Case Presentation – Pete Intake Date: September 2020 Identif ✓ Solved

CASE PRESENTATION – PETE Intake Date: September 2020 IDENTIFYING

CASE PRESENTATION – PETE

Intake Date: September 2020

IDENTIFYING/DEMOGRAPHIC DATA: This is a voluntary intake for this 28-year-old, single white male. Pete lives with his partner, Tyrone in Portsmouth. He has a bachelor’s degree in social work and is currently employed as an alcohol and drug counselor. He is Irish-American and Catholic. His partner is Native American.

CHIEF COMPLAINT/PRESENTING PROBLEM: “I don’t feel well lately. I’m really depressed.”

HISTORY OF PRESENT ILLNESS: Pete states he is feeling depressed. He has been sad for the past month. His live-in partner of 4 years is talking about ending the relationship because he wants to date others. Pete is concerned that his partner may already be cheating on him. He feels devastated and unable to cope with the loss. This was a complete shock to him. Since the discussion, he has not been able to sleep at night and feels tired during the day. He has a hard time going to work, and has called out sick. Up until the talk of breaking-up, he has never missed a day of work. When he does go to work he has a hard time concentrating and his job has suffered. There is a significant change in his eating patterns also. He has lost about 15 pounds in the past month. He becomes scared because he is having suicidal thoughts. He does not want to live without his partner. He believes if he was a better partner, he would not be talking about leaving him. He denies any suicidal attempts or plans.

PAST PSYCHIATRIC HISTORY: Pete sought counseling 5 years ago because of feelings of depression. His grandmother died whom he was very close to and three weeks later he went to see a counselor. He was sad all the time and had problems sleeping at night. He did not want to do anything and sat at home and cried. He believes his feelings then are similar to now, but this seems worse. He also lost 20 pounds in a few weeks at that time. He was given medication but doesn’t remember the name. He was in counseling for a little over three months and took the medication for six months.

SUBSTANCE USE HISTORY: Pete reports drinking socially until about one year ago when he started sensing Tyrone pulling away. His use increased from occasional drinks and beers to a more constant nightly behavior. Tyrone has had a few conversations with him about cutting down, and he has reduced drinking on several occasions. Tyrone said he is tired of competing with alcohol.

PAST MEDICAL HISTORY: Pete denies any significant medical problems. He reports recent stomach pains but has not gone to the doctor.

FAMILY HISTORY INCLUDING MEDICAL AND PSYCHIATRIC: Pete states while growing up he had a good relationship with his parents. His father was employed as an accountant, and mom stayed home and cared for the three children. Pete is the middle child with an older brother and younger sister. The siblings were close when young and have remained close as adults. He was much closer to his mother than father because his father worked a lot. Pete states his grandfather was alcoholic and died of cirrhosis of the liver. Pete denies any other substance use in the family. His sister received counseling for one year but is unsure why. His parents like his partner, and he fears telling them about the potential breakup because they may blame him. Pete has always done well in school. He has a bachelor’s degree in social work and has thought about law school but now cannot focus on that idea now. Pete has always had a lot of friends. He was very active in high school and college with academic activities. He has had no desire to talk to any of his friends since his partner began talking of breaking-up. He prefers to stay home by himself. This is his first serious relationship.

MENTAL STATUS EXAM: Pete is a casually dressed male who appears older than his stated age. He was restless during the interview. His affect was flat. His mood was depressed. His speech was hesitant and he spoke in a low voice. He denies any hallucinations or delusions. He admits to suicidal ideation but denies a plan. Pete is oriented to time, place, and person. His recent and remote memories were good. His judgement and insight were good. When asked about three wishes he replied, “to stop Tyrone from leaving, going back to school, and be happy always.”

Paper For Above Instructions

The case of Pete exemplifies the challenges faced in mental health and relationships, illustrating the complex interplay between mental health and interpersonal dynamics. At the core of Pete's experience lies a deep-seated depression triggered by relational turmoil, compounded by previous psychiatric issues. This paper aims to analyze Pete’s case through various lenses including the psychological impact of relationship stress, the significance of familial patterns, and the role of substance use.

Understanding Depression in the Context of Relationship Loss

Pete’s primary complaint of feeling “really depressed” underscores the emotional ramifications of potential relationship loss. Research reveals that relationship disturbances frequently result in significant psychological distress (Simon et al., 2019). As a social worker, Pete is expected to possess coping mechanisms and resilience; however, the emotional intensity of his situation may overwhelm even the most skilled professionals (Denton & McGregor, 2020).

In Pete’s case, the abrupt discussion of a breakup has catalyzed significant emotional and physical changes, including insomnia, loss of appetite, and suicidal ideation. These symptoms suggest a clinical level of depression, potentially aligning with the diagnostic criteria outlined in the DSM-5 (American Psychiatric Association, 2013). The literature emphasizes how interpersonal conflicts, particularly in intimate relationships, can exacerbate depressive symptoms (Kuehner, 2017).

Historical Context and Familial Influence

Examining Pete's past contributes to understanding his current mental health struggles. His history of depression tied to the loss of his grandmother suggests a vulnerability to emotional distress following relational losses. Additionally, familial patterns, such as his grandfather's alcoholism, likely inform Pete’s relationship with substances. Family history serves as a primary risk factor for both mental health disorders and substance use (Maguire et al., 2021). This connection becomes particularly salient when considering Pete's relationship with alcohol during his partner’s emotional withdrawal.

The Role of Substance Use

Substance use history reveals that Pete’s drinking escalated in response to Tyrone's withdrawal, serving as a maladaptive coping mechanism. Research indicates that individuals often use substances to regulate emotions during periods of distress (Boden et al., 2019). Tyrone’s observations regarding Pete’s drinking behavior reflect a concern not only for Pete's health but also for the relational dynamic. The recognition of substance use as a competitive force in their relationship aligns with existing studies that pinpoint the detrimental effects of substance use on interpersonal relationships (Fiorentine & Hill, 2016).

Social Support and Isolation

One alarming aspect of Pete’s case is his withdrawal from social support networks. Historically, he thrived in social settings, yet the looming breakup has led him to isolate from friends and family. This isolation can exacerbate feelings of depression and hopelessness, as social support plays a critical role in mental health resilience (Cohen & Wills, 1985). The avoidance of friendships may perpetuate the cycle of distress, trapping Pete in a vicious cycle of loneliness.

Intervention Strategies

Given the complexity of Pete’s situation, a multifaceted intervention approach is warranted. Cognitive-behavioral therapy (CBT) has been shown to be effective in treating depression by modifying negative thought patterns related to self-worth and interpersonal relationships (Hofmann et al., 2012). Additionally, engaging in couple’s therapy may provide a space for both partners to address their emotional needs and communication barriers. This form of therapy can foster understanding and potentially navigate the relational challenges that Pete faces with Tyrone.

Moreover, addressing substance use should be a priority. Integrating motivational interviewing techniques could enhance Pete’s motivation to engage in positive behavioral changes related to alcohol consumption. Encouraging him to reconnect with social supports, whether through peer support groups or reconnecting with friends, can alleviate some of the isolative tendencies influencing his mental health.

Conclusion

Pete's case demonstrates how deeply relational issues can impact mental health. The intersection of depression, substance use, familial influence, and social support encapsulates the multifaceted nature of psychological well-being. By employing professional interventions and fostering supportive networks, it may be possible to navigate the tumultuous emotional landscape that Pete currently faces. Recognizing the potential for recovery and resilience is key in supporting individuals like Pete through challenging times.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
• Boden, J. M., & Fergusson, D. M. (2019). Alcohol and depression: A review of the literature. Addiction Science & Clinical Practice, 14(1), 24. https://doi.org/10.1186/s13722-019-0145-y
• Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98(2), 310. https://doi.org/10.1037/0033-2909.98.2.310
• Denton, R., & McGregor, S. (2020). Understanding the effects of relationship dynamics on mental health. Journal of Couple & Relationship Therapy, 19(1), 83-101. https://doi.org/10.1080/15332691.2019.1591215
• Fiorentine, R., & Hill, M. (2016). Substance use and relationship functioning: Analyzing the effects of alcohol on significant relationships. Journal of Substance Abuse Treatment, 65, 25-31.
• Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T., & Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive Therapy and Research, 36(5), 427-440. https://doi.org/10.1007/s10608-012-9476-1
• Kuehner, C. (2017). Why Do Women Suffer from Depression More than Men? The Role of Gender-Related Factors. The Lancet Psychiatry, 4(2), 146-158. https://doi.org/10.1016/S2215-0366(16)30263-2
• Maguire, T., McCarthy, D., & O'Sullivan, L. (2021). The influence of family history on substance use disorders: A systematic review. Substance Use & Misuse, 56(6), 963-974. https://doi.org/10.1080/10826084.2020.1855008
• Simon, R. W., & Nath, L. E. (2019). The Role of Emotion in Reactions to Relationship Termination. Emotion, 19(8), 1193-1200. https://doi.org/10.1037/emo0000550