Case study -Edward Essay

It was developed by his past experience from infancy up to present. The subject would feel depressed whenever he is experiencing paranoia and suspicion. This will lead for the subject to be deprived of sleep, lose his appetite and experience extreme sadness. He also experience feeling of hopelessness and worthlessness. When he was an infant, his father was always busy at work as a utility man. His mother is the only one who is always taking care of him. Although the subject was loved by his siblings, he still deeply longs for the love of a father; it is the main reason for the development of his impairment in interpersonal functioning. When the subject reaches his early childhood up to puberty, his longing for the love of a father is still with him. This longing for love of a father developed his hatred. He thinks that his father doesn’t love him because he is not spending so much time with him. There was an instance where he embarrassed his father in front of his friends by answering back without respect. The subject feels guilty after that incident. He knows that he should have not done that. And when he was in college, he was accused of being involved in a  fight between two fraternities because of his tattoo. This triggers his suspiciousness and paranoia. He thinks that people around him are talking about his involvement in that fight. In fact, he even thinks that some of his friends are NBI agent trying to spy on him. He becomes very depressed because of his anxiousness. He even experience visual and auditory hallucination. This affects his perception towards himself and the environment. As a result, his overall functioning became impaired by making him deviate from what he believes is real from unreal and right from wrong. Abnormal content of thought The patient’s content of thought was abnormal. It is deeply depressed and anxious. Because of his visual and auditory hallucinations, his paranoid ideation was developed for he believes that what he sees and what he hear is true. The patient has delusion of persecution. He would think that people around him are always talking about him. He even hears voices from television and radio talking about him. He thinks that people around him are planning something to destroy him. This resulted for the subject to became depressed and be emotionally unstable. Because of his paranoid ideation, the subject becomes very anxious about people around him. He thinks that vendors and door-to-door salespersons are NBI agents trying to get information about him. He even thinks that his friends, classmate and relatives are conspiring against him. The subject also has a delusion of grandeur. He thinks that he is very popular worldwide. He is also having a suicidal thought but is afraid in acting upon it. The patient is also having a feeling of hopelessness and worthlessness as he says â€Å"wala nang kwentang mabuhay†. He even feels that he has no allies and everyone is against him, he said that, â€Å"wala na kong kakampi†. This also triggers his impairment in overall functioning. Illogical form of thought The patient has a thought insertion. He is calling it â€Å"dagdag bawas†. He said that there were times that his thought were being taken away and then brought back. His form of thought was illogical. He thinks that people around him are spying and conspiring against him. He is having irrational suspicion about people around him due to his auditory hallucinations that  made him anxious. He is acting accordingly to his auditory hallucinations which are commanding him to do things. He would also rather hear a word which is out of context of what is being said to him or latter added in a word changing the meaning of the sentence. Distorted perception The patient’s perception was distorted; he would think that what he it was made of human flesh. He decided not to eat anymore because he believes that it will make him more of a sinner. He believes that he is an â€Å"aswang† and everything he ate was made up of human flesh. He decided to stop eating because he thinks that it will make him more of a sinner. He also believes that he deserves to die and acted upon it by slashing his wrist with a knife. He views himself differently far from what is real. This resulted for the subject to lose his appetite and loss his interest in things. He also believes that he is known internationally. He would also believe that people around him are conspiring against him to destroy him. This resulted for the patient to withdraw. Increasing his anxiety, and impaired his overall functioning. Mood and affect His mood was deeply depressed and anxious. It is due to his paranoid ideas about his friends and family conspiring against him. He even said that â€Å"wala na kong kakampi† because he thinks that everyone around him are destroying him. He even thinks that his family is spying on him too. He is preoccupied with that thought. His affect was constricted due to his lack of emotional reactivity. It is the result of his depression because he finds it hard to express his emotions and feelings. In fact, in his MSE report, there are no verbal outputs about his speech, thought process, thought content, judgment and insight, and reliability. Impaired sense of self The subject’s sense of self was impaired due to his unawareness of his physical and mental state, he believes that the problem is not in himself but in the environment, although he is somewhat right in that point considering the environmental factors that which have led to his impairment, but in reality the problem was inside himself, he is the only one who can help himself and of course the origin of his disease was his weak sense of  self due to his inability to fight it off, he easily believed his hallucinations and his distorted perception about people, things and his self, in other words he was the one who pushed himself to madness. He believed that he is an â€Å"aswang† making him to decide to stop eating. He also believes that he deserves to die and acted upon it by slashing his wrist with a knife. Altered volition The subject’s course of action was altered by his false beliefs about things around him. He stops on eating because he believes that he is an â€Å"aswang† and everything he ate was made out of human flesh. He also decided to withdraw due to his paranoid ideations about people around him. He viewed most of the people around him to be NBI agent spying on him. He even reacts accordingly to his auditory hallucinations which are commanding him to do things that are harmful to him. He also decided to kill himself by slashing his wrist with a knife because he believes that he deserves to die. Impaired interpersonal function It is first developed when the subject is still a child. His father is not always around him making him envious with other kids which have a good relationship with their father. This longing of fatherly love developed hatred towards his father. He even embarrassed his father in front of his friends by shouting and cursing at him. This incident made his relationship to his father more difficult. And when he was in college, he was mistakenly accused as one of the students who started the fraternity fight because of his tattoo. After that incident, gossip still continues about him being involved about the fight which is believed to be drug related. This made the subject to be very anxious about people around him. He thinks that his classmates are NBI agents in civilian trying to spy on him. Because of his paranoid ideations, his interpersonal activity decreased because he decided to withdraw. It made him depressed and loss his interest in things. Change in psychomotor function There was a drastic change in the patient’s psychomotor function after the incident of being mistakenly accused of being involved in a fight two  fraternities. His suspiciousness towards people around him is extreme to the point that he believes that even his family is conspiring against him. He experience slowing of movements described as â€Å"kilos parang zombie†. This is the result of his loss of appetite and interest in things. He is also having difficulty in initiating and maintaining sleep. It made him unhealthy and affected his psychomotor functions. As a result, his interpersonal relationship was affected because of his condition. He became depressed and decided to withdraw and isolate himself. This made the subject have low self esteem and feels inadequate. Depression Depressed or sad The subject’s depression was due to his past unhappiness. It may be the result of his guilt feelings about his relation to his father and to his brother’s business. He feels guilty about embarrassing his father in front of his friends by shouting and cursing at him. And the incident of being mistakenly accused of being related to a fraternity fight made him depressed. After that incident, gossip about him still continued and precipitated his illness. He became very anxious about people around him and made him preoccupied with his paranoid ideation. As a result, the subject loss his appetite and interest in things. His interpersonal relationship is also affected and his overall functioning became impaired. Guilt Feelings The subject’s guilt feelings are the result of his past unhappiness. When he was in high school, there was an incident where he embarrassed his father in front of his classmate by shouting and cursing to him. He feels guilty after it but he did not apologize. He also feels guilty to the closure of his brother-in-law’s electronic shop. He thinks that he is the reason why the business became bankrupt and felt guilty about it. This resulted for the subject to become depressed in feel self worthlessness. He thinks that he is good for nothing as the voices in his head telling him that he is â€Å"walang kwenta†. Feelings of worthlessness Because of his paranoid ideations, he becomes very anxious about people  around him. He started to think that everyone is against him and he has no allies. This made him think that it is not worth living and he deserves to die. There are even voices who is telling him derogatory remarks like, â€Å"walang kwenta†, â€Å"lapastangan† , â€Å"gago† , and â€Å"rapist† which made the subject made more less worthy of himself. His feeling of worthlessness triggers his suicidal thought. He acted upon it by cutting his wrist with a knife. Hopeless and helplessness The subject felt hopeless and helpless due to his paranoid ideations. He believes that his classmates are NBI agent in civilian trying to get information about him after he was accused of being involved in the fraternity fight. He thinks that everyone around him is against him. He also thinks that he has no allies left even his own family. He believes that his family is talking about him and saying that he is good for nothing. He was once heard saying â€Å"wala na kong kakampi†. He viewed people around him suspiciously. This worsened his depression and he feels more worthless, hopeless, and helpless and drove him to the idea of suicide. Feeling of inadequacy The subject has feeling of inadequacy because of lack of fatherly love. He feels envious to other kids who have a good relationship with their father. His feeling of inadequacy is also caused by his guilt feelings about his brother-in-law’s business closure. As a result, the subject feels worthless, hopeless, and helpless. There are voices in his head saying that he is â€Å"walang kwenta†. It made him feel that he is really good for nothing. He said that he has no allies left even his own family and he thinks that he deserves to die. This triggers the subject to commit suicide. Suicidal Ideation The subject’s suicidal ideation is due to his feeling of worthlessness, hopelessness, and helplessness. He thinks that everyone around him, even his family and relatives, are conspiring against him. He said that he has no allies left. He feels inadequate and he believes that he is good for nothing. He even heard voices telling him that he is â€Å"walang kwenta† and he  heard a voice calling him â€Å"Judas†. It made him depressed and he decided to commit suicide just the way Judas did. He hanged himself with a rope but he failed in doing so. The thought that he deserves to die trigger him to finally do his suicide attempt by cutting his wrist with a knife. Anxiety His anxiety was triggered after he was mistakenly accused of being involved in the fight of two fraternities. After that incident, gossip about his involvement continued. That is the time when the patient started to think that some of his classmates are NBI agents in civilian trying to get information and spy on him. He became very anxious about people around him. He is preoccupied with the thought of being watched by someone. He suspected even the vendors and door-to-door salesperson to be NBI agents. As a result, his social functioning was affected by his anxiety and paranoid ideations. Social Isolation and withdrawal The patient has a lot of anxiety and paranoid ideas around people around him. There is an incident where he is alone one night, he felt someone touching his ear and calling his name. This made him depressed and made him withdraw. He isolates himself because of the thought that he is being watched by people around him. He feels suspicious even to his family. He thinks that everyone is conspiring against him to destroy him. His feelings of inadequacy also reinforce his attitude of social isolation. He feels that he is good for nothing and he has no allies left even his own family. His delusion of persecution is the main reason of his social isolation and withdrawal. Low Self-esteem The subject has low self-esteem because of lack of fatherly love. He feels envious to other kids who have a good relationship with their father. His low self-esteem is also caused by his guilt feelings about his brother-in-law’s business closure. As a result, the subject feels worthless, hopeless, and helpless. There are voices in his head saying that he is â€Å"walang kwenta†. It made him feel that he is really good for nothing. He said that he has no allies left even his own family and he thinks that he deserves to die. This triggers the subject to commit suicide. His low self-esteem is also caused by his paranoid ideation and illogical thinking about people around him.