Week 4: Mood Disorders
Lori Sfakios
College of Nursing-PMHNP, Walden University
NRNP 6665: PMHNP Care Across the Lifespan I
Dr. Trace Yule
December 28, 2021
, 2
Subjective
Initials : P. P.
CC: I have a history of taking meds and stopping them. I don’t feel like I need them.”
HPI: Client is a 25-year-old Caucasian female that has been referred for a mental health
assessment. She reports history of depression, anxiety, and bipolar disorder, but is currently not
taking any medications. She reports being on a medication that began with an “L”and although it
helped, “it squashed me in creativity.” Client has history of four previous hospitalizations for
mental health treatment. Her first hospitalization was when she was a teenager and she had been
up for four to five days with no sleep and states “I think I may have been hearing things”. She
reports her mother had her admitted for mental health treatment. In 2017, she attempted suicide
by overdosing on Benadryl. Her most recent hospitalization was spring 2020 after being brought
to the emergency department by the police for dancing in a filed in her nightgown, playing the
guitar. She reports that “four to five times a year, I have these times when I don’t want to get out
of bed. I have no energy. I have no motivation to do anything. I can’t feel any interest in
creativity…..This is usually happening after I have been up for four to five days….Everyone
says I am depressed but I am not sure. It could be that I am exhausted from working so hard.”
She reports feeling energized and motivated when she has periods of creativity. She states “ I
love those times. Those are the reasons I don’t always take my medications….. I have lots of
energy to do a lot of things. I can go 4-5 days with very little sleep….My friends tell me I talk to
much and appear scattered”. She reports being permicuous during her creative episodes and
these episodes usually last about one week.
Psychiatric History
Hospitalizations -four times, most recent in the spring of 2020
Suicide attempt in 2017-overdose on Benadryl
Diagnosed with depression, anxiety, and biopolar
Medication Trials
Zoloft: “made me feel really high. I couldn’t sleep, my mind was racing”
Risperidone and Seroquel led to significant weight gain
Klonopin “Seems to slow me down”
“I just stopped taking a medication that began with an “L” helped but it squashed my
creativity”
Family Psychiatric/Substance Abuse
Lori Sfakios
College of Nursing-PMHNP, Walden University
NRNP 6665: PMHNP Care Across the Lifespan I
Dr. Trace Yule
December 28, 2021
, 2
Subjective
Initials : P. P.
CC: I have a history of taking meds and stopping them. I don’t feel like I need them.”
HPI: Client is a 25-year-old Caucasian female that has been referred for a mental health
assessment. She reports history of depression, anxiety, and bipolar disorder, but is currently not
taking any medications. She reports being on a medication that began with an “L”and although it
helped, “it squashed me in creativity.” Client has history of four previous hospitalizations for
mental health treatment. Her first hospitalization was when she was a teenager and she had been
up for four to five days with no sleep and states “I think I may have been hearing things”. She
reports her mother had her admitted for mental health treatment. In 2017, she attempted suicide
by overdosing on Benadryl. Her most recent hospitalization was spring 2020 after being brought
to the emergency department by the police for dancing in a filed in her nightgown, playing the
guitar. She reports that “four to five times a year, I have these times when I don’t want to get out
of bed. I have no energy. I have no motivation to do anything. I can’t feel any interest in
creativity…..This is usually happening after I have been up for four to five days….Everyone
says I am depressed but I am not sure. It could be that I am exhausted from working so hard.”
She reports feeling energized and motivated when she has periods of creativity. She states “ I
love those times. Those are the reasons I don’t always take my medications….. I have lots of
energy to do a lot of things. I can go 4-5 days with very little sleep….My friends tell me I talk to
much and appear scattered”. She reports being permicuous during her creative episodes and
these episodes usually last about one week.
Psychiatric History
Hospitalizations -four times, most recent in the spring of 2020
Suicide attempt in 2017-overdose on Benadryl
Diagnosed with depression, anxiety, and biopolar
Medication Trials
Zoloft: “made me feel really high. I couldn’t sleep, my mind was racing”
Risperidone and Seroquel led to significant weight gain
Klonopin “Seems to slow me down”
“I just stopped taking a medication that began with an “L” helped but it squashed my
creativity”
Family Psychiatric/Substance Abuse
