A client diagnosed with borderline personality disorder has a history of self-mutilation and suicide attempts. The client reveals feelings of depression and anger with life. Which type of medication would the nurse expect to be prescribed? Benzodiazepine Mood stabilizing medication Monoamine oxidase inhibitor (MAQI) Cholinesterase inhibitora
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This can often lead to self-harm and suicide attempts. Secondly, the client is expressing feelings of depression and anger. These are common symptoms in people with borderline personality disorder and can be severe. Given these factors, the most likely type of Show more…
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Helen Bates was a 27-year-old single administrative assistant who presented for counseling for mood problems. She had recently begun an intensive outpatient program after a first lifetime hospitalization for an impulsive overdose following the breakup of a 2-year relationship. She said she had become increasingly sad and hopeless for 1-2 months in anticipation of the breakup. A month prior to her admission, she started seeing a new psychotherapist who told her that she had "borderline traits" and "situational mood swings." During these 4-8 weeks, Ms. Bates' mood has been moderately depressed throughout the day on most days with no diurnal variation and intact mood reactivity. She had recently gained about 10 pounds from "overeating comfort food and junk." She denied prominent irritability or argumentativeness. She described her self-esteem as "none" and had found it hard to feel motivation or to concentrate on routine tasks. By contrast, sometimes she would have "bursts" of nonstop thinking about her estranged boyfriend and devising ways to "get him back," alternating with "grieving his loss." She described times of being flooded with strategies to regain his interest (including purchasing a full-page newspaper "open letter" to him) and recently found herself awake until 5:00 or 6:00 am journaling or calling friends in the middle of the night, "for support." She would then "trudge through the day" without fatigue after only 2-3 hours of sleep. These symptoms began prior to her hospitalization. She denied drug or alcohol misuse and self-injurious behavior. Until this break-up, she denied a history of particularly intense or chaotic relationships as well as a history of suicidal behavior. Ms. Bates saw a counselor in high school for "moodiness" and poor grades. She became "depressed" in college. At that time, she began antidepressants and psychotherapy but improved quickly, stopping both after a few weeks. While in the hospital following her suicide attempt, she started medications at bedtime for "sleep." Ms. Bates was the youngest of three children who grew up in a middle-class suburban home. She attended public school and a state college as "mostly a B student" and hoped someday to go to law school. She described herself as having been a "quiet, anxious" child and "not a troublemaker." Her older brother abused multiple substances, although Ms. Bates said she herself had never used illicit substances. Her young sister was treated for "panic attacks and depression," and Ms. Bates knew of several aunts and cousins who she thought were "depressed." Based on the above case, what diagnosis would you provide (with appropriate specifiers)? How did you arrive at the above diagnosis? Use the below outline to help organize some of your diagnostic process- Diagnostic Process Establish all symptoms the patient is exhibiting Are the symptoms better explained by typical behavior? Are the symptoms better explained by a general medical condition? Are the symptoms better explained by substance use? Create a list of disorders that are likely diagnoses Evaluate each item on the list for reasons it may or may not be the disorder Establish the primary diagnosis.
Supreeta N.
John is a 19-year-old male who is incarcerated for selling drugs. At the age of 15, his best friend was killed and died in his arms, according to John. This led him to think, "Forget life." He soon began dealing drugs and committing other non-violent crimes. In prison, John is seen by a therapist for ADHD. He also exhibits signs of hopelessness and disinterest in activities that fellow inmates enjoy, such as playing cards and exercising outside. The therapist, suspecting something might be wrong with John, in addition to his struggle with ADHD, administers the Beck Depression Inventory. While taking the inventory, John asks the therapist how she can work with rapists. John then discloses that he was raped as a young boy. John completes the inventory and writes the name "Mayhem Matt" on it. The therapist reviews the inventory, notices the usual signature, and inquires about it with John. John insists, "That's not my paper." The therapist responds, "But you just filled it out." John says he has no recollection of this. The therapist next inquires about John's rape disclosure, to which John replies, "I never said that." In subsequent sessions, John asserts that he was never raped nor took the Beck Depression Inventory. John says the handwriting on the assessment is not his. Eventually, John is referred to a psychiatrist for further evaluation, but he is released from jail before meeting with the psychiatrist. Months later, John contacts the therapist to share how well he is doing and reiterates that the two aforementioned incidents never took place. The client's diagnosis The reasoning for the diagnosis Prevalence rates and theories on etiology pertaining to the diagnosis Recommended treatment, including, but not limited to, biomedical and psychological counseling interventions
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