Differential Diagnosis

[RanRoc]

A hypothetical scenario:
A woman in her mid-thirties has trouble sleeping, low energy, suicidal thoughts, feelings of hopelessness, crying spells, all for the last two years since she had brain surgery and found out that she has just a few years to live. She is currently unemployed, her husband just got out of jail but regularly cheats on her with his ex-wife. Also, she admits to purging and restricting her food intake to as little as a couple of bites of fruit a day...she has been doing this since early high school. She states that her doctors are aware of this and tell her to eat better. They have prescribed her anti-depressants, She wants to see a therapist for counseling to address her depression and sadness. How would you treat her, or what do you see as the most important thing to address?
-RY

[Dr. Adams]

Question is a bit complex to answer in this setting, but in effect she appears to be pathologically dependent and unquestionably self-defeating. The most important initial intervention would be to insure that she has proper nutrition (will eat) and often this requires hospitalization.

[RanRoc]

Hypothetically:
What if she refuses to get treatment for the eating disorder? Should a counselor refuse her treatment and encourage her to get medical attention? Or should the counselor address her presenting issues of depression, while still encouraging her to get medical attention?
-RY

[Dr. Adams]

I do not know a great deal about counselors and their level of responsibility or competency, but I would hope that such a person could form a contract with the patient so that it is seen as a biopsychosocial problem and treated accordingly.

[RanRoc]

agreed. Thank you.
-RY

[Dr. Adams]

Take the note you sent me and go to the Emergency Room of your closest hospital, and let them read it. From your message, you need hospital care not simply medication.

[filosofia@ni.sb]

i went to the hospital but they found out that there no need for hospitalization.

[filosofia@ni.sb]

i went to the hospital but they found out that there no need for hospitalization.ALSO OURS HOSPITALS LIKE THOSE FROM MIDDLE AGES.

[filosofia@ni.sb]

[
Also Ours Hospitals Like Those From Middle Ages.

[Dr. Adams]

There is no assistance that anyone can offer you over the internet other than to re-direct you back to doctors and hospitals in your area.

[filosofia@ni.sb]

i have question for you doctor?does my dose of drugs is tomuch for one gril of 23,80mgprozzaka,120mgmianserina,60mgdiazepama per day.i wondering if my iracional behaviour is made by too many pills.i am taking this those for year and a half,but my doctor said that i must be patient.before my illness i was very sexual active and,my husbend was comleing with me because of my sexual wishes,now i cannot have orgasm,i have no wish for sex and i am very sad about that

[Dr. Adams]

Several anti-depressants have the potential for sexual side effects. The dosage levels and similar concerns need to be managed by your doctor. If you are displeased with his care, you can consider other doctors in your community. Good luck to you.

[filosofia@ni.sb]

[
If I Take 1200mg Prozzak,840mg Mianserin,600mg Diazepam,shall I Die?for Howlong Must I Weit For Death?or If This Dose Canot Kill Me,if I Take With Alcohol What Will Be,and For How Long?please Answer Me I Have Already Made My Mind.i Am Just Asking For Help

[Dr. Adams]

Again: Your problems and concerns cannot be solved on the internet. You need to see doctors in your own country and impress upon them how badly you are feeling. Good luck.

[filosofia@ni.sb]

[
But I Only Have Question For You.it Is Simple Or You Are Not The Experct As Someone Believe

[Dr. Adams]

Best of luck to you.

[filosofia@ni.sb]

That Is Not My Answer.people Die Every Day.planet Will Be Released From One Parasito As Me

[lorinabrown]

I love your post. Keep up post and share this kind of valuable tips.
Thanks a lot.

[johnrembo09]

I like your post about Differential Diagnosis. It is very helpful and interesting for every one who want to know about all this thing. All of you have a share such kind of useful information.

[olenils]

nice thred. But i found some more infomastion.



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