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Case #1: Abby Thurmond is clearly suffering from Bulimia Nervosa. She seemingly meets all the criteria and is a prime candidate for the disease. Being from an urban area, such as Miami, has put her at a higher risk. The social learning and cultural ideas she is constantly exposed to may have played a role in the start and continuation of her disorder. Also, Abby is described as “single, independent, and devoted to her work. ” These characteristics may lead to perfectionism which is a common personality trait in those with Bulimia nervosa.
The fact that she is 42 and writing her first screenplay leads me to believe that she enjoys trying new things and is not afraid to do so. This novelty-seeking personality and behavior can contribute to the impulsivity of her binges. Also, it is known that eating disorders are always more prevalent among women. With this particular diagnosis, later onset is not uncommon. As stated, Abby has been struggling with this problem for 15 years, placing the onset at approximately age 27. This relapse was brought on by a bout of depression she was experiencing after the high of her latest success had worn off.
Against her better judgment and the knowledge she had obtained from Overeaters Anonymous, she allowed herself to spend an entire day surrounded by food at her friend’s wedding. In her emotionally vulnerable state and once alone, Abby began to binge. Within the five hours this continued, she experienced a sense of loss of control, trance-like state, anxiety of being found out, and then shame. This is the vicious cycle that takes place with binge eating. If the story ended here I would say she had binge eating disorder, but the presence of incessant exercising and smoking cigarettes to control her appetite lead me to a different disorder.
These behaviors are called compensatory and are not present in those with binge eating disorder but are in bulimia nervosa. Fortunately, Abbey does not purge or abuse laxatives/diuretics because these particular compensatory behaviors create significant damage to the body rather quickly. However, biking at night in dangerous places in the city may be equally life-threatening. Based on all the information given, my conclusion is as I previously stated a diagnosis of Bulimia Nervosa. Case 2: The information given about the male who is a freshman in college was limited. Only one night out with the guys was described.
I am unable to make a legitimate diagnosis based on only one event; I can merely speculate about what might be going on with him. This may have been the one and only time he has gone binge drinking or it could be a pattern. He certainly abused the substance by consuming ten glasses of beer. His extreme intoxication changed his behavior and psychological functioning by affecting his central nervous system. After drinking heavily, social problems began to transpire. He became aggressive and this would have developed into violence had the man he challenged agreed to fight.
When the man refused him, the depressant aspect of the alcohol became evident. His mood became sad and he appeared close to crying. The bartender grew annoyed by the man’s clumsiness caused by his impaired motor coordination. These are results of an increase in the release of the inhibitory neurotransmitter gamma amino butyric acid. The morning after he was slightly hung over, experiencing a headache, but was not experiencing withdrawals. I think he is just an average college kid that had too much to drink one night, but if he continues to drink this much he will then form a tolerance and a dependence. Case 3:
This Caucasian man in his mid-thirties is serving a prison sentence for??the crime of child molestation. His crimes can be traced back to the improper way his uneducated mother introduced him to sexual activity. His mother frightened him to the point that he believed that all heterosexual contact led to sexually transmitted diseases. This fear led him to form a sort of genophobia. This fear of sexual contact, instilled in this man led him down a path of unhealthy sexual practice and eventually to deviance. His mother was the root cause of this young man ceasing normal heterosexual activity at the age of twelve.
His mother obviously had an unhealthy relational history with men and instilled in her son that all men were “beasts. ” It is my opinion that this young boy likened himself to an animal and thus led to his experimentation in zoophilia. He was horrified by the thought of masturbation since in his mother’s eyes it was “nasty. “??When his peers discussed this sexual contact with animals he was apt to try this practice of bestiality??as a substitute for masturbation. From the ages of thirteen to eighteen, this young man engaged in coitus with cattle. Due to his upbringing, this may have actually seemed normal to him because he onsidered himself a “beast” as his own mother had told him. Later, the breakout of disease within the bovine community around him scared him away from contact with animals and subsequently led to yet another form of sexual perversion, pedophilia. This man had always had a heterosexual orientation and preferred the idea of human females, however, due to fear, did not act on these normal inclinations. When he was older and animals were no longer an option for meeting his sexual desires, he reasoned that prepubescent girls who were not yet sexually active would not have venereal diseases and would therefore be “safe” for him to engage with.
All of this resulted in this man becoming extremely mixed up and acting on his fantasies of sexual contact with young girls and thus making him a child molester. He was caught and will be spending a long time in prison. It is unfortunate case because had his mother not distorted reality so drastically at such a young, influential age, he may have lived a relatively normal life. Case 4: In this situation, a troubled teen named Danny was left unsupervised and later his older brother, Ray, found him intoxicated. The whereabouts of the parents are unknown.
It is reasonable to assume that there is neglect from the parents. Ray was already aware of Danny’s use of marijuana and underage drinking and smoking. Danny’s appearance seems rebellious by his display of drug paraphernalia, piercings, and the implications of his logo tee. The top four drugs used by youth in America are tobacco, alcohol, marijuana and inhalants. Teenagers often use inhalants because they are easily accessible and low cost. Many inhalants can be found around the house at no cost to the teen. Examples of such include: whipped cream cans, cleaning fluids, gasoline, paints, glue, freon, etc.
The symptoms that Danny presents with are clearly due to inhalants because they are different and more varied than with other drugs. The specific symptoms depend on the particular inhalant, and many different chemicals can be inhaled. In Danny’s case, his vision was blurred and double, he was crying, mumbling, had a short attention span, had slurred speech, a staggering gate, and vacillated between apathy and hostility. He was also experiencing involuntary rapid eye movement and tremors likely resulting from neurological problems caused by damage to the myelin sheath. His muscle weakness could be either a sign f withdrawal from another inhalant or a symptom of his latest use. The effects of inhalants usually last anywhere from a few minutes to a few hours. After 45 minutes the medical team observed some of the symptoms subsiding. The rash around his mouth and nose were a good indicator of what had occurred to cause his condition. When the toxicology screen came back positive for aromatic inhalants the doctor could be sure there was nothing else going on. Many teens experiment with drugs and then eventually stop. Whether Danny continues to use drugs regularly and becomes dependent or decides to give them up will be determined by multiple factors.
We are not given any information about his parents or extended family so we do not know biologically if he has a predisposition. We do know supervision and accountability are lacking in his environment, possibly lessening the consequences of his poor decision making. This may enable him to continue until it becomes a serious problem and permanent damage is done to his body. Case 5: As a result of his wife leaving him for another man and filing for divorce, this 43 year old man resorted to drinking large amounts of alcohol on a regular basis.
I would assume this was because he was experiencing a great deal of pain and had fallen into a majorly depressed state. Subsequently, he became an alcoholic which caused a great deal of functional impairment within his daily life. He often missed work causing him to lose many jobs. Due to the popularity of his trade he continued to find new work for a while. Unfortunately, in his current state, he appears to be jobless and without any money. Because he was unable to buy alcohol, he begun to experience severe withdrawal symptoms from his chronic heavy drinking. The first signs to appear were tremors, insomnia, confusion, and increased anxiety.
The neighbor noticed the man acting peculiar and called the man’s sister. When his sister arrived she immediately took him to the hospital. At that point, it had been three days since his last drink. Alcohol hallucinations are present in the most severe cases of withdrawal and begin within one to two days after stopping. During the exam, he started experiencing formication; he thought bugs were in the bed with him. Next, he went into full blown delirium tremens, including extreme disorientation, fever, and apprehension that may have caused an increase in his blood pressure. He was disoriented times two, to place and time.
Eventually he had intense hallucinations that are of all three types: auditory, visual, and tactile. The doctor’s efforts to test for Wernicke-Korsakoff syndrome and Wernicke’s encephalopathy were inconclusive because the patient was unable to cooperate. Later, the results from an electroencephalogram confirmed encephalopathy. This means permanent damage has been done to his brain and he may now be unable to regain full cognitive function and remain incapable of caring for himself for the rest life of his. Case 6: If Mr. A has to buy 3 cases of beer a week, he is consuming an average of 10 beers a day.
That is more than “a few beers. ” The fact that he is minimalizing it, lying, and in denial about the actual amount tells me there is a more serious problem than he is leading us to believe. He admits that he has been drinking since he was a teenager. Most likely within that amount of time, his tolerance has increased and is now very high. Conversely, the increase could have not been gradual and could be due to the recent rise is his stress level. Mr. A has experienced several major life-changing events compounding each other within a short period. First, his mother suffered from a major illness.
His father is now her main caregiver and it is taking a toll on his health. Mr. A is faced with the reality he may lose both his parents in the near future. This is a frightening thought and has made him very worrisome. Within this same year, he changed jobs. The description does not tell us why. Perhaps he found a better school or he could have been asked to leave. Then, he decides to commit adultery with a co-worker leading to the divorce from his wife of eleven years. The two of them had children together, complicating the situation further. Apparently, she still continues to make his life a living hell.
On top of everything else, Mr. A decides to marry his paramour making him the step father of yet another child. It is not surprising this man’s blood pressure is high. I believe he is correct in saying his tiredness and distractibility is not related entirely to his drinking problem. These characteristics I would associate with the magnitude of his responsibilities. Whatever the cause, he is regularly abusing alcohol. Driving while he is under the influence is a high risk choice that should always be avoided. After consuming the alcohol, he is obviously not thinking straight.
I would like to know more about what happened the one month he stopped drinking. There was no details given, but he may have experienced withdrawals if he is truly dependent on alcohol. Counseling is a step in the right direction. Hopefully he can learn to cope with his stress in healthier ways leading him to get along better with his new wife and have more energy to devote to his children. Case 7: Mr. Evans has an addictive personality. He has successfully given up alcohol and recently cigarettes but is still hooked on caffeine. During the week, he drinks four cups of coffee a day while at work.
In an effort to decrease his anxiety and trouble sleeping, Eric decides to refrain from coffee on the weekends. When the symptoms do not subside he goes for a psychiatric consultation to determine what is causing them. He has also been experiencing fatigue, loss of motivation, headaches, nausea, feeling unsociable, and difficulty concentrating. I think he is experiencing the effects of the residual caffeine in his system and the waning withdrawal symptoms from the nicotine. After one ceases from smoking, withdrawal symptoms can last as long as a month or more.
These symptoms may include all the ones he is currently complaining of. For example, the person may have a depressed mood, insomnia, anxiety, difficulty concentrating, and restlessness. On weekends he described worrying about his job. A degree of anxiety in his profession would be expected but there may be additional concerns that we are unaware of. Or he may be experiencing a mild anxiety disorder that is causing him to worry too much. In this case, it is likely that more than one of the possible explanations are happening simultaneously with another and are comorbid.
Case 8: This man was prescribed codeine five years ago after a back surgery. After abusing the pills by taking too many, he became addicted. Codeine is classified as an opioid and is highly addictive to begin with. After building a tolerance, he had to develop a circle of physicians to get the amount of pills needed to achieve the same effect. Following his recent hernia surgery, it became difficult for the doctor to manage his pain due to his high tolerance. His functioning has been impaired in his career and home life.
He has lost two jobs and his wife of eleven years divorced him. The physician referred him to a psychiatrist that will hopefully convince him to check himself into rehab. Withdrawal symptoms from these drugs are very intense. It is in the best of the patient that they be supervised when going through opoid withdrawals. The symptoms may last for one to three days, within this amount of time the addict will usually find more drugs to make the awful side effects go away. This is the reason many people never get fully free from this type of addiction.