Vignette 5 - Assessing for Depression in a Mental Health Appointment

Summary

In the provided transcript, Tony is referred to a social worker by his medical provider due to symptoms of depression and anxiety. Tony admits to feeling angry and having a lack of energy, which has affected his interest in basketball and his academic performance. He reveals that his emotions have been tumultuous since his breakup two months ago, leading to thoughts of self-harm and a physical sensation of chest pain and increased heart rate. The conversation highlights the importance of addressing mental health and the impact of emotional distress on daily life.

Takeaways

• 🏥 Tony has been referred to a social worker by his medical provider due to concerns about his mental health.
• 🤔 Tony is initially unsure about what the social worker means by asking about his mood.
• 😔 Despite not feeling sad or depressed, Tony admits to feeling angry and wanting to fight someone.
• 🏀 Tony enjoys basketball but lacks the energy to play and has lost interest in school.
• 📉 His academic performance has declined, as he no longer completes his homework.
• 🍺 Tony occasionally drinks beer with friends, indicating potential substance use.
• 😡 Tony has been feeling this way for about two months, which coincides with his breakup with his girlfriend.
• 💔 The breakup has left Tony feeling angry and hurt, to the point where he experiences physical symptoms like chest pain and increased heart rate.
• 😨 Tony has had thoughts of self-harm and has expressed a lack of desire to be alive.
• 🧐 The social worker is trying to understand the depth of Tony's feelings and the impact of the breakup on his mental state.
• 🔍 The conversation highlights the importance of addressing mental health issues and the role of professionals in providing support.

Q & A

Why was Tony referred to a social worker by his medical provider?

Tony was referred to a social worker because his medical provider was concerned about symptoms of depression and anxiety that Tony reported during his physical exam.

What is Tony's initial response when asked about his mood?

Tony expresses uncertainty about what is meant by asking about his mood, indicating a possible lack of awareness or difficulty in identifying his emotional state.

Does Tony admit to feeling sad or depressed?

Tony does not admit to feeling sad or depressed, suggesting he may not recognize or is unwilling to acknowledge these feelings.

How does Tony describe his experience with crying?

Tony states that he doesn't really cry, which could imply a suppression of emotional expression or a coping mechanism.

Is Tony experiencing feelings of hopelessness?

Tony denies feeling hopeless, but this could be a defense mechanism or a lack of self-awareness regarding his emotional state.

What emotions does Tony admit to feeling?

Tony admits to feeling angry sometimes, indicating a possible expression of underlying emotional distress.

How does Tony's interest in basketball relate to his energy levels?

Tony mentions that he likes basketball but sometimes lacks the energy to play, suggesting that his energy levels fluctuate and are affected by his emotional state.

What has been the impact of Tony's emotional state on his school performance?

Tony's grades have been going down because he doesn't do his homework anymore, indicating a decline in motivation and engagement due to his emotional struggles.

Why does Tony say he doesn't do his homework anymore?

Tony attributes his lack of homework completion to a general dislike for school and difficulty getting up in the mornings, which may be symptoms of depression.

Does Tony engage in substance use, and if so, to what extent?

Tony admits to occasionally having a beer or two with friends, which could be a form of self-medication to cope with his emotional distress.

How long has Tony been experiencing these emotional difficulties?

Tony has been feeling this way for about 2 months, which coincides with the time since his breakup with his girlfriend.

What physical symptoms does Tony experience when thinking about his breakup?

Tony experiences a tight pain in his chest and an increased heart rate when thinking about his breakup, which are physical manifestations of his emotional turmoil.

What are Tony's thoughts about self-harm?

Tony admits to having thoughts about doing something to hurt himself, indicating a serious level of distress and a potential risk for self-harm.