The patient in this case is a 16 year old, single female name Sonia Sanchez. She is of Hispanic descent. The child has what seems like a stable home life. Her parents are married and she lives with them in a suburban area. Sonia attends the local high school. She is popular, outgoing and friendly. She has had the same friends since childhood.
Description of Problem
In order to understand what is happening with the child and properly assist in interventions and diagnosis we conducted interviews with the patient’s parents, family and school friends. The interviews revealed some interesting information about the problem. Around the age of 14, Sonia’s parents and friends say she began to act differently and hang out with another crowd. The new group of girls was concerned about appearances more than academics. One thing that was different was that she began to not want to eat family meals. This was odd because she always loved eating with her family. She then began to make excuses for why she wouldn’t join her family at the table. Excuses included:
I have a lot of homework
I’m not hungry
I’m too tired to eat.
I’m going to shower right now
The family began to notice that whenever Sonia would eat she would run to the rest room and purge. Sonia never had body issues prior to this. The family is starting to think that hanging out with her new friends negatively affected her self-esteem and body image. The patient’s family has tried to stage interventions, talking to the patient, and nothing has helped. The discussions usually result in Sonia crying and denying anything is wrong. The family has to terms with the fact that their daughter has an eating disorder. They want to help her get better.
Additional Information:
Sonia mental health status is stable. What we believe is that Amelia is suffering from Anorexia. National Eating Disorders describes it as “Anorexia nervosa is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss.”(National Eating Disorders Association). Patient’s had no abnormalities in her childhood and adolescent development.
The patient has always been an active participant in community events, sports, dance and always got along well with other students. Up until this issue Sonia has been healthy. Neither the patient nor her family has any history of psychiatric problems.
Diagnosis (DSM 5)
According to the DSM 5. “ Anorexia Nervosa is characterized by a Persistent restriction of energy intake leading to significantly low body weight and by an intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain .” (Feeding and Eating Disorders, 2013)
Sonia has shown the following symptoms:
-Inappropriate Behaviors
-Not eating for fear of gaining weight
- Vomiting after meals
-Weighing herself constantly
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Diagnosis
We arrived at the diagnosis of Anorexia Nervosa because of the fact that our patient exhibited the symptoms described in the DSM-5. That is why at first we wanted to go with a diagnosis of Anorexia.
Unfortunately eating disorders are becoming all too common. There was always a stigma associated with these disorders so people who suffered were embarrassed to ask for help. Dr. Emily Deans, describes, “The cases cases of anorexia and bulimia escalated in the 1970s and 1980s, and though some will say they peaked in that time, the national survey data suggests that bulimia, especially, continues to escalate” (Deans, 2011). The confirmation of this diagnosis was heartbreaking to Sonia’s family. However, all though they are hurting they are willing to do whatever it takes to help her. The first step should be to separate her from the group of friends that have affected her mental state and thinking. Sonia’s family has decided to enroll her in the local private school where some of her childhood friends attend in order to further separate her from the bad influences. Her family is willing to be a strong support system. They know there is a lot of work to be done in terms of treatment but they believe she can overcome this problem. Her childhood friends are also willing to help.
What is most important right now is finding the right treatment options right now. There are possible treatment options. The first step is that “Families are encouraged to strategize on how best to restore their child’s weight” (Fursland, Hill, Raykos, Byrne, and Dove, 2015). Once the patient has reestablished a positive relationship with food she can visit a nutritionist to show her how to positively control her weight if she even needed to.
The next step is to work on the patient’s view of herself. Building her body image and self-esteem is imperative. Low self-esteem was one of the main causes of her Anorexia so she needs to work on appreciating her body. The family and the patient have agreed to all of these steps and are willing to work on a complete recovery.
Reference Page
Deans, E. History of Eating DIsorders. Retrieved December 2, 2015, from https://www.psychologytoday.com/blog/evolutionary-psychiatry/201112/history-eating-disorders
National Eating Disorders Association. Retrieved December 2, 2015, from https://www.nationaleatingdisorders.org/bulimia-nervosa
Feeding and eating disorders. (2013). Retrieved December 2, 2015, from http://www.dsm5.org/documents/eating%20disorders%20fact%20sheet.pdf
Fursland, A., Hill, S., Raykos, B., Byrne, S., & Dove, E. (2015, November 23). Having a history of anorexia Nervosa: Implications for Bulimia Nervosa treatment. Retrieved December 2, 2015, from http://www.jeatdisord.com/content/3/S1/O24
