Gary Case Study
Mental health is a pivotal part of the functioning of an individual. It includes our psychological, social, and emotional well-being. As a result, it influences the way we approach situations, feels, and act (American Psychiatric Association, 2013). Also, it is crucial in our ability to handle stress and make important decisions in life. Mental health is significant in every stage of life that is from childhood to adult hood. A good mental health condition enhances our ability to have healthy relationships especially at later stages in life when one has to form and rely on these interactions. A dilapidating mental situation can, therefore, threaten various aspects of a person’s life ranging from his body health to their relationships (American Psychiatric Association, 2013). This paper preliminarily diagnoses Gary’s case and its significance in his current life situation as well as exploring possible remedies.
Predominantly, based on his description, Gary has multiple psychological and emotional problems. First, he seems to have a sleep-wake disorder per the sleep patterns described. Moreover, he has a form of the depressive disorder that appears to be triggering a comorbid of other of mental ailments like sexual dysfunction, mild anxiety disorder, and a form of Trauma- and Stressor-related disorders (American Psychiatric Association, 2013). These conclusions are primarily based on an assessment of his previously described functionality. Gary is an educated upper-middle class who seems to have worked hard to get to his current socio-economic class, indicating that he has had a good track record of productive functions. There are no health issues to trigger his declining mental wellbeing, and as a result, it is prudent to conclude stress arising from his economic and marital toll is the primary cause of his situation. Currently, he still appears productive, but has little to no satisfaction in life. Although there is a need for further sessions to assay the certainty of the analysis, the listed are the primary diagnosis.
There is an array of symptoms to ascertain the diagnosis. Stress takes an enormous toll, which in Gary’s case, is evident in the form of increased irritability and moodiness (American Psychiatric Association, 2013). Although his rapid weight gain can be as a result of his eating disorder, it could also be triggered by the stress. His sexual dysfunction is based the decreased libido although for a conclusive report on the same, we need months of observation. Symptoms of his anxiety disorder are the concrete anxiety and his reduced self-esteem (American Psychiatric Association, 2013). Though mild, the guilt arising from seeing his wife take on all those responsibilities could be a sign of Trauma- and Stressor-related disorders. Lastly, he has trouble sleeping, which is convincingly a symptom of sleep-wake disorder. Thus, the explained symptoms are the reasons for the diagnosis deducted earlier.
Stress is a way of the body to cope with the demands of life. In Gary’s situation, it is his internal conditioned reactions to his perceived external economic and social pressures that arise as thoughts and feelings eventually escape as unhealthy thought processes and actions (Good Therapy, 2017). The fundamental goal of his treatment reduces his stress levels and negative thinking processes. An effective treatment would be cognitive behavioral therapy. This technique should help mitigate his negative thought patterns that arise in stressful situations (Kennerley, Kirk & Westbrook, 2016). Emphasis on the cultivation of personal practices that relieve tension such as deep breathing, yoga, meditating, and crafting should significantly help him. Consequently, knowing his cause of stress, cognitive behavior therapy can help Gary to improve his outlook on life while reducing his stress levels.
Many factors can cause eating disorders. In the named patient’s case, it could be related to his stress. A reduction in the stress levels would, therefore, do a lot to repair his unhealthy eating patterns. Eating disorders have grave consequences on an individual if left untreated (American Psychiatric Association, 2013). Extensively, I would utilize three main approaches in his consumption condition to regain a sense of normalcy and stop his weight gain. These approaches are psychotherapy and family approach (NEDC, 2016). In psychotherapy, I would focus more on the thought process again, his motivations, and his relationships. Depending on his level of response, the various options are available, that is, cognitive behavior therapy and dialectical behavioral Tterapy (Kennerley, Kirk & Westbrook, 2016). Regarding the family approach, I would primarily involve the wife. Thus, a combination of a reduction in stress and therapy would help alleviate the problem.
The sexual dysfunction may not be as severe as it sounds. For an adequate diagnosis, at least six months and more exact criteria are specified by the DSM-5 regulations (American Psychiatric Association, 2013). I would treat the other symptoms before declaring Gary’s reduced libido a concern. Improvement in the other disorders may work to help him function better, sexually. Thus, the sexual dysfunction is not an emergency case until it proves itself a worry.
Anxiety and low self-esteem, on the other hand, is a serious problem. At the patient’s age and responsibilities, he cannot afford to have any form of anxiety. In my attempt to remove the problem, I would use three methods: Cognitive behavioral therapy (CBT), Mindfulness and Applied Relaxation, and Medication Therapy (NHS, 2016). The CBT method has a high level of proved efficacy in handling anxiety problems (Reinholt & Krogh, 2014). This approach would involve guiding Gary to a place where he identifies how his thoughts, behavior, and emotions interact with each other to bring out his anxiety. Progressively CBT will help him confront and question his negative and anxious thoughts. The Mindfulness and Applied Relaxation technique would require concentrating his mental energy on the present moment to acknowledge and accept his feelings. This process can be used to reduce anxiety stemming from fear of actual situations present in Gary. The last resort for his anxiety would be a medical prescription even though I would be reluctant until the preceding two approaches fail. Regarding raising his self-esteem, I would recommend a few personal practices such as being kinder to himself, challenging himself and learning to be assertive (NHS, 2017). Thus, his anxiety and esteem problems would be fixed using the explained approaches.
Gary’s guilty feelings also can be handled. The first step in doing so would understand that it is not his fault the economy is struggling and that the health complications with the wife are not his fault. Progressively this can be achieved with CBT method (Kennerley, Kirk & Westbrook, 2016). After a comprehensive treatment of this particular problem and the previously discussed comorbid issues, the various approaches should work towards a remission of the patient.
However, the feelings of guilt may persist in which case, I will treat them not as natural guilt, but as Toxic guilt. Normally, toxic guilt has no specific cause; it is a free floating feeling of something being wrong with a person’s life. In the patient’s case, the problem would be rooted in their subconscious because of either losing control of his life’s situation or his wife’s role in holding things together. Whichever of the two is the cause, the key is in understanding whether it is reparable or not. If it is losing control of his life, then the patient can be easily treated by showing them it is possible. Should the cause be his wife’s medical condition, an approach would involve reminding Gary that the condition was already pre-existing before everything else happened. In the end, toxic guilt may be as a product of accumulated guilt over the course of his 12 year marriage that have attached to his current perceived transgression. After a deeper exploration of the patient I should be able to identify the underlying problem in which case cognitive behavior therapy targeting the source of the guilt should work in eliminating it (Reinholt & Krogh, 2014). Furthermore, through Mindfulness and Applied Relaxation, we can explore the patient’s guilt.
The patient exhibits several strengths. First, the most important one is that he recognizes that he has a mental problem leading to his overall physical, emotional, professional, and personal status in decline. Past that, he has taken a few steps to regain control in his life, both financially and mentally, which include moving out of the home office to his office. The move can be interpreted as him creating independence in a time where he had felt very codependent. Having his employees around him can help raise his esteem. Also as a plan, he knows what he wants and is willing receive contribute to achieving it. The willingness on his part will make the various therapies easy and efficient. Moreover, he has not let the situation affect his children. Should, there be need to involve the family, they will form a stable support structure. He is an educated person, and thus his level of education might make him more open minded to techniques such a Mindfulness and Applied Relaxation. Lastly, he recognizes and appreciates the effort his wife has done for him and the family. Should the treatment process require the two to attend, Gary will be very cooperative. Consequently, the patient has multiple advantages that will be helpful in the course of the treatment process.
Apart from his advantages, Gary also has his weaknesses in almost equal measure. He has a hint of escapism. I would approach this mindset by showing him all he has to be thankful for and by building the courage in him to fight for it. The patient also seems to lack resolve in the way he handles various matters. This weakness could be as a result of his current esteem status. The said flaw can be fixed effectively by raising his firmness, assertion and learning to say no for instance to clients that drag on payments (NHS, 2017). Garry seems to have a week communication system with his wife based on fear and obligation. With a raised self-esteem I will make him face his fears with his wife and consequently establish a healthy form of communication. Also, I will encourage him to dedicate more time to her wife so that she doesn’t feel neglected in the relationship. Therefore, the guy has a few weaknesses which I will address for that reason.
Furthermore, for the sake of his treatment, I would include two homework assignments as part of the treatment plan. I would recommend that in addition to making time for his wife daily, Gary also sets a day aside every month to do something special and to engage with her. This activity should reduce the apparent gap between the couple while alleviating Gary’s feelings of guilt. The other exercise I would recommend is once every sixty days he stands up to that one client that is dragging their payments. This assignment will help boost his self-confidence while ensuring his business has a more consistent cash flow (NHS, 2017). Accordingly, when these tasks are achieved, they will be instrumental in regaining his control.
Other areas worth exploring over the course of our continued sessions also exist. These are Gary’s relationship with the extended family that is the in-laws in case there is pressure from that side. His social relationships are also potential associations to analyze. I would also explore his career goals given his current business situation. Moreover, a detailed analysis of all of the patient’s individuation-assertion relationships would be prudent. Here, I would explore the all the individual relationships are based on the patient’s assertion on his needs with respect to the desired personal growth. I would base this exploration specifically on the partner and the specificities missing for self-growth in Gary. Thus, I would not limit the assessment process to just Gary.
In essence, mental health is an important part of a person’s productivity and has a significant effect on our social, emotional and economic status. A declining mental condition can, therefore, have severe consequences on a person’s life. In the case study, the patient suffers from a comorbidity of disorders with stress being the main trigger. These disorders include depressive disorder, sleep wake disorder, sexual dysfunction, anxiety, and guilt associated PTSD. These conditions are however are presumed as a consequence of a preliminary diagnosis on the first session with the patient. He exhibits and describes symptoms consistent with the analysis made. These symptoms include insomnia, declining self-esteem, weight loss, moodiness, anxiety and low libido. Luckily all the diagnosed symptoms all can be treated. Cognitive Behavior Therapy is the recurrent remedial approach with slight deviations for each disorder. For instance some disorders like stress will require Mindfulness and Applied Relaxation. Despite his mental condition, the patient exhibits multiple exploitable strengths while he also has weaknesses to match. His strengths comprise of his acceptance to receive help, the value he places on his family and his intellect while his escapism, lack of reserve and lack of proper communication pose a threat.Over the course of treatment I would I assign two main tasks for him to do; both of which have and crucial role in his restoration. Moreover, I would not leave other aspects of his life to chance as I would explore a good number of them in the process. Thus, Gary’s case holds the promise of a healthy recovery.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Good Therapy (2017). Stress. Retrieved from http://www.goodtherapy.org/learn-about-therapy/issues/stress
Reinholt, N., & Krogh, J. (2014). Efficacy of trans diagnostic cognitive behavior therapy for anxiety disorders: A systematic review and meta-analysis of published outcome studies. Cognitive Behavior Therapy, 43(3), 171-184. Retrieved from http://dx.doi.org/10.1080/16506073.2014.897367
Kennerley, H., Kirk, J., & Westbrook, D. (2016). An introduction to cognitive behavior therapy: Skills and applications. Retrieved from https://books.google.co.ke/books?hl=en&lr=&id=tfhNDQAAQBAJ&oi=fnd&pg=PP1&dq=Cognitive+Behaviour+Theraphy&ots=n5O9mhSbXA&sig=FewWv7DlvHrGGQ3V592e78R1QgQ&redir_esc=y#v=onepage&q=Cognitive%20Behaviour%20Theraphy&f=false
NEDC. (2016). Treatment Approaches. Retrieved from http://www.nedc.com.au/treatment-approaches
NHS. (2016). Generalised anxiety disorder in adults – Treatment. Retrieved from http://www.nhs.uk/Conditions/Anxiety/Pages/Treatment.aspx
NHS. (2017).Raising low self-esteem. Retrieved from http://www.nhs.uk/Livewell/mentalhealth/Pages/Dealingwithlowself-esteem.aspx
