ProfessionalGenre9Riaz

__**Patient Report**__ CASE REPORT Name: Michael Jackson Age: 25

Patient History: He was abused as a child, and felt lonely at such a young age. Meaning he was depressed for many years. The patient is displaying clear signs of depression. He is displaying severe sense of hopelessness and despair. He suffers from guilt and feeling worthless. The patient sleeping patterns have been affected by this he has now developed insomnia. He lost a significant amount of weight, more than 5% of his body weight in fewer than 2 months. Patient has reoccurring thoughts of suicide and death. Patient has no interest in communicating with people his own age, rather he's interested in communicating with children 12 years and younger. Depression does not run in the family. Prior to being seen in this clinic he has not been prescribed any medication for his condition. No exam tests have been tested on the patient. The patient has passed 2 depression assessments.

Discussion: Since the patient is dealing with clear signs of depression we will begin treatment. The patient has not been prescribed any medication. The patient at first didn't believe he was depressed; the clinic only works with voluntary patients. In order to move on with treatments and such we need the patient to accept that he/she is in fact depressed. After the patient acknowledged that he is depressed, we tried having him do activities he enjoyed. That failed. We asked his family members to always be supportive and appreciative of him. Usually being around happy people makes you happy. That failed. We asked his family members to take him to his favorite places, which failed. The symptoms worsened after that. We asked the family to monitor his eating and make sure hes eating to prevent more weight loss. The next treatment we tried on the patient was changes in nutrition, sleep, social support and stress reduction. When a patient changes their lifestyle, our hope is there outlook on life changes such as how they perceive the world. My prediction is that the patient has suffered with depression for many years without any help, that he has become accustomed with it. Its too familiar he doesn't know how to change. The activities did not work so the next step is to get the patient on medication. The medication will hopefully help the symptoms lessen or even disappear for periods of time throughout the day. We will have the patient continue with the lifestyle changes and the medication, hopefully both treatments together can effectively help the patient.

Conclusion: Michael will be put on medication for depression and insomnia to help effectively treat his depression. It will be over a 6 month period of time. My predictions are the lifestyle changes and the medication will definitely be a start to helping Michael.

__**Patient Analysis**__

Michael Jackson grew up in Gary, Indiana in a very strict household. He is the 7th child out of 9 children to parents Joe and Katherine Jackson. Michael's life is unusual to the average person. Michael was abused verbally and physically at as young as 5. He was abused with items like a belt, iron chords and anything in sight for Joe. The abusing continued and never lessened. Since Michael was in the spotlight at a young age he never had a childhood. Which was a big loss in his eyes, he would cry because Joe wouldn't allow him to do elementary things. Since Joe never let Michael live his childhood he never grew up in his mind. People would label this as the “Peter Pan Syndrome” meaning a man who never wants to grow up. In Michaels mind how could he grow up when he never fully lived his childhood. Joe damaged his son forever by making him grow up at such a young age. Psychologically when a child is abused at a young age they are bound to develop psychiatric problems. In this case Michael shows that he clearly developed severe psychiatric problems by becoming depressed. Basically he threw Michael into depressions arms by not letting him be a kid. Since Michael wasn't able to live his childhood to his way, this severely affected his relationships with people his own age. Michael was very lonely throughout his life, he never had anyone he can call his best friend. All Michael wanted to do was to get married and have kids so he can treat them with love and lots of care. Losing his childhood and not being loved by his father affected his life dearly. Psychologically when a child is suffering from feeling lonely they are almost guaranteed to be anti-social, which in Michaels case this is true. Growing up Michael suffered from maintaining and adult relationship.

Also to cope with losing his childhood Michael built the Neverland Ranch. This is Michaels custom built house that offers many different elementary things such as a movie theater, game rooms, train station and so much more. Michael would always have kids over so they can have fun and be happy. He mostly brought kids from the hospital since they were sick he would bring them over and let them have the time of their life. Unfortunately Michael was accused by two different families of molesting their children. This exacerbated Michael's feelings of having no one. Doing this to someone who is already dealing with depression is the worst possible thing you can do. This just made Michael feeling even lonelier; this confirmed he had no one in his life. Psychologically we need to socialize as human beings, we are social animals. Friendships are like food, we need them to survive. In this case Michael lost his food; everything in his kitchen was gone. When you don't have a social life you begin to fall apart mentally and physically. This affects the brain and once the brain is affected everything in your body is affected since all the nerves are in your brain. Which Michael has clearly shown his mental and physical state are not in a healthy state. A depressed person looks at a situation by thinking I have no one, what do I need to live for? When Michael was in his teen years, Joe would call him ugly. Joe would say Michael had a fat nose and he wasn't from his side of the family, he even commented on his pimples.

Michael then became very conscious and tried to hide his face as much as he could, it was hard since he was famous and was always in the spotlight. The verbal abuse continued which constantly made Michael sad and depressed. Psychologically verbal abuse is worse than physical abuse, because its more frequent. Calling him ugly made him believe he was ugly; this made him feel no one would love him. You gain a sense of worthlessness and you begin to think everything is your fault. So when Michael was getting abused he was thinking “oh its my fault I must have done something to make Joe hit me”. Emotional abuse is deeper than physical abuse. In Michael's case again he clearly shows signs of this as well. Since Michael was depressed most of his life, his weight was affected by that he was always rather skinny. Michael was so scared of his father that at the sight of him Michael would either faint or vomit, this could have played a big role on his weight as well. I spoke with my colleague about this who happens to be a Doctor. He confirms that this most likely played a big role on his weight because if he was constantly around his father, he was constantly vomiting. When you vomit your emptying your stomach which means he was losing weight. Psychologically emotional abuse goes hand in hand with weight loss, in Michael's case he is suffering from emotional abuse so therefore he is suffering from poor health as well.

Lastly the patient is suffering from insomnia. This is a sleeping disorder, where the patient cannot sleep or only sleep for 2 to 3 hours a night. Psychologically when someone suffers from insomnia they must be dealing with one or many of the following negative mood, fatigue, decreased quality of life, mood disturbance and increase in depression. In Michael's case he shows signs of all of the above. In order to effectively help Michael with the depression, he must change his lifestyle. The main changes he will have to make are nutrition, social support, sleep and stress reduction. Michael will have to eat a more healthy diet and he needs to gain some weight in order to be considered healthy. Social support again we will give this a try with a life coach, his family and myself. He will be given pills in order to help him get into a healthy sleep pattern. Stress reduction will be with meditation or things he enjoys to do such as singing. Michael will be medicated for depression and insomnia. His dosage will be 2 500mg pills of Selective serotonin reuptake inhibitors (SSRIs) a day, for depression. For insomnia he will need to take 1 500mg pill of Ambien every night before bed. This will continue for 6 months and hopefully effectively help Michael with his depression.

__**Depression Assessment**__ To complete this preliminary assessment use your courser to highlight the frequently with which you experience the following symptoms.

A total of 30 points is possible. Common Symptoms Never 0 Sometimes 1 Frequently 2 Always 3 I have a loss of appetite. Frequently I have a loss of sleep. Always I have a loss of energy. Frequently I have a problem with poor concentration. Always I have trouble making decisions. Always I have suicidal thoughts or gestures. Always I feel hopeless about my future. Always I feel worthless. Always I have feelings of guilt and low self esteem. Always I have lost interest or enjoyment in activities. Always Your Score: __28___

If your score is 1-10 Your score indicates that you are experiencing normal to mild depression. Often this is “situational” – related to a recent loss or disappointment. While therapy may not be required, short-term counseling can help you identify your feelings and come to greater peace and acceptance over time. Therapy can offer practical solutions to work more easily through these ups and downs. Self help books and resources are useful, particularly ones about grieving and loss. Medication assessment is rarely needed with this level of depression.

If your score is 11-20 Your score indicates that you are experiencing mild to moderate mood disturbance that is affecting your ability to rest and to resolve present and future problems. Sometimes this is “situational” but more often it is a mood disorder of longer duration that may have been triggered by a loss but has continued to get worse. Professional help at this point can increase your sense of resilience and self- worth, explore what contributes to your depression and restore your sense of hope. Medication assessment is useful to determine if your particular symptoms warrant anti-depressant medication; this level of depression can be treated without medication but it often takes a longer period of time.

If your score is 21-30 Your score indicates that you are experiencing a severe form of depression that makes life feel just too hard every day. Hopelessness seems like a reality, not a feeling, and the future looks dark and hopeless. Immediate professional help is needed -- severe depression is life- threatening and life-changing; it does not resolve without professional help. Assessment for anti-depressant medication, particularly if you are experiencing suicidal thoughts and/or severe loss of energy and appetite, to support daily functioning and recovery.

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