Nursing Essay on Martin’s Mental Health Journey

Martin’s Case Analysis

Introduction

There are hundreds of mental health issues reported daily all over the globe. According to the statistics, almost 13% of the world’s population suffers from a mental health disorder. The most common type of mental health issue is anxiety, affecting approximately 284 million people worldwide (Dattani, 2021).

The highest number of mental health issues are seen in USA, Columbia, Ukraine, and Netherlands, while Shangai and Italy have the lowest number of mental health issues (Wikipedia, 2021)

This essay will discuss the case of a 41-year-old man who suffered from paranoia, depression, distress, suicidal thoughts, and self-neglect. The study estimates that almost 2.3% to 4.4% people all over the world suffer from paranoia (clevelandclinic, 2017).

Other than this, the patient also suffered from depression, suicidal thoughts and self-neglect. Almost 3.8% of the population suffers from depression, among which 5.0% are adults and 5.7% are people older than 60 (WHO, 2021). Among them, a few seek medical assistance, however, a large population still doesn’t see a doctor.

Background

This essay will review the case of a 41-year old Martin, who has been suffering from mental health issues for more than 20 years. He complained of suffering from distress, depression, anxiety, paranoia, self-neglect, and suicidal thoughts. Moreover, he also complained of smelling foul smells frequently.

Besides different mental health issues, Martin also suffered from physical issues like asthma and weight gain. Besides, he also had chickenpox and mumps when he was young. Seeing these complaints, it can be observed that the patient requires medical assistance to make sure Martin starts feeling better.

To make sure he stays safe from suicidal thoughts and attempts, it is necessary that he is given medical assistance as soon as possible. A systematic and comprehensive for individuals with mental health problems will be conducted to make sure Martin’s condition is thoroughly evaluated.

Case Presentation and Discussion

This case is of a 41-year older man, Martin, who has been feeling distressed for the past 20 years. This shows that the patient has been suffering from long-term mental health issues. Long-term mental health issues can lead to several side effects.

Other than just depression, long-term mental health disorders can cause insomnia, paranoia, irritability, decreased libido, chronic fatigue, and several other issues. Moreover, if the depression remains untreated, it can result in suicidal thoughts and attempts as well (Joinaresearchstudy, 2020).

According to the patient, he had a happy childhood up until he was 15 years old. However, he started suffering from constant distress, which gradually increased, resulting in severe symptoms like depression, suicidal thoughts, paranoia, and self-neglect.

Systematic Nursing Assessment

It is appropriate to examine whether or not to treat depression. According to Regional Health Pathways recommendations, Martin has been experiencing symptoms for at least 20 years, and his PHQ-9 score of 21 suggests severe depression.

The decision to diagnose depression may be influenced by the need to confirm the patient’s symptoms, to spare the patient the expense of a repeat visit, or to fulfil diagnostic criteria (Goodfellow Unit, 2016).

Depression, on the other hand, is often misdiagnosed on the initial visit to the doctor. According to a meta-analysis, primary care doctors were 50 per cent more likely than specialists to identify depression incorrectly (a false positive) than they were to diagnose it correctly (a true positive).

The distinction between transient emotional distress and depression may be difficult to make; people who have a high PHQ-9 score but do not have depression may seem to be depressed.

Among the side effects, Martin experiences different foul smells frequently. Besides, he also experienced hearing voices – mainly neighbours shouting and abusing his mother and him. These are mainly the hallucinations and paranoia symptoms that developed over time because of chronic depression.

Paranoia is a symptom of a variety of mental health conditions. According to the studies, one who suffers from anxiety, depression, or poor self-esteem can be more prone to have paranoid thoughts – or to be more bothered by them – than you otherwise would be. This might be due to the fact that you are more on edge, worry a lot, or are more prone to perceive things in a negative light.

Some patients who suffer from severe clinical depression can also experience hallucinations and delusional thinking, which are indicators of psychosis, in addition to their symptoms of clinical depression. Psychotic depression is a kind of depression that occurs in conjunction with psychosis.

The exact origin of psychotic depression is still a mystery to researchers. It is well understood that depression has many distinct causes and may be triggered by a variety of factors. Stressful life events such as a death in the family, a divorce, a significant illness, or financial difficulties might be the catalyst for some.

Genes are most likely involved since severe depression may run in families; however, it is not understood why some individuals also acquire psychosis at the same time as depression. Many persons who suffer from psychotic depression had to deal with hardship as children, such as witnessing a horrific incident or being bullied.

In Martin’s case, he used to drink alcohol to get rid of his stress and worries. He also avoids going out with people, which indicates he is an introvert. Moreover, he constantly worries about what people would think about him – this reveals low self-esteem. His self-esteem issues were mainly because of chronic distress.

Martin’s family also has a history of physical and mental health issues. Martin’s father has reported having depression and insomnia. This means there is a possibility of genetic depression as well.

This can apparently be the reason why Martin also suffered from insomnia and disturbed sleeping patterns from time to time. To assess Martin’s sleeping pattern to determine whether he has insomnia or not, a series of questions need to be asked to make sure the patient is diagnosed properly.

Person-Centered Nursing Care

In the field of mental health treatment, the term “person-centeredness” has traditionally been understood to refer to a holistic approach that is characterized by respect for the individual and his or her unique experience and needs.

Although it has been shown that professionals may learn such abilities via training, demonstrating the influence on clinical outcomes has proven to be more challenging in randomized controlled studies too far (Santana, 2018).

According to current research, it is vital to recognise and address the amount of complexity within the healthcare system, which is preventing good implementation and results from person-centred mental health treatment (Edvardsson, 2015).

To achieve person-centeredness, we must modify the way services and organizations work and finally include families and communities in the delivery of healthcare services. To be really meaningful, the phrase “people-centeredness” must include not just healthcare but also health and social policy, as well as the larger societal backdrop. (Santana, 2018).

It has been shown that there is a link between mental and physical health in the following ways: Poor mental health is associated with chronic physical problems. A substantial proportion of those suffering from major mental health issues is also at risk of developing chronic physical diseases. People who suffer from chronic physical illnesses are more likely to suffer from poor mental health (Ross, 2015).

In addition to chronic physical problems, the social determinants of health have an influence on mental health as well. Some of the most important parts of prevention include boosting physical exercise, guaranteeing access to nutritional meals, maintaining appropriate income, and developing social inclusion and social support (Ross, 2015).

This opens the door to changes to strengthen protective variables while simultaneously reducing risk factors associated with elements of mental and physical health.

In order to establish effective methods for preventing co-occurring disorders and supporting people who are currently suffering from mental illnesses and chronic physical illnesses, it is necessary to first understand the relationships that exist between the mind and the body (Price, 2016).

Individuals suffering from mental illness are more concerned about their physical health, which is a rising problem throughout the globe. Already many decades ago, the British Medical Journal noted that there was an extremely substantial relationship between poor physical health and mental disease.

According to the findings, age-adjusted mortality rates were found to be two to four times higher than those of the general population, with life expectancy being reduced by 13–30 years. Psychiatric patients were shown to have a greater frequency of obesity, cardiovascular disease, viral infections, and respiratory tract disorders when compared to individuals who did not suffer from mental illness.

Unable to adhere to medical therapy or unwilling to seek medical assistance, a major mental disorder may contribute to a patient’s failing physical condition. As a consequence, a thorough physical examination of a mentally ill patient is required (Sanders, 2014).

This would offer a fuller picture of the patient’s overall general health and improve patient outcomes by identifying and documenting medical comorbidities that may affect mental treatment plans and results owing to the adverse effects of many psychotropic drugs. (Gask, 2012).

Patients’ mental and physical health conditions may be assessed completely by doctors, but resource restrictions, such as brief consultations in an acute hospital environment, and clinical problems, such as severe agitation, might make it difficult for physicians to perform a thorough assessment.

In addition, physicians who do not feel comfortable interacting with patients who are suffering from major mental illness may create a barrier to ensuring that proper medical treatment is administered. With this research, we hoped to learn more about how often patients admitted to an acute mental inpatient unit are evaluated in terms of medical screening (Santana, 2018).

In the case of Martin, the physical issues he’s feeling include breathing issues, headaches, and other physical issues as well. Thus, we can clearly say that mental health is directly related to physical issues as well.

Case Formulation

Martin was born in Leicester, where he lived with his parents and two sisters in a three-bedroomed house. His father worked as a driver, and his mother worked as a home help.

Martin’s condition has gotten worse over the past few years. Mainly because he didn’t get proper treatment; after the thorough assessment, we can conclude that Martin suffered from distress for 20 years which was also because of his low self-esteem.

Not only this, but Martin was also an introvert, which means he didn’t go out and socialize with a lot of people, which ultimately led him towards depression.

The patient also claimed to have suicidal thoughts and attempts. He accepted harming himself by cutting his arms and neck.

He said he was terribly sick and kept hearing voices – especially his neighbours hurling hatred at him or his mother. He also had paranoia, thinking others were talking about him and following him.

Other symptoms of his illness were melancholy, suicidal ideation, and self-neglect. He also detected a lot of odours.

He had asthma and gained weight. He’s had the mumps and chickenpox.

He stated he had attempted to kill himself and damage himself by slashing his neck and wrists. He said he had never hurt anybody else. He had a good childhood till he was 15. One of the finest parts of living with my family was visiting his grandparents.

The toughest part of living with his family was his father’s drug addiction. There were also several family feuds. My family has a history of major physical and mental health issues. In addition to his father’s sadness and sleeplessness, his mother’s heart issues, and his sister’s

He also stated he consumed alcohol to relieve his tension and anxiety. He avoided social engagements because he was afraid of what others may think of him. Martin preferred remaining at home and doing things alone since meeting new people is tough for him.

He is now single due to a lack of opportunities to meet new people. The voices he heard also made him feel alone and distant. He also has trouble sleeping.

He seldom worries about expenses, despite the fact he has trouble finding and keeping work.

Martin grew up in a three-bedroom house in Leicester with his parents and two sisters. His father was a trucker, and his mother a housekeeper.

Martin’s health has been worse over the last several years. Mainly because he didn’t receive good therapy, after the complete examination, we can infer that Martin suffered from anguish for 20 years which was also due to his poor self-esteem.

Not only this, but Martin was also an introvert, which means he didn’t go out and mingle with a lot of people, which finally led him towards despair.

The patient also spoke of having suicidal thoughts and attempts. He consented to injure himself by slashing the limbs and neck.

He indicated that he was quite sick and continually experiencing issues such as hearing voices – Particularly he heard the neighbours yelling obscenities at him or his mother. He also suffered paranoia, feeling that others were talking about him and following him around.

Other issues he has faced as a consequence of feeling sick include sadness, suicidal thoughts, and self-neglect. He also regularly detected various sorts of bad scents. He has suffered from many medical ailments, such as asthma and weight gain. He has also got chickenpox and mumps.

He added when he is feeling at his lowest, he has attempted to murder me and damage me by slashing my neck and wrists despite the fact that he claims to have never caused damage to anybody else.

He had a nice upbringing until he was 15 years old, when everything started to go wrong. Among the many benefits of living with my family were the opportunities to become part of a family and spend time with his grandparents.

Additionally, he mentioned that his father’s addiction to prescription pharmaceuticals was the most difficult aspect of living with his family. In addition, there were several disagreements among the family.

My family has a history of major physical and mental health issues, and this is not the first time. His father suffered from depression and sleeplessness, his mother suffered from heart issues, and his sister suffered from depression as well as his brother.

He also said that he drank alcohol on a regular basis since it helped him to get rid of his tension and problems. He disliked going out and meeting new people at social gatherings because he was concerned about what other people could think of him and his appearance.

Martin enjoys spending a lot of time at home and doing activities on his own since he finds it difficult to meet new people on a consistent basis. He is not presently engaged in a close physical and emotional relationship since he does not have enough possibilities to go out and meet new people.

He is single and does not have children. Because of the voices he heard, he also feels alienated and separated from the rest of the world. He also has trouble sleeping on a regular basis, according to him.

Conclusion

From the above discussion, we can see that the patient suffered from serious depression, because of which he had several other secondary behaviours as well. Martin faced depression due to reason that he omitted therapy and treatment sessions, which made his condition even worse.

Thus, we can say that Martin had depressive disorder, which needs to be treated with counselling and psychotherapy.

References

Clevelandclinic, 2017. Paranoid Personality Disorder: Symptoms, Diagnosis & Treatment. [Online]

Available at: https://my.clevelandclinic.org/health/diseases/9784-paranoid-personality-disorder#:%7E:text=This%20disorder%20often%20begins%20in,4.4%25%20of%20the%20general%20population.

[Accessed 12 01 2017].

Dattani, S., 2021. Mental Health. [Online]

Available at: https://ourworldindata.org/mental-health

[Accessed 20 08 2021].

Edvardsson, D., 2015. Notes on person-centred care: What it is and what it is not. Nordic Journal of Nursing Research, 35(2), pp. 65-66.

Gask, L. &. C. P., 2012. Person-centred mental health care: the challenge of implementation. Epidemiology and psychiatric sciences, 21(2), pp. 139-144.

Goodfellow Unit, 2016. Depression or distress?. [Online]

Available at: https://www.goodfellowunit.org/medcases/depression-or-distress

[Accessed 2016].

Joinaresearchstudy, 2020. Long Term Effects of Untreated Mental Illness. [Online]

Available at: https://joinaresearchstudy.com/2020/09/28/long-term-effects-of-untreated-mental-illness/

[Accessed 28 09 2020].

Price, B., 2016. Exploring person-centered care. Nursing Standard. 20(50) ed. s.l.: Nursing Standard.

Ross, H. T. A. M. &. C. A., 2015. Understanding and achieving person‐centred care: the nurse perspective. Journal of clinical nursing, 24(9-10), pp. 1223-1233.

Sanders, P. &. H. A., 2014. Counselling for depression: A person-centred and experiential approach to practice.

Santana, M. J. M. K. J. R. J. Z. S. Q. H. &. L. M., 2018. How to practice person‐centred care: A conceptual framework. Health Expectations, 21(2), pp. 429-440.

WHO, 2021. Depression. [Online]

Available at: https://www.who.int/news-room/fact-sheets/detail/depression

[Accessed 12 09 2021].

Wikipedia, 2021. Prevalence of mental disorders. [Online]

Available at: https://en.wikipedia.org/wiki/Prevalence_of_mental_disorders

[Accessed 24 12 2021].

Frequently Asked Questions