Study 5 Patient Name: Kayla Richardson Gender: Female Date of
I need help identifying the protective and risk factors what would they be? CASE #6 – JEROME Jerome is 5’10, 125 pound, 32-year-old, mixed-race, gay, male who reports he has an “unhealthy relationship with food.” Jerome has been an accountant since he graduated college. He often undereats but on occasion will overeat or eat unhealthily when he is stressed. For example, around tax time if he walks into the breakroom, he will eat 2 donuts because he is super stressed, when he typically wouldn’t eat at all while at work. He reports that he often finds himself obsessing about his weight and wishing for a leaner body. In addition to eating concerns, over the last two-three years he has also been having a continuous battle with “overwhelming sadness,” so much so that it impacts “my ability to concentrate at work.” For example, he noted “I will sometimes miss deadlines or make errors that my supervisor has to reprimand me for.” Jerome has never been formally diagnosed with any mental health related concerns but has been in counseling services before. His past experience in counseling was neutral, he didn’t think the counselor “liked me very much.” Further, “the counselor never picked up on the fact that I am gay.” In college, Jerome reports his eating habits were the “worst.” There was a period during college when he starved himself for 5 days and lost 20 pounds. Jerome denies any regurgitation of his food, past or present. Currently, he reports not eating anything until 5:30 or 6 PM and typically eats a chicken salad for dinner. Jerome reports that he “loves drinking water, but only distilled.” He typically drinks 1-2 glasses a day, and maybe has a glass of green tea. If he drinks more in a day’s time, he reports feeling “bloated and fat.” Two months ago, while out shopping for a birthday gift for a friend, Jerome passed out. Jerome reported he had not eaten or drank anything that day. This incident “scared” him. Jerome shows some insight, stating “I recognize that I manipulate the way I eat so I can maintain a leaner figure.” Lately, Jerome has been exercising less, but has a history of excessive exercise routines. “Even if the scale reported a low number, I would go to the gym for hours because I was afraid of gaining weight.” Jerome reports feeling self conscious about his body starting back in college when he got into the dating scene. He would frequent gay bars on the weekends and felt “much less attractive than the other guys.” Jerome acknowledges issues with sleep during the last few years; even after a long day at work “I have difficulty shutting off my brain and relaxing. After eating dinner, if I don’t exercise, I will watch TV and before I know it, it is 2 AM and I have to be up at 6 AM for work.” Further, Jerome shared that he feels lower than most people, most of the time. “My boyfriend often refers to me as Eeyore and gets frustrated when I don’t want to go out with friends.” Jerome denies any current suicidal ideation but reports thinking about death a lot during high school when he began to realize that he was attracted to other men. He remembers feeling like he could never tell anyone because he was raised in a very strict Christian household. It wasn’t until Jerome went to college that he was able to be more open and freer about his identity. Jerome reports that his father was diagnosed with Bipolar Disorder in his 30’s; his parents got divorced soon after Jerome was born, and they didn’t have a great relationship. He reports that he has a better relationship with his mom. “She would do anything for me or anyone else, she’s a good Christian lady.” Although out on his own now, Jerome still tries to call his mother once a week and visits for all the major holidays. As mentioned previously, Jerome is in a committed relationship with his partner whom he has been dating for 3 years now. They are considering moving in together; however, Jerome’s partner does express concerns about Jerome’s mental health stability and whether there is going to be a future for them. This is one of the main reasons Jerome is seeking counseling. Jerome reports that he does not go to the doctor regularly. He had difficulty remembering the last time he had a physical with bloodwork. He thinks it has been several years. He denies any substance use and is not currently taking any prescription medications. Jerome denies any history of manic or psychotic symptoms.
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