Problem:
Samantha "Sam" Thompson is an 18-year-old high school senior, with PMH of Bipolar Disorder Type 1 since age 16, had one previous hospitalization for mood stabilization 8 months ago. She engaged in cognitive-behavioral therapy (CBT) and psychiatric care for mood stabilization. Past trials of medications
Include Abilify, which caused weight gain. She has been on Lithium 300 mg BID for 1 year. Her last lithium level three months ago was 0.6. She presents today with experiencing profound mood swings, with periods of feeling "gray," which she describes as an emotional state that exists between manic and depressive episodes. During these times, she expresses feelings of hopelessness and lethargy, and she struggles with sleep difficulties and decreased appetite, particularly noted during her depressive phases.
Sam attributes some of her emotional distress to the instability of her moods and reports a strong family support system that includes actively involved parents and siblings. She occasionally consumes alcohol at social gatherings and she denies drug use.
Sam has engaged in self-harm thoughts and behaviors, specifically mentioning an interest in cutting her leg with a box cutter from her parents' garage. This behavior was expressed as a desire to see blood as a way to feel something real, stating that it might provide her with a sense of relief or control over her emotional turmoil. She reports that she has cut herself approximately four times, the last being two months prior to this interview.
Additionally, Sam reveals that she has been thinking about suicide, describing these thoughts as an "option," and admits to having considered specific methods, including the use of the box cutter. Sam does currently have thoughts of suicide. She has been contemplating suicide in the past week and describes these thoughts as something comforting. While she has not acted on these thoughts, she expresses that they occur when she feels particularly down or anxious about her mood swings. Sam acknowledges that thoughts of her younger siblings, Ethan and Lily, discourage her from following through on any suicidal plans, as she does not want to cause them pain or trauma. She also recognizes that despite the severity of her feelings, she has some belief that her circumstances may change, stating, "I think it can get different." This acknowledgment suggests that she maintains a degree of hope for improvement, which is likely a contributing factor to why she is actively seeking help today.
Please humanize. Need Assignment Help?