Vignette 5 - Assessing for Depression in a Mental Health Appointment

YMH Boston

22 May 201302:43

Summary

TLDRIn 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.

Outlines

00:00

😔 Mental Health Concerns and Emotional Struggles

The first paragraph introduces Tony, who has been referred to a social worker due to symptoms of depression and anxiety noted by his medical provider. The social worker begins an assessment by inquiring about Tony's mood and feelings. Tony expresses confusion about the question but admits to occasional anger and a lack of energy, which has affected his interest in activities like basketball and his school performance. His grades have dropped because he no longer completes his homework. Tony also discloses occasional alcohol use with friends. The conversation reveals that Tony has been struggling with these feelings for about two months, particularly since his breakup with his girlfriend, which has left him feeling angry and, at times, suicidal, experiencing physical symptoms like chest pain and increased heart rate.

Mindmap

Keywords

💡Depression

Depression is a mental health condition characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in activities. In the video, Tony's medical provider is concerned about symptoms of depression that he reported, which is a central theme as it leads to his referral to a social worker.

💡Anxiety

Anxiety refers to a sense of worry, unease, or nervousness about something with an uncertain outcome. It's a common condition that can accompany depression, as seen in the video where Tony's medical provider is concerned about his symptoms, indicating a possible dual diagnosis.

💡Mood

Mood is the emotional state or temper of an individual at a particular time. In the script, the social worker inquires about Tony's mood to assess his emotional well-being, which is a key aspect of understanding his mental health.

💡Hopelessness

Hopelessness is a feeling of having no hope or expectation of things improving, which is often associated with depression. Tony denies feeling hopeless directly, but his overall narrative suggests a sense of hopelessness regarding his situation.

💡Anger

Anger is an intense emotional response to a perceived provocation, hurt, or threat. Tony admits to feeling angry sometimes, which is a significant emotion to explore as it could be a symptom of his underlying mental health issues.

💡Energy

Energy, in the context of mental health, refers to the level of vitality and motivation one has. Tony mentions not having much energy, which affects his interest in activities like playing basketball, indicating a possible symptom of depression.

💡Interest

Interest is the feeling of wanting to know or learn about something or someone. Tony's lack of interest in things, including school, suggests a withdrawal from activities he once enjoyed, which is indicative of a change in his mental state.

💡School Performance

School performance refers to how well a student is doing academically. Tony's declining grades are a concern raised in the video, potentially linked to his mental health struggles, as he admits not doing his homework anymore.

💡Substance Use

Substance use involves the consumption of drugs or alcohol. Tony's occasional beer consumption with friends is mentioned, which could be a coping mechanism for his emotional distress, although it's not explicitly labeled as problematic in the script.

💡Breakup

A breakup is the end of a romantic relationship. Tony's breakup with his girlfriend is a significant event that he links to his emotional distress, suggesting it as a potential trigger for his current mental state.

💡Suicidal Ideation

Suicidal ideation refers to thoughts of engaging in behavior that would result in one's own death. Tony admits to having thoughts of not wanting to be alive, which is a critical point indicating the severity of his mental health crisis and the need for immediate support.

Highlights

Tony is referred to a social worker due to symptoms of depression and anxiety reported by his medical provider.

Tony admits to feeling angry sometimes, with a desire to fight someone.

Tony experiences low energy and disinterest in activities, including a decline in his passion for basketball.

Tony's school performance has declined, with grades dropping due to lack of homework completion.

Tony mentions occasional alcohol consumption with friends.

Tony has been feeling this way for about 2 months, starting after his breakup with his girlfriend.

Tony experiences intense anger and chest pain when thinking about his ex-girlfriend.

Tony admits to having thoughts of self-harm and not wanting to be alive.

The social worker identifies Tony's lack of understanding about what is meant by 'mood'.

Tony denies feeling sad, depressed, hopeless, or crying frequently.

Tony's interest in basketball remains but is inconsistent due to energy levels.

Tony's school performance decline is attributed to not doing homework and difficulty getting up in the morning.

Tony's feelings of anger are linked to the breakup and subsequent emotional turmoil.

The social worker probes deeper into Tony's feelings of anger and its triggers.

Tony's self-reported symptoms suggest a need for further mental health evaluation and support.

The conversation highlights the importance of addressing mental health in conjunction with physical health.