Mental Health:Analysis of Issac's - Case Study Example

Running Head:Mental Health Name: University: Course: Tutor: Date of Submission: Q 1 Isaac was brought up in dysfunctional family setting environment which affected him due to constant family struggles as well as poverty. Though, Isaac was born a good boy with good character as well as behavior, lack of motherly love, support and the frustrations he encountered during his childhood made him change. He was sexually molested by his father an event which affected him both emotionally as well as psychologically. Growing up in a dysfunctional surrounding environment of drug abuse compelled Isaac to start smoking marijuana as well as cigarettes. Goldberg, (1998) defines a dysfunctional family as a family in which conflict, misbehavior occur constantly and regularly within the family forcing all the family to accommodate such actions against their own will which was evident in Isaac case (Goldberg, 1998). Isaac starting smoking marijuana and cigarettes like any other person around him eventually becoming a victim of unforeseen as well as unfortunate circumstances. Isaac eventually became addicted to smoking marijuana and cigarettes to extend that he could not do without them. He only thought about drugs becoming hard to do without them a situation which caused him to be hopeless and worthless in the society. This addiction caused him problems associated with anger, irritability especially if the drugs were not available. Smoking marijuana affected his brain leading to severe mental disorders including depression (Barry, 1998). He suffered from depression not only as a result of smoking marijuana but also a result of his bitter and painful childhood experiences. In addition he suffered from paranoid schizophrenia a situation which he caused him to experience hallucinations as well as delusions (Baker & Velleman, 2007).Based on information from the psychological counseling institutions, most victims of marijuana are pushed into the use of the drug perhaps due to the social challenges facing the family. Isaac’s family being of the Aboriginals is presumably affected by race and it is quiet evident that neglection by the society could be a key reason behind excessive drug abuse by the family (Dudgeon, Garvey & Pickett, 2000).The case study clearly indicates that the whole family consumes marijuana and this therefore could be a trait that Isaac borrowed from his parents for they were found smoking the substance when the child Isaac was born. From the case study Isaac has mental problems associated with depression, paranoid schizophrenia as well as psychological and emotional disorders. Isaac life has deteriorated and in his current mental state he poses potential risks and harm not only to himself but other people around him too. In order to best care for Isaac in his mental state it I will involve Isaac in various treatment therapies such as cognitive behavioral therapy which help him change his behavior as well as ensure his safety (Weller & Muijen, 1993) This therapy will help him to start living a normal life like any other person and starting thinking straight as well as maintain his personal grooming and hygiene. In addition, I will initiate drug addictions counseling session for him. This will help him to quiet smoking marijuana and cigarettes too. I will ensure that he is not accessible to any drugs by putting him through a drug rehabilitation program which will help him quit drug and substance abuse. I will help him get over the depression disorder through counseling sessions and as way of calming him down when he gets violent as well as angry I will administer depressants such as fluoxetine. In the event he start craving for marijuana I will administer an alternative to clam him down including his anxiety. In addition I will administer Antipsychotics which is a tranquilizing psychiatric medication primarily meant to manage delusions as well as hallucinations resulting from paranoid schizophrenia (Brunero & Stein-Parbury, 2008). Q2. Isaac’s Mental State Examination Appearance The patient is a slim young man fifteen years old wearing dirty and darted clothes. He is dirty, unkempt with neglected self hygiene. His hair has lice a clear indication of poor grooming. He has no stable posture, he keeps on making movements all through the interview. He seems disturbed, nervous and afraid making it hard for him to maintain a good eye contact. Behaviour He reports being angry, aggressive as well as suspicious for no reason. When feels angry he becomes outrages, uncontrollable, hostile and unpredictable. He is arrogant and unfriendly especially when he is angry. He gets annoyed for no apparent reason and objectively appears sad, anxious, quiet and tense at different times. Speech He speaks impulsively and very slow, becoming pressured at times, but he is interruptible. Rhythm and expressive intonation are normal. Volume is occasionally loud.Speech is sometimes understandable depending on the kind of questions being asked but at times he mumbles at himself and it’s hard to actually comprehend what he is talking about. When he talks some words are poorly articulated because of the high rate of speech production. Mood He is depressed, feels irritable at times and despondent for no apparent reason. He is unhappy and it’s hard for him to smile. He has a disturbed mind Affect Isaac’s emotional expression is labile, full of range and inappropriate to the content he is being interviewed. Unhappiness as well as past painful moments in his life have triggered feelings of low self-worth, experience of low feelings and hopelessness Uncontrollable craving for marijuana as well as Euphoric feelings Form of Thought His thoughts are not logical neither are they goal directed rather they directed on substance abuse. He is quiet circumstantial launching into emotional accounts of his pain life experience as well as how he has suffered emotionally and psychologically. Evidence of impaired memory, thought blocking and blank Disorientation Content of Thought He is preoccupied with suicidal or homicidal thoughts , intentions of harming other people around him as well as himself.He thinks his mother is the cause of his problems hence he does not see her importance in his life hence his thoughts are linked towards getting rid of her. He has Obsessive thoughts about marijuana smoking and he seems to be suffering from Social phobia as well as personal delusions Perceptual There is evidence of hallucinations as well as other modality thoughts. He has imaginations that people around him hate him Cognition When asked a question he answers immediately, though in some occasions he takes a long time to answer and at times he deliberately refuses to answer until he is pressured to do so. He keeps to himself, very quiet unless asked to speak. Insight The patient does not recognize the presence of his mental illness as well as his dangerous behaviour. He refuses to admit that he is sick mentally and needs medical attention rather he insists that marijuana and smoking is something normal. Hypothesis/Formulation From the mental state examination it is clear that Isaac is suffering from depression, family violence, marijuana and cigarette smoking addiction, psychological as well as emotional trauma and paranoid Schizophrenia. Q3 From mental examination of Isaac it is obvious that he has mental health problems. Under his current state Isaac poses various potential risks to himself as well as to other people around him. First and foremost Isaac is suffering from depression and in this condition suicidal thoughts are key symptoms when an individual is depressed as in the case of Isaac (West, Christina, & Sieloff, 1992). Since Isaac is depressed he is not in his proper senses thus his thinking capacity has been greatly affected. Under this condition there is a great possibility that within the twenty fours when left alone, he may feel frustrated because there is no marijuana as well as cigarettes around him to smoke so that he can calm his depression down. In this condition he may feel out of place, hopeless, helpless since he is locked up. Once these thoughts arises and overwhelms they will turn into suicidal thoughts. According to research done by (Goldberg, 1998) on depression it indicates suicidal thoughts are one of the key symptoms of depression. This actually implies that if Isaac is left alone there is a greater possibility that he may decide to commit suicide or harm himself in the event of trying to end his painful life. Apart from posing a potential risk of harm to himself, he poses potential risk of harm to other people as well as patients around him. According to the journal of Australian Physiotherapy Association (1996), it shows that people who are addicted to marijuana tends to get angry for no apparent reason (Australian Physiotherapy Association, 1996). Isaac tends to get angry and hostile for no apparent reason which is one of the symptoms of marijuana addiction. It is clear that within twenty fours hours he may get angry at himself and other people around him pushing him to cause harm to them given the mere fact that in his mental state he is not thinking straight. In addition, he seems to get paranoid for no apparent reason a situation which may make him start imagining that people around him are gossiping about him, a condition which could make him even more hostile and uncontrollable. Under this condition, there is possibility that he may try to break doors and windows of room he is locked in order to escape causing harm not only to himself but also other people could be injured too. Since Isaac is deeply addicted to smoking marijuana he cannot do without it within twenty four hours there is a possibility that he will have constant and excessive craving for the substance and obsessive thoughts about Marijuana. Craving for marijuana will push him into all means of getting money as well as out of the hospital in order to acquire the substance. Under this condition, he may get more violent just to gain access to the drug and the event he is locked up it maybe more frustrating for him. Frustrations may stimulate anger even more making it hard for him to concentrate, sleep or even calm down (Elder, Evans & Nizette, 2009). Q4 Hypothesis surrounding Isaac’s case According to mental health research done by( Brunero & Stein-Parbury, 2008), there is growing evidence that people with serious mental illness, including depression as well as psychosis are more likely to have used cannabis for long periods of time ( Brunero & Stein-Parbury, 2008). Isaac has been smoking marijuana as well as cigarettes for a long period of time resulting to his current mental illness disorders. As evidenced by mental state examination of Isaac, he is suffering from various mental health disorders. First and foremost he is suffering from depression as result of his childhood life as well as constant smoking of marijuana. Depression is a serious mental health disorder which actually differs from occasional short periods of sadness since it is consistent hence it does not interfere with individual daily functioning. Studies done by Cryan & Leonard (2010), indicates smoking marijuana for a long period of time tends to cause depression at point becoming difficult for an individual to do without it especially when he feels depressed (Cryan & Leonard, 2010). The other mental disorder which Isaac is suffering from is Schizophrenia. Regular use of drugs especially marijuana appears to increase the risks of an individual developing psychotic episodes or long-term schizophrenia which is the second mental disorder that Isaac is suffering from(Cryan & Leonard, 2010). Schizophrenia sometimes medically referred to as split personality disorder is perceived to be a chronic, severe, debilitating mental illness which actually affects about 10% of the entire population of marijuana addicts (Goldberg, 1998).It is one of the psychotic mental disorders which in most cases associated with symptoms of thought, behavior as well as social problems. From the case it is evident that Isaac is suffering from paranoid schizophrenia which is evidenced by his social problems with the neighbors, thoughts, behavior, paranoia thinking as well as delusions. From the case Isaac is suffering form emotional as well as psychological trauma. The other issue which is present in Isaac case is the mere fact that he is suffering from Emotional and psychological trauma. Emotional and psychological trauma is one of the disorders resulting from extraordinary stressful events (Barry, 1998). These events normally shatters an individual’s sense of security making him or her feel helpless as well as vulnerable to the surrounding environment as in the case of Isaac. Reading through the case Isaac has gone through traumatic events which have affected him in his entire life. The other issue affecting Isaac is drug addiction. Drug addiction is a complex illness associated with uncontrollable desire to stop using the drug despite frequents efforts to stop doing so (Baker & Velleman, 2007). Isaac is suffering from marijuana and cigarette smoking addiction. Marijuana addiction in particular has severe consequences on the user including Uncontrollable craving for marijuana, Obsessive thoughts about marijuana, Psychosis, Depression, Social problems, anger, aggression, irritability, withdrawal, among others (Baker & Velleman, 2007). According to the journal of American Psychiatric Association (1994),it states that marijuana smoking has devastating effect on the brain which has affected Isaac’s brain resulting to his current mental state. The active ingredient in marijuana normally referred to as delta-9 tetrahydrocannabinol or THC, in most cases usually acts on cannabinoid receptors as well as nerve cells hence influencing cells activities causing mental problems (American Psychiatric Association ,1994). Q5 NURSING CARE PLAN TEMPLATE Problem Plan (Interventions) Expected Outcome (O) and Criteria for Evaluation (E) Rationale (1)depression symptoms evidenced by sad moods, social withdrawal, unhappiness, lack of motivation ,overwhelming sense of despair, experience of low feelings, hopelessness, Recurring thoughts of death or suicide, signs of anxiety, feelings of irritability, Feeling restless, tense and anxious, difficult to concentrate and think straight. (ii) Marijuana addiction and paranoid schizophrenia evidenced by lack of motivation, depression, Anxiety, relationship problems, defensiveness, aggressive, anger, constant craving for marijuana, irritability, restlessness, hallucinations paranoia thinking, delusion as result of paranoid schizophrenia, constant mood changes and behavior Commence administration and monitoring of prescribed psychiatric medication. Since Isaac is suffering from clinical depression it is necessary anti-depressants be administered for example fluoxetine. Introduce the patient to various psychotherapy therapeutic therapies which in most case is a major option for many mental disorders. There several types but in this case three major therapies will be important. Cognitive behavioral therapy is a mental treatment program which helps a patient process and evaluates thoughts as well as feelings in a more realistic way. Behavioral therapy meant to change his behavior. Motivational therapy meant to make him motivated, more aggressive at life as well as other opportunities around him. Administer Antipsychotics which is a tranquilizing psychiatric medication primarily meant to manage delusions as well as hallucinations In order to control Isaac anxiety it will be necessary to administer Anxiolytics such as benzodiazepines Introduction of Addiction treatment programs, Counseling Behavioral therapy and Drug counseling (O) (i) considerable changes in mood levels (ii) Modified patterns of thoughts and behavior (iii)signs of happiness (iv)feelings of self worth (vi) increased levels of motivation (vii) Decreased thoughts of irritability, death as well as suicide (E) (i) client self-reported changed mood patterns (ii) client self-reported improved levels of concentration as well as thinking (iii) evidence of increased social interaction (vi) client reported improved social relationships with his neighbours and family members vii) Client self reported changed perspective about himself as well as life (O) (i)Considerable changes in thoughts as well as ideas generation (ii) Considerable changes in his behavior (iii) Improved personal grooming and hygiene (iv)Decreased feelings of irritability (v) Faded symptoms of hallucinations as well as delusions (vi) Managed levels of marijuana craving as well as cigarette smoking (E) (i) client self-reported changed levels of understanding in particular harmful, unhelpful ,false ideas and thoughts (ii) client self-reported more realistic thinking and idea generation (iii) Evidence of changed behavior (iv) Client self reported that he has stopped smoking marijuana as well as cigarettes (v) Client self reported managed levels Evidence suggests that commencement of antidepressant therapy as well as psychotherapy therapeutic therapies improves depressive symptoms (Goldberg, 1998) Evidence suggests that commencement of Antipsychotics manages delusions and hallucinations (Baker & Velleman, 2007) Evidence suggests that commencement of Anxiolytics such as benzodiazepines controls anxiety(Barry, 1998). Evidence suggests that commencement of Addiction treatment programs, Counseling, Behavioral therapy and Drug counseling helps an individual to stop drug and substance abuse(Weller & Muijen, 1993) References American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC Australian Physiotherapy Association (1996). The Australian journal of physiotherapy, Volumes 42-43.Publisher: Australian Physiotherapy Association Brunero, S & Stein-Parbury, J (2008).Australian Journal of Advanced Nursing Baker, A & Velleman, R (2007).Clinical handbook of co-existing mental health and drug and alcohol problems. Publisher: Psychology Press Barry, D. P. (1998). Mental health and mental illness. Philadelphia: Lippincott Cryan, J.,F & Leonard, B., E (2010).Depression: From Psychopathology to Pharmacotherapy. Publisher: Karger Publishers Elder, R., Evans, K., & Nizette, D. (2009). Psychiatric and mental health nursing (2nd ed.). Chatswood, NSW: Elsevier Australia Goldberg, R. J. (1998). Practical guide to the care of the psychiatric patient (2nd ed.). St. Louis: Mosby Dudgeon, P., Garvey, D., & Pickett, H. (Eds.). (2000). Working with indigenous Australians; A handbook for psychologists. Perth, W. Aust: Gunada Press. Weller, M., & Muijen, M. (1993). Dimensions of community mental health care. London: WB Saunders. West, P., Christina, L., & Sieloff, E. (Eds.). (1992). Psychiatric and mental health nursing with children and adolescents. Gaithersburg: Aspen. Read More