Case Presentation Minji 민지 Intake Date July 6, 2019 Identify

Case Presentation Minji 민지intake Date July 6 2019identifyingdem

CASE PRESENTATION – Minji - 민지 INTAKE DATE: July 6, 2019 IDENTIFYING/DEMOGRAPHIC DATA: Minji is 48-year-old, married, Korean female. Minji immigrated from South Korea 28 years ago with her new husband. They have 4 children who are all currently out of the house. Minji lives in San Francisco. CHIEF COMPLAINT/PRESENTING PROBLEM: Minji presented to the emergency room reporting that she had overdosed on a handful of antihistamines shortly before she arrived. She described her problems as having started 2 months earlier, soon after her husband unexpectedly requested a divorce. She felt betrayed after having devoted much of her 28-year marriage to being a wife, mother, and homemaker. After medically clearing Minji, the hospital referred her for outpatient treatment. HISTORY OF PRESENT ILLNESS: Minji reports being sad and tearful at times, and she occasionally has difficulty sleeping. There are no vegetative symptoms. She felt desperate and suicidal after she realized that “he no longer loved me, this is not supposed to happen in my culture.” PAST PSYCHIATRIC HISTORY: Minji reports no previous psychiatric difficulties. SUBSTANCE USE HISTORY: Minji denies any drug or alcohol use. PAST MEDICAL HISTORY: Minji reports being in good health. She has not had any major illnesses. CURRENT FAMILY ISSUES AND DYNAMICS: Minji loves being a wife and mother. Her family is “her world.” She enjoys time with family and friends. Minji’s childhood was unremarkable. She married her husband in South Korea and he immediately was offered a job in the United States working in technology so they immigrated to the U.S. The move was challenging at first since she did not speak the language but once the children started to be born she acculturated to the American way. She has a variety of friends and accommodated her husband to be successful in his career. She was involved in many activities at the children’s school where she met a wide friendship circle. She reported no particular difficulties in her marriage. Her mood has varied these past two months, she admitted to anxiety and depression. MENTAL STATUS EXAM: Minji is a well-dressed woman who looks her stated age. Her mood is depressed, and she lacks eye contact. Her affect is anxious. Motor activity is appropriate. Speech is clear. Thoughts are logical and organized. There is no evidence of delusions or hallucinations. On formal mental status examination, Minji is found to be oriented to three spheres. When asked how she sees her future she responded “I need to come to terms with the possibility of life after divorce and need to explore my best options under the circumstances.”

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The case of Minji illustrates the profound psychological impact that major life changes, such as divorce, can have on an individual’s mental health, particularly within the context of cultural and personal identity. Minji’s presentation highlights how emotional distress, when unaddressed, may lead to self-harm behaviors and necessitate emergency intervention. This case exemplifies the importance of comprehensive psychiatric assessment and culturally sensitive care tailored to the unique needs and backgrounds of patients.

Minji, a 48-year-old Korean woman residing in San Francisco, demonstrates the classic features of depression compounded by situational stressors. Her presentation with overdose of antihistamines, following her husband's request for divorce, underscores the critical need for timely mental health intervention in response to acute suicidal ideation. The fact that her depressive episodes are recent and tied closely to her familial disruption highlights the importance of assessing recent life events and their influence on mental health.

The psychological impact of immigration is an important facet of Minji’s case. Having immigrated from South Korea 28 years prior, she initially experienced challenges with language and cultural adaptation. Despite her integration and social involvement in her local community, the sudden marital upheaval appears to have rekindled feelings of cultural expectations and personal failure, contributing to her emotional distress. Racial and cultural identity issues often influence the presentation and management of mental health conditions among immigrant populations (Kirmayer et al., 2011).

Her mental status examination reveals a woman who is well-oriented and able to maintain logical thought processes, yet her affective state is profoundly impacted. Her depressed mood, lack of eye contact, and anxious affect indicate significant emotional distress. Notably, her absence of psychotic features such as delusions and hallucinations suggests her symptoms are primarily mood-related and stimulated by her current life crisis.

Minji’s case also underscores the critical role of culturally sensitive mental health care. As a woman from a collectivist culture, her identity is deeply rooted in her familial roles, and her distress is intertwined with her cultural expectations of marital stability and gender roles. Her statement about needing to come to terms with life after divorce signifies her active engagement in processing her grief and uncertainty. Culturally competent therapy can support her in navigating these complex emotions, helping her reconcile her cultural identity with her current circumstances.

Interventions like psychotherapy, particularly modalities such as cognitive-behavioral therapy (CBT), can be effective in addressing her feelings of depression, anxiety, and suicidal ideation. Additionally, social support and community resources tailored to immigrant women can bolster her recovery process. In some cases, pharmacotherapy may be considered if depressive symptoms persist or escalate, bearing in mind potential cultural considerations and her personal preferences.

Ultimately, Minji’s case illustrates the importance of integrating mental health services with culturally informed practices. Healthcare providers must recognize the influence of socio-cultural factors, immigration experiences, and individual resilience in developing effective treatment plans. As she explores her options for the future, ongoing mental health support can help her rebuild her sense of self and stability amidst her challenging circumstances.

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