Native American Elder Discussed on Page 13

¶ … Native American elder discussed on page 13 in the text is a peculiar one. However, the employment of the five-axis diagnosis provided in the Diagnostic and Statistical Manual of Mental Disorders provides a good deal of information about what sort of issues this elderly man is dealing with.

One of the facets of this manual that I would readily utilize is the capacity to use a provisional diagnosis and defer full diagnosis until later, so that I could properly gather more information than that which is provided in the text regarding his ailments. The first axis is for clinical disorders except those pertaining to personality disorders and mental retardation (APA, 2013, p. 28).

Again, based on the information at hand, I would make a provisional diagnosis that the client is suffering from clinical depression, perhaps in some part due to the fact that he was previously an alcoholic. In John Marszalek's video, the doctor declared that facets of substance abuse may be linked to depression -- and, specifically, that drinking or attempting to stop or actually succeeding in stopping drinking can induce clinical depression as well (No date).

It is key to note that alcoholism is a condition from which one never fully recovers: every day is simply another test for the former alcoholic to remain sober. As such, I would include the fact that the patient is recovering from alcoholism in the first axis, a fact which corroborates the provisional diagnosis that he may very well be clinically depressed. The second diagnosis is for personality disorders and mental retardation.

There was no evidence for either one of these phenomena in the literature, so in this portion of the assessment I would simply state "none indicated." The third axis of this assessment is for general medical conditions which may adversely affect the patient. In this area I would mention his arthritis, a fact which has made this gentleman take acetaminophen daily for quite some time.

Although there may not be a direct connection between the symptoms of his arthritis and his depression, this medication will surely factor into other medication if some if needed to account for what may be clinical depression. Additionally, it is worth noting that there are other physical signs of deterioration which may be linked to his depression. The pain that he is complaining about and which may be related to arthritis certainly indicates some sort of malady that may be psychological in nature -- or rather exacerbated by psychological factors.

Of particular note is pain experienced in his chest and abdomen, which certainly is not related to arthritis. I would recommend the client see a medical doctor and get those areas of his body looked at. The fourth axis is for psycho social and environmental problems, and there are many to record in this area. The most salient of these may be the client's withdrawal from his family, which is significant and consistent with the preliminary diagnosis of depression. This axis is the very well the most problematic of.