Borderline Personality Disorder- Mental Illness (Essay Sample)
In each case read the case carefully and note the patient's symptoms, their signs (observable behavior) and their history. Then align each symptom, behavior, etc. with the actual criteria in the DSM. Make sure you indicate in your write-up how each piece of information in the case is an example of the criteria in the DSM so that you can justify your diagnosis. The next section will require you to offer "rule out" diagnoses. These are possible diagnoses that "could" be true, but after careful analysis do not meet ALL OF THE CRITERIA necessary to make that diagnosis. A medical example: a patient complains of a severe headache, stiff neck and a high temperature. You may suspect meningitis....that would be a "rule out" that requires further investigation. Clearly, it is a possible diagnosis, but when a spinal tap is done, it is negative, and meningitis is "ruled out." It was the flu! When you give me two rule outs for the case make sure each one is plausible. For instance, if your final diagnosis turns out to be schizophrenia, a rule out of a phobia for elevators is not even close to the symptoms of schizophrenia and would never be a possibility. You must describe why each of your rule outs DO NOT describe the patient by noting the DSM criteria that are not met. As you read about disorders you will see that there are clusters of somewhat similar disorders that can be differentiated from one another. Finally, you will be asked to discuss treatment options for your diagnoses and the prognosis for the patient, that is what is the likely outcome and possibility for improvement or deterioration. Remember, all reports must be at least 1 full page, single spaced 12-point font.
Make sure you read the case study info below very carefully. Most critical is that you line up each symptom, complaint, sign, and history with the exact criteria in the DSM 5 that will justify your diagnosis. Do not generalize, but do a criteria by criteria justification. For instance, Mr. Q complains of feelings of tiredness and not getting pleasure out of his usual hobbies (Dx criteria that aligns are" fatigue and anhedonia" to help justify a dx of Major Depression). You are also required to rule out diagnoses that "could "be possible but not all necessary criteria. are met. List all criteria that are Not met. Notice that many diagnoses in a chapter are somewhat similar but have significant differences. This exercise is called "differential Diagnosis" for that reason.
Case Study: Ms. Seeker
Ms. Seeker is a 23-year-old medical assistant who was hospitalized after she recently attempted to slash her wrists with a tin can. She told the staff on admission, “I don’t really need to be here.” Three months before admission she learned her mother was pregnant and she began drinking heavily in order to “sleep at night.” During her heavy drinking, she began sleeping around in a variety of 1-night stands. Before admission, she reported feeling panicky and having the feeling like she was removed from her body and in a trance. At one point she claims she heard a voice telling her to jump off a bridge.
At admission to the hospital, Ms. Seeker appeared disheveled and frail. She was cooperative and coherent and looked forward to being free of her anxiety. She reported feelings of loneliness and inadequacy and brief periods of depression and anxiety since adolescence. She claimed that she was “just an empty shell that is transparent to everyone.”
Ms. Seeker’s parents divorced when she was three and she was raised by her grandmother who was an alcoholic. She had night terrors and had to sleep with her grandmother. She was sent to a boarding school when she was 6 years old when she reports she was sexually abused by a teacher. As an adolescent she had an active but unsatisfying sex life but her relationships with men would end abruptly after she became angry with them for disappointing her in some way. She could not establish a stable living arrangement with roommates with whom she would often become quite jealous and angry. She was living alone at the time of admission.
What is her diagnosis?
What are the symptoms that helped you make this diagnosis? What diagnostic criteria do they relate to?
What are two other possible diagnoses and why did you not choose them?
What is her prognosis?
Borderline Personality Disorder
Borderline Personality Disorder
Borderline personality disorder is a mental illness characterized by a continuous pattern of mood swings, variation in self-image and behavior. People with borderline disorder often result in impulsive actions, have problematic relationships and may experience episodes of depression, anxiety and intense anger that can last from a few hours to days (Gunderson et al., 2018).
Ms. Seeker is a medical assistant and 23 years of age. She was hospitalized for attempting to cut her wrists with a tin can, and she felt that there was no need for her admission. She has been drinking heavily and engaging in reckless sexual behavior in the last three months. She reported feelings of dissociation and suicidal ideation before her admission; she claimed she had a voice telling her to jump off a bridge. During examination, she reported feelings of loneliness and inadequacy, emptiness and periods of depression and anxiety that traces back to her adolescent years. She was raised by an alcoholic grandmother and was sexually abused as a child. She has a history of unstable relationships which often left her disappointed. Also, she has difficulty living with friends and often becomes jealous and angry.
The diagnosis for Ms. Seeker is borderline personality disorder. DSM-V defines borderline personality disorder as “a pervasive pattern of instability in interpersonal relationships, self-image, and emotion, as well as marked impulsivity beginning by early adulthood and present in a variety of contexts” (American Psychiatric Association, 2013). For diagnosis, at least five of the following symptoms should be present: frantic efforts to avoid real or imagined abandonment; a pattern of intense and unstable personal relationships, identity disturbance, impulsive behavior, recurrent suicidal behavior or self-harming, emotional stability, chronic feelings of emptiness, anger issues and transient stress or dissociative symptoms. Ms. Seeker exhibits six of these symptoms.
There are three possible diagnoses for MS. Seeker: borderline personality disorder, bipolar disorder, and schizophrenia. The first diagnosis is borderline personality disorder. She experiences the following symptoms associated with the disorder. A pattern of intense and unstable personal relationships; she had had several relationships but unsatisfying sex life often ending after she became angry with them for disappointing her in some way. Dissociative symptoms; she reported feeling like she was removed from her body and in a trance (American Psychiatric Association, 2013). Recurrent suicidal behavior or self-harming; she was admitted for attempting to slash her wrists with a tin can, and at one point she heard a voice telling her to jump off a bridge. Impulsive behavior; she engages in reckless sexual behavior and heavily drinking alcohol. Chronic feelings of emptiness; she claimed she was “just an empty shell that is transparent to everyone.” She was sexually abused as a child and was raised by an alcoholic grandmother both of which are risk factors that may con
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