Rule Out Explosive Disorder Case Study
Marshall is a 37 year old white male. He is a successful musical artist, but he has been having problems writing and developing his music. He expressed that his mind is either racing with a million thoughts at a time or it feels like he doesn’t even have a mind at all and it hurts to think. Marshall has not been feeling like his normal self for quite some time. He admits that he often becomes extremely angry without cause. Marshall has expressed that his anger is so strong that it feels like it could rip through his skin or cause him to explode. Marshall has a history of tumultuous relationships. He is estranged from his mother and has two failed marriages, to the same woman. In 2008, Marshall was arrested for Criminal Domestic Violence and
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admits that he just can’t control his anger. Marshall’s best friend was killed in 2006 during an altercation at a nightclub. Marshall feels like this was a turning point in his life. Marshall has been sleeping through the days and often takes sleeping pills to help him sleep longer. He also has a history of alcohol , marijuana, and prescription drugs, including Vicodin, Ambien, Valium and Methadone. Marshall was recently hospitalized for an apparent drug overdose and suicide attempt.
1. Referral Question and Source: Marshall was referred for counseling services by Detroit Medical Center upon his discharge for a drug overdose and suicide attempt. 2. Identifying Information: Marshall is a 37 year old white male and successful musical artist. 3. Presenting Problems: Attempted suicide, history of suicidal ideations, extreme anger with explosive outburst, history of substance abuse, relationship issues, and lack of focus and concentration.
4) Psychosocial History: Marshall Bruce Mathers III, A.K.A. Eminem, was born on October 17, 1972. Marshall is oldest of two children, raised in single parent household. Marshall’s father abandoned the family when Marshall was only a year old. He and his mother lived in a poverty stricken area of Warren, Michigan. Marshall struggled in school and was often truant. At age seventeen Marshall quit school all together. In 1991 Marshall’s uncle committed suicide by shooting himself in the head with a shotgun. Marshall was devastated by the lose of his uncle. Marshall has one biological daughter, Hailey Jade Scott, with his ex-wife Kim Scott Mathers. Marshall and Kim met in high school in 1989, starting their on and off again relationship. The couple married in 1999 and later divorced in 2001. They married again in 2006, to only get divorced again later that same year. Marshall and Kim remain connected. Marshall adopted Kim’s niece and youngest daughter.
5) Assessment and Evaluation:
6) Axis I: Bipolar I; Poly-substance Dependence Axis II: R/O Intermittent Explosive Disorder; R/O Antisocial Personality Axis III: None Axis IV: Relationship issues, legal troubles, Axis V: GAF
7) Rule Out Intermittent Explosive Disorder- Marshall has reported an excessive level of anger and has a history of aggressive and violent behaviors.
Rule Out Antisocial Personality- Marshall has a history of impulsivity, reckless disregard for himself and others and excessive irritability and aggression.
8) Etiology of Presenting Problems: Family history of mental illness is unknown, however Marshall claims that his mother suffers from Munchausen Syndrome. History of suicide in the family. History of substance use.
9) Treatment Goals: Marshall will reduce the thoughts of suicide, learn appropriate coping skills, and recognize patterns of behavior and triggers for relapse.
10) Treatment Suggestions: Cognitive Behavior Therapy and Mood-stabilizing medication can help control the symptoms of bipolar disorder. However, patients often need help and support to take medicine properly and to ensure that any episodes of mania and depression are treated as early as possible. Some people stop taking the medication as soon as they feel better or because they want to experience the productivity and creativity associated with mania. Although these early manic states may feel good, discontinuing medication may have very negative
consequences. Suicide is a very real risk during both mania and depression. Suicidal thoughts, ideas, and gestures in people with bipolar affective disorder require immediate emergency attention.
admits that he just can’t control his anger. Marshall’s best friend was killed in 2006 during an altercation at a nightclub. Marshall feels like this was a turning point in his life. Marshall has been sleeping through the days and often takes sleeping pills to help him sleep longer. He also has a history of alcohol , marijuana, and prescription drugs, including Vicodin, Ambien, Valium and Methadone. Marshall was recently hospitalized for an apparent drug overdose and suicide attempt.
1. Referral Question and Source: Marshall was referred for counseling services by Detroit Medical Center upon his discharge for a drug overdose and suicide attempt. 2. Identifying Information: Marshall is a 37 year old white male and successful musical artist. 3. Presenting Problems: Attempted suicide, history of suicidal ideations, extreme anger with explosive outburst, history of substance abuse, relationship issues, and lack of focus and concentration.
4) Psychosocial History: Marshall Bruce Mathers III, A.K.A. Eminem, was born on October 17, 1972. Marshall is oldest of two children, raised in single parent household. Marshall’s father abandoned the family when Marshall was only a year old. He and his mother lived in a poverty stricken area of Warren, Michigan. Marshall struggled in school and was often truant. At age seventeen Marshall quit school all together. In 1991 Marshall’s uncle committed suicide by shooting himself in the head with a shotgun. Marshall was devastated by the lose of his uncle. Marshall has one biological daughter, Hailey Jade Scott, with his ex-wife Kim Scott Mathers. Marshall and Kim met in high school in 1989, starting their on and off again relationship. The couple married in 1999 and later divorced in 2001. They married again in 2006, to only get divorced again later that same year. Marshall and Kim remain connected. Marshall adopted Kim’s niece and youngest daughter.
5) Assessment and Evaluation:
6) Axis I: Bipolar I; Poly-substance Dependence Axis II: R/O Intermittent Explosive Disorder; R/O Antisocial Personality Axis III: None Axis IV: Relationship issues, legal troubles, Axis V: GAF
7) Rule Out Intermittent Explosive Disorder- Marshall has reported an excessive level of anger and has a history of aggressive and violent behaviors.
Rule Out Antisocial Personality- Marshall has a history of impulsivity, reckless disregard for himself and others and excessive irritability and aggression.
8) Etiology of Presenting Problems: Family history of mental illness is unknown, however Marshall claims that his mother suffers from Munchausen Syndrome. History of suicide in the family. History of substance use.
9) Treatment Goals: Marshall will reduce the thoughts of suicide, learn appropriate coping skills, and recognize patterns of behavior and triggers for relapse.
10) Treatment Suggestions: Cognitive Behavior Therapy and Mood-stabilizing medication can help control the symptoms of bipolar disorder. However, patients often need help and support to take medicine properly and to ensure that any episodes of mania and depression are treated as early as possible. Some people stop taking the medication as soon as they feel better or because they want to experience the productivity and creativity associated with mania. Although these early manic states may feel good, discontinuing medication may have very negative
consequences. Suicide is a very real risk during both mania and depression. Suicidal thoughts, ideas, and gestures in people with bipolar affective disorder require immediate emergency attention.