Wednesday, July 28, 2010

Doing my own preparatory psych eval :)

So in preparation for my psych evaluation tomorrow, here is my own psych eval of myself:

Identification: Liz is a twenty-year old Caucasian female who came in today for a medication evaluation.

History of Present Illness: Liz has had an eating disorder since age 14 and was diagnosed with severe bulimia at age 16. She was in recovery for three years, before she relapsed in March. She also has a history of self-injury, beginning at age 13 and continuing today. The last time she self-injured was two weeks ago. She admits to suicidal ideation at times, but not at the current moment. She also describes anxiety and depression symptoms. She says that she is sad and lonely a lot of the time, especially late at night. She has really low self-esteem and says she hates herself a lot of the time. When asked what she liked about herself, she said that she likes her hair color and her organizational skills.
She also gets really anxious about trivial things. She says she can't watch sports or games, such as basketball or swimming, because she gets too anxious about who is going to win or if someone will get hurt. She worries a lot about her work and schoolwork. She is frequently anxious about what people think of her, and she is constantly self-monitoring.

Previous Psychiatric Experience: Liz has never seen a psychiatrist or received psychiatric medication before. She has received counseling in Oregon for her eating disorder when she was 16.

History of Abuse/Unusual Events in Childhood: Liz has a history of physical, emotional, and sexual abuse. She was physically and emotionally abused by her mother as a child. She was sexually abused by an older boyfriend when she was 16.

Pertinent Medical History: Liz has chronic Achilles tendinitis from being a dancer. She also has plantar fasciitis. These combined foot/ankle conditions cause limitations to her activity. She cannot stand up or walk around for extended periods of time, making things like shopping or taking walks difficult. She has seen a podiatrist and several physical therapists for this, and wears customized orthotics in her shoes almost daily.
Liz also has a history of migraines. She takes Excedrin Migraine, and that usually makes them go away. Additionally, she has frequent heartburn, probably caused by her bulimia. Recently she has started developing boils, which she is currently on antibiotics to prevent. Her primary care physician suspects that she may have Hidradenitis suppurativa, which may be to blame for the boils.

Family Mental Health History: Maternal mental health history is positive for depression, eating disorders, and bipolar disorder. Paternal mental health history is positive for eating disorders and depression.

Social History: Liz is currently in college and will be a junior in the fall. She is a good student who generally gets A's and B's in her classes. She is currently in a long-term relationship with a man her own age. She currently works at Innovative Counseling. During the school year, she is employed in the AV Media Services department at her college, as well as being an overnight host for prospective students and a tutor for learning disabled students. She is a high achiever. She is involved in Kappa Delta sorority and the Gay-Straight Alliance at her college. She considers herself to be Christian, but is not active in any particular church.

Substance Abuse History: Liz has used marjiuanna in the past, although is not currently using. She also uses alcohol, sometimes to excess, although she does not believe it to be a problem. She smokes occasionally.

Allergies: Liz has seasonal pollen allergies. She is not allergic to any medications that she knows of.

Current medications: Liz is currently taking birth control (Orthocyclen) and an antibiotic for boils.

Strengths and supports: Liz's support system includes her boyfriend, her family, her boyfriend's family, and her close friends (like you guys!!)

Diagnostic Impressions:

Axis I:            Eating Disorder NOS
                      Generalized Anxiety Disorder
                      Depressive Disorder NOS
Axis II:          Deferred
Axis III:        Chronic Achilles tendinitis, migraines, boils
Axis IV:        Moderate stressors
Axis V:         Current GAF: 55

Treatment Plan: I have no idea... some sort of medication, of course. Probably something like Lexapro or Prozac or maybe Topamax? Something. We'll see :) Maybe Alprazelam as needed.


Wish me luck tomorrow!! I hope it goes well :) Oh also, I want to mention that I'm a vegetarian, so that's why my food plan is devoid of meat.
I love you guys!! You're amazing :) Stay strong everyone <3


  1. Good luck and lots of happiness. I'll miss you're sweet comments but I'm glad you're getting better. Lots of love and support. <3

  2. Good luck!!!
    Lots of love!!!!

  3. Good luck. You are amazing, and I'm so happy you've chosen to recover <3

  4. Wow, this is amazing. Are you going to bring it with you to the evaluation? It seems to have everything in it. :)

  5. 0.0 Bloody hell that looks complicated!

    Hmm, I think beans and tofu have high protein content? You'd know more than me though, you being the veg-head and all :p

    Good luck for tomorrow <3 I'll be hugging you and holding your hand in spirit :)

  6. Use a backup birth control until 5 days after you finish the antibiotic. Atib. can reduce the effectiveness of the pill by more than 40% . Take care.

  7. OMG, I just had to do this for class. It was six pages.

  8. Good luck. Going on psych meds was a very difficult time for me. Not because the act itself was emotionally difficult, but because it took so long to find one that didn't have a bunch of bad side effects. (but the alprazelam I get to use "as needed" is nice, lol). Just be careful and be honest *which I'm sure you will* and be patient. It wasn't until the 6th medicine I tried where we found one that didn't make me batty or give me bad physical side effects. There is one out there that will work for you. Just be patient.
    PS, I'm a "Liz" too. It's the best name! :)

  9. good luck at everything girl, i know you can do it!
    Also, I just wanted to let you know that I'm also a kappa you know how much i support you. Love and AOT!
    --frenzy xX

  10. Reminds me a little of the case studies Greg had for the exam, and we had to diagnose.