Case study

Case Study 2
Mrs. Smith is a 30-year-old married woman whose family
brings her to the emergency room due to what they call odd behavior. Mrs.
Smith is the youngest of 5 children. She was born prematurely, but despite
being low in weight, there were no other negative consequences from this. She
met all her developmental, cognitive, and social milestones on time. It was
reported that she did well in school academically, made friends easily, and
interacted in several extracurricular activities to include yearbook and
cheerleading. After graduating from high school she began working in a bank, as
her family did not have enough money to send her to college. She was married 5
years ago and has 2 children, ages 1 year and 3 years. Mrs. Smith did not
return to work after the birth of her first child. One week prior to her family
bringing her to the emergency room Mrs. Smith went to her primary care
physician complaining of dizziness and trouble sleeping. She also reported to
him that she has been feeling down in the dumps and that she was a failure as
a mother and wife. Her doctor made her an appointment with a therapist for the
following week. Before she could attend the appointment though, her family
brought her to the emergency room due to her odd behavior.
Four months prior, Mrs. Smith had left her husband and moved
in with her mother and father. Shortly after she moved back home with her mother
and father, her brother was in a car accident and was seriously injured, and
the man she had been dating went to jail on a drug charge. About a month after
she moved home, her family began to notice a deterioration in her ability to
take care of herself, including making her own meals and bathing. This
culminates in the police finding her wandering about a mile from her home. She
is unable to tell them who she is or how she got there. On that day she is
brought to the hospital in a very agitated state and reports to the hospital
staff that voices are telling her to kill herself and her husband. Mrs. Smith
is hospitalized and treated and discharged 3 days later to begin outpatient
treatment. Three months later she is brought to the hospital by her family. She
reports at this time that she has been experiencing anxiety, insomnia,
delusions, and auditory hallucinations during the past 3 weeks. On further
investigation, she reveals that the hallucinations and delusions have been
occurring for the past 3 months, but she was worried she would get readmitted
to the hospital, and so she did not want to share this with her outpatient
therapist. She describes that she thinks others are out to get her and that she
is getting messages from the television. She reports that she can hear others
talking about her but when she looks no one is there.
Mrs. Smith s mother also reports that about 3 weeks ago her
daughter started to go on frequent shopping sprees. At first this made her
mother happy, as she thought her daughter was coming out of the funk she had
been in. But her mother reports that Mrs. Smith also had an overabundance of
energy and had difficulty sleeping in the evening, often pacing the floor. About
3 days before this hospital admission, she became irritable and was talking
about how the teacher at the college she was attending was out to get her . On
returning home from school she reported that she heard God talking to her and
that voices were discussing her, accompanied by the feeling that someone was
touching her although no one was there. She slept for only 1 or 2 hours on the
nights prior to being admitted to the hospital. Instead she would sing loudly,
dance, and recite Scripture.
During this second admission, she is
irritable and hyperactive, displays a flight of ideas, and talks nonstop. She
also believes she can heal others with her thoughts.
Case Study 2 is due by 11:59 p.m. (ET) on Sunday of
Module/Week 6.

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