The clnical rotation for Caring for Clients with Mental Health Alterations allowed students to participate in the care of patients who suffer from mental illness. The following is a case study describing a patient I cared for at the Parthenon Pavillion.

             On September 16^th and 17^th, 2008, I was able to participate in the care of a patient who was diagnosed with bipolar depression. The patient will be addressed as B.H. throughout the case study.  B.H. was brought to the Parthenon Pavilion on September 11, 2008 by one of his good friends. He was a voluntary admission to the hospital. B.H. was admitted because he was having suicidal ideation, inability to function due to mood, severe impulsiveness, and co-morbid alcohol and drug abuse. The DSM-IV diagnosis criteria for B.H. was based on five axes. Axes I diagnosis for B.H. was bipolar affective disorder type II, and multiple drug use including cocaine and methamphetamine. Axes II was deferred. Axes III indicated migraines, ulcerative colitis, hypertension, Gastroesophageal reflux disease (GERD), and post testicular cancer. Axes IV was severe, and axes V was a global assessment functioning (GAF) of 25. A GAF of 25 indicates B.H.’s behavior is considerably influenced by hallucinations or delusions, a serious impairment in communications or judgment, or inability to function in all areas. He stated that he had a suicide plan to cut his wrist, and he was abusing methamphetamine and crack cocaine (B.H., personal communication, September 16^th, 2008). The reason he used drugs was because he wanted to remain in the manic stage of bipolar disorder. He was 5’10” and weighed 164 pounds. He stated that his religion was Christian.  His drug allergies were: Amitrex, Morphine, Nubain, Risperdal. He also had a food allergy, MSG. He is unemployed and is considered disabled. His past employment was in the Military where he was involved in the medical field. B.H. was recently separated from his wife and he has one child that is 20 months. He has no living will or durable power of attorney. B.H. grew up with his mother and father and he has 3 sisters.

            B.H. has a significant history of physical problems related to his depression. He has a history of testicular cancer. When I spoke with B.H. about how he felt when he had the testicular cancer, he said he was very depressed. He mentioned going through the chemo treatments, and the side effects of the chemo therapy was a terrible experience for him (B.H., personal communication, September 16^th, 2008).  On September 16^th he was talking to me about a lump on his neck that the doctor’s thought could possibly be cancer. He was very upset about the possible cancer diagnoses because he had testicular cancer in the past. When I spoke with him about the lump, his voice was low, he looked at the ground a lot, and he sighed often. He showed depression through his actions while he spoke with me.