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Understanding the mind is a complex process on its own. Now add mental illnesses, chemical imbalances and more, that is a puzzle many aim to put together and unravel. With the study of Disco Di, this paper aims to understand the abnormal behaviors of a patient with mental disorders connecting it to the different diagnostic features, cultural impacts as well as social impacts, and the paradigms that can be used in the case of Disco Di. At the end of this paper the reader should understand what Disco Di was diagnosed with, the treatments she went through, her story, and the influences in her life leading her to be diagnosed the way she was diagnosed. In the great words of William James The greatest discovery of my generation is that human beings can alter their lives by altering their attitudes of mind. From a young age Disco Di did not have the best start, so, throughout this essay, the research will demonstrate the trends in abnormal psychology to understand at the end why Disco Di had the life she had.
Diagnostic Features/Differential Diagnosis
Disco Di was diagnosed with Major Depressive Disorder (MDD) and Borderline Personality Disorder (BPD) after several hospitalizations. With the information provided this seems to be the right diagnosis. Disco Di attempted suicide a couple of times landing her into these hospitalizations. The first attempt was through the severe slitting of her wrist and later attempting with a high dose of valium and alcohol. As shown in the text Disco Di experienced and showed diagnostic features of MDD and BPD. She first experienced MDD as those who experience MDD later tend to develop diagnostic features of BPD. Those with MDD tend to self-medicate with either drugs or alcohol, express themselves with anger, have distracting behaviors such as sexual hyperactivity, and even personal relationship withdrawals (BryantBedell & Waite, 2010). Similar to Disco Di who utilized alcohol intensively along with valium of around 40mg/ day which later increased to 80mg/ day with also the abuse of marijuana and hallucinogens. Disco Di was also extremely sexually hyperactive as she would go around sleeping with random men in their car. Said by Gobbler (2013), those who have MDD have suicidal thoughts, are easily agitated, as well as have negative thoughts. Disco Dis attempt at suicide, easy agitation from her mother messing up on certain things such as placing her food in a particular order are symptoms pointing to someone with MDD. MDD comes about with family dysfunction, death in the family, and unemployment (BryantBedell & Waite, 2010), with this knowledge it is not surprising that Disco Di was diagnosed with MDD has she lost her sister in a fatal car crash when she was 11 and her father left Disco Di at the age of 3. Apart from being diagnosed with MDD, Disco Di was also diagnosed with BPD. Said by Furnham et al., the hypothetical person with BPD was judged as least happy and second least successful at work, and having good personal relationships (pg. 318). With this definition Disco Di could not attain a job or even have good personal relationships, noted in the text Disco Dis best relationship was with her dog yet found that to be a bit boring. Borderline Personality Disorder is manifested by a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood (Fossati, 2014, pg. 20). As one can see BPD has similar symptoms as MDD which can cause it to be easily unnoticed yet, Disco Dis low self-image shown by her eating binges but the need to go on a diet and obsession with calories, her fear of abandonment shown through her needing to call her therapist many times a day and wanting 100% attention from her parents are little signs a therapist must pick up and distinguish from other mental disorders such as MDD. Those with BPD have an impulsive nature which Disco Di had at the age of 15 where she ran away with a 17-year-old boy; she craved excitement shown through drinking, dancing on tables and the impulse to leave with a different man every night. From these activities, Disco Di also had feelings of boredom, isolation, and even the feeling of being anxious which led to these behaviors and thoughts led by MDD. Due to the research provided the diagnosis of Major Depressive Disorder and Borderline personality is correct and well assigned.
Aside from MDD and BPD, one may see that Disco Di is also experiencing Obsessive-Compulsive Disorder (OCD) and Post Traumatic Stress Disorder (PTSD). Throughout the study of Disco Di, she was extremely concentrated on assuring that different things are arranged and placed in a particular order, so extreme that she would throw tantrums to the point where plates were broken and she had to be restrained by her father. A person with OCD is someone who repetitively has unwanted thoughts and even urges, they have compulsions of repetitive behaviors and thoughts (Hirschtritt, 2017). Similarly, Disco Di had urges to eat a certain amount of calories and have her food met a certain way mentioned above. Along with all this, she has repetitive negative behaviors such as going on binges of food and immediately crashing to go on a diet repetitively. Another disorder that the doctor failed to diagnose Disco Di is Post-Traumatic Stress Disorder (PTSD) which occurs when a traumatic event happens. In the case of Disco Di, her sister died when Disco Di was 11 years old. This is where the lack of interest, the use of hallucinogens, as well as estrangements from others (Gautam, 2017), as she was unable to make friends and unable to maintain a positive relationship with her dog began to start.
Cultural and Gender Factors
Culture shapes the diagnosis by making it harder to improve as western culture makes it hard for people with MDD and BPD to get help. Not getting help causes diagnostic features/symptoms to worsen and even lead to suicide. A study shown that those who are in the -isms groups, so, age, gender, ethnicity, education and more were less likely to seek help (Magaard et al., 2017), this study showed how many fail to seek help and places them in a situation that will worsen their situation, similarly to Disco Di, after several attempts of therapy her situation worsened as she would not seek help rather just rant about her family, not wanting to go anywhere and closing herself off. Another way culture shapes the diagnosis and the diagnostic features/ symptoms is that in western culture it is very rare for BPD to be diagnosed (Pascual et al., 2008). Due to this, it can cause maltreatments as well as confusion and worsening symptoms. Disco Dis diagnosis could have missed BPD or even confused it with another disorder because of the culture and lack of communication around BPD and resources provided for those with MDD. Nevertheless, culture is not the only factor that can shape someones diagnosis and diagnosis feature. Gender shapes the diagnosis and diagnosis features as women are seen to be more susceptible to MDD. A study found that women are more prevalent in the somatic and atypical subtype of depression (Delisle, 2012). This study demonstrates that if you are a woman you are more likely to be depressed as well as feel the symptoms more than a male; not to say men do not feel depressive symptoms. With this knowledge, one can see Disco Di has a better chance of having MDD and feeling the way she felt so strongly due to her gender. Gender was able to shape the number of symptoms and the susceptibility of MDD.
Finally, the social environment encompasses both gender and culture, it shapes the diagnosis as one’s environment such as peers and family can influence someone’s behavior, knowledge, and thoughts. The culture of their environment through social media can harm the way they view themselves and the way gender roles are portrayed also influences such diagnosis and how someones point of view might lead to a certain diagnosis. For example, Disco Dis peers were negative got her doing drugs and drinking which later on was an addiction to suppress MDD and BPD which then after was the aid for her suicide attempt. Her environment has been negative since she lost her sister who they had strong connections with along with her dad leaving her, it is easy to feel abandoned developing symptoms of MDD and BPD. The social environment is very crucial for someone’s development and growth with their mental state, physical state, and even emotional state which Disco Di did not have very positive social environments around her which could have prolonged her progress in therapy.
Paradigm/Treatment Methods
When looking at Disco Dis case the cognitive behavioral paradigm would be the best to examine her nature of behavior. The cognitive behavior paradigm is a 20th-century paradigm that is used to release mental stress. Said by Jane Milton (2001) a patient is trained to recognize and modify the maladaptive, conscious thinking and beliefs that are, it is argued, maintaining his or her problems and distress (pg. 434). In Disco Dis situation to train her to cognitively understand and learn her emotions through writings, to help her recognize negative automatic thoughts, and later on challenging her logic and reality-testing of thoughts (Milton, 2001) can aid in helping her find the motivation to do a task as well as understanding the thoughts and feelings that she feels, it helps her distinguish her reality from her thoughts and deescalate a situation she might face leaving her feeling as if it is not her fault, as well as, leave her distressed so in return, it can help her leave the drugs and alcohol alone to calm herself down. It examines the environmental impacts that surround her life and can filter out the negative ones which one can see that her environment played a big part in her changes and development. Due to her situation, the best paradigm to examine Disco Di is CBT.
Disco Di was diagnosed with MDD and BPD. If she was just diagnosed with MDD the best treatment would be the biological treatment of antidepressants, but, since she was diagnosed with both, a treatment that can be beneficial is psychotherapy. Psychotherapy helps those with BPD which ultimately lifts those with depressive symptoms from MDD. It forces the patient to talk and reflect on the emotions felt. In Psychotherapy specifically behavioral cognitive therapy can help Disco Di manage her thoughts as they can be reflected on her actions, manage distress, learn skills to cope with strong emotions, as well as, open the mind of Disco Di to better understand her behaviors and why she is thinking the way she does (Salters-Pedneault, 2020). Many would suggest that Disco Di should also pair antidepressants with psychotherapy but, because of her history with drugs and utilizing them as an attempt to suicide it is not recommended as there is much different psychotherapy she can take part in to soothe her depression and anxiety from MDD and BPD.
References
- BryantBedell, W. (2010). Understanding major depressive disorder among middleaged African American men. Journal of Advanced Nursing, 66(9), 20502060. https://doi.org/10.1111/j.1365-2648.2010.05345.x
- Delisle, B. (2012). Revisiting Gender Differences in Somatic Symptoms of Depression: Much Ado about Nothing? PloS One, 7(2), e32490e32490. https://doi.org/10.1371/journal.pone.0032490
- Fossati, A. (2014). Borderline Personality Disorder in Adolescence: Phenomenology and Construct Validity. In Handbook of Borderline Personality Disorder in Children and Adolescents (pp. 1934). Springer New York. https://doi.org/10.1007/978-1-4939-0591-1_3
- Furnham, F. (2015). Mental health literacy and borderline personality disorder (BPD): what do the public make of those with BPD? Social Psychiatry and Psychiatric Epidemiology, 50(2), 317324. https://doi.org/10.1007/s00127-014-0936-7
- Gautam, J. (2017). Clinical Practice Guidelines for the Management of Generalized Anxiety Disorder (GAD) and Panic Disorder (PD). Indian Journal of Psychiatry, 59(5), 6773. https://doi.org/10.4103/0019-5545.196975
- Grobler, G. (2013). Major depressive disorder. South African Journal of Psychiatry, 19(3), 157. https://link.gale.com/apps/doc/A343258862/AONE?u=yorku_main&sid=AONE&xid=bff6ee51
- Hirschtritt, B. (2017). Obsessive-Compulsive Disorder: Advances in Diagnosis and Treatment. JAMA: The Journal of the American Medical Association, 317(13), 13581367. https://doi.org/10.1001/jama.2017.2200
- Magaard, S. (2017). Factors associated with help-seeking behavior among individuals with major depression: A systematic review. PloS One, 12(5), e0176730e0176730. https://doi.org/10.1371/journal.pone.0176730
- Pascual, M. (2008). Immigrants and borderline personality disorder at a psychiatric emergency service. British Journal of Psychiatry, 193(6), 471476. https://doi.org/10.1192/bjp.bp.107.03820
- Salters-Pedneault, K., PhD. (2020). Borderline Personality Disorder Treatment Psychotherapy, Medications, Hospitalization, and Self-Help. Verywellmind. Retrieved from https://www.verywellmind.com/borderline-personality-disorder-treatment-425451
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