Apply Dsm-Iv to William Styron

Topics: Major depressive disorder, Psychiatry, Bipolar disorder Pages: 5 (1557 words) Published: December 10, 2011
Human Behavior in the Social Environment III

Client: William Styron

Axis I 296. 25 Major Depressive Disorder, Single Episode, In Partial Remission

Axis II 799.9 Deferred

Axis III Deferred

Axis IV Recent awarding ceremony
Problems related to the social environment: Death of friends Problems with primary support group: Unsolved grief

Axis V GAF= 50
GAF= 65
SOFAS = 45
SOFAS = 70

Defensive Functioning Scale

A. Current Defenses styles or Coping Style:
1. Self –observation
2. Sublimation
3. Affiliation
4. Intellectualization
5. Devaluation
6. Passive aggression

B: Predominant Current Defense level:
High adaptive level

William Styron has laid out a detailed description about the signs and symptoms of his illness. The concluded diagnosis is based on William Styron’s illustration and his current mental state. Styron’s symptoms have fulfilled the criteria of depressive disorder. The basic abnormality in depressive syndrome is the alteration in mood with a group of vegetative symptoms (Andreasen & Black, 2011). He chronicles “the leaden and poisonous mood” (Styron, 1990) that occupies most of his days. He reflects his diminished interest and pleasure towards “exceptionally island’s pleasure”, his “beloved home”, writing and other activities that he used to enjoy. He wonders how his friendly place seemed so hostile and forbidding. As a writer it felt helpless and painful to him when he found out “the writing becomes more difficult and exhausting, finally ceased” because depression has made him unable to concentrate. Styron’s statement of “two or three hours of sleep I was able to get at night” indicated that he suffered from insomnia and the everyday sleepless was “a rare torture” to him. It was clear that his insomnia evolved from middle insomnia to severe insomnia just right before his hospitalization (Andreasen & Black, 2011). Styron also stated his slowed psychomotor functions that manifested in “slowed-down responses, near paralysis, psychic energy throttled back close to zero”. Styron further describes his mental illness severity as “reached the phase of the disorder where all sense of hope had vanished, along with the idea of a futurity”. While these particular descriptions depict Styron’s hopelessness and despair, he also proposed a question “Why wasn’t I in a hospital” which implies his later voluntary hospitalization and improvement in his illness. In addition, Styron constantly thinks about death and suicide evidenced by “Death, was now a daily presence”. His house has also become a place that was filled with possibilities of committing suicide. These core symptoms in Styron’s case defined major depression and has presented for more than two weeks (American Psychiatric Association, 2000). Styron stated by himself that there was no manic episode occurs. And there were no evidence for a Mixed Episode. Although it was clear that client’s alcohol abuse history and his overuse of sleep medication play roles in his depression client’s depression are not due to the direct physiological effects of the substances or any general medical condition (American Psychiatric Association, 2000). It is interesting to address that client’s symptoms are not better accounted for by Bereavement but the unresolved grief Styron had toward his mother can be consider a major factor that contributed to his depression. The childhood trauma and the unresolved grief will be discussed later in this essay. In Styron’s case his depression began gradually during the six to eight month time frame. “Styron is on point in his astute description of milder dysthymic...
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