals often go through a sensation of pounding heart and this is often wrongly interpreted as if the individual is going through a heart attack.

This leads the person to a situation where he starts getting worried about every physical sensation that he gets as he thinks that it is related to his disease. This has the wrong effect and the person may get into a full attack because of his own feelings of tension. In turn this leads to further problems and the person tries to avoid situations that will lead to his attacks of panic. When this has developed to an extreme level, then the person may be said to be having agoraphobia. The treatment in such cases is cognitive behavior therapy and this removes both panic disorders as also agoraphobia. The treatment may include training for relaxation, training for relaxation of breathing, slowly and purposefully getting into situations that lead to panic, reduction of stress and also understanding of the problems by the patient. (Panic disorder and agoraphobia?)

When the patient is being met by the nurse, the nurse knows that the patient is suffering from the disease, and the requirement for the patient is to get out of the immediate symptoms. For this the patient may have already been prescribed some drugs, and if that is so, then the drugs should be given at the earliest. If there are no drugs, then the nurse should try to calm down the patient, and if needed may have to apply "placebo." This means that some items are given to the patient and the patient is given to believe that the item is a medicine, though it may not have any such effect. The main aim is to cool down the patient.

Question

Regarding the patient ordering the pizzas from a locked ward on the telephone looks improbable as if a person is not capable of looking after himself why should he be permitted the use of a direct phone? Anyway let us assume that it was so, then the pizza man has to be dispatched away by some means, and if he delivers it to the patients in the locked ward, then probably he also deserves to be there along with the patients. That should not be a major problem, but let us also look at the treatment of such illnesses. This is generally provided through electroconvulsive therapy for giving the patients relief, and this is used in cases of acute depression, mania and schizophrenia. The condition of the patient has to be checked and medicines given accordingly. (Electroconvulsive therapy)

Some treatments are prescribed when the patients are suicidal, self-injurious, refuse to eat or drink, refuse to take medication that has been prescribed and are likely to be of danger to themselves or others. This does not seem to be the case here and some medicines may have to be prescribed, though it may be said that medicines of that type also have a lot of side effects. The present form of treatment through electrotherapy was started after noting the similarities of the disease with epilepsy, but this was not very successful initially. Anyway, that decision is best left to the doctors, and the nurse should just get rid of the pizza supplier, if the case mentioned is possible. (Electroconvulsive therapy)

Question

Depression is a fact of life and in a severe case as mentioned here it is only that more of the symptoms occur at the same time. There may be different reasons for the depression to start or it may happen as the total impact on the individual's life through a continuity of events. In this case, the patient seems to be almost at the edge and if left alone, she is likely to cause harm to herself. No amount of medicine is likely to help her as once she commits whatever she wants to do, and then she will not left around for treatment. What she requires is constant supervision by some responsible person and this can be from her own relatives or even some societies who provide such help. The solution is to contact her relatives for taking care of her, if possible, or to get her in a position where she will not be able to carry out any drastic act. At the same time, one should remember that depression stays with people for a long time, and the crisis comes to the individual when the individual faces a crisis… [END OF PREVIEW]

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