Nursing Case Study: Agoraphobia And Borderline Personality Disorder

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Ms. C is a 26-year-old single woman studying in computer engineering at Concordia University. She has been living in Montreal with her mother for the past 6 years. She was diagnosed with major depression and post-traumatic stress disorder in January 2015. Agoraphobia and borderline personality disorder traits were later added to her diagnosis. The patient has a history of suicide attempts and self-mutilation. She has been cutting her forearms since the age of 10 until recently. She states that this is triggered by anger towards others and towards herself. The patient has admitted to attempting suicide twice: in December 2014 she took 30 Tylenol pills and in September 2015 she overdosed on 60 Ativan pills. She was not hospitalized in both cases. …show more content…
Her uncle suffered from major depression and committed suicide three years ago at the age of 39 by hanging himself (Refer to Appendix A: Genogram and Appendix B: Ecomap).
(2) Strengths, Deficits, Risks, and Resources
Strengths
Patient states that even though she is having trouble concentrating at school and sometimes skips class, it is the only thing keeping her out of bed. She sees this as something positive because it helps her distract herself from her thoughts and depression. The patient has passed all her classes since her diagnosis of major depression and PTSD.
Also, Ms. C does not consume any drugs, cigarettes, or alcohol and she is compliant with her treatment plan, which includes medication and therapy. She comes to her appointments on time and verbalizes her feelings.
Deficits
• Patient views her lack of support system as her biggest
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Patient has a history of suicide attempts and self-mutilation. She states that her acts are often impulsive and she does not have control over her thoughts and actions. She often resorts to self-mutilation or self-medicating with large amounts of medication to numb her pain. When asked what else she can do to deal with her pain patient states “I don 't know”.
• Patient appears to lack insight regarding her illness.
She is unable to associate her behaviors with her illness. She constantly denies that she has a history of depression, however, her description of her past is very consistent with her present behaviors (self-mutilation, isolation, sadness, lack of motivation, self-conflict). The patient also doesn’t understand how therapy and improving problem-solving skills can help her. However, despite her lack of knowledge she is still compliant with her treatment and makes the effort to show up to her therapy sessions.
Risks
Patient is at risk for suicide related to depression and poor coping skills.

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