Week Seven Focused SOAP Note and Patient Case Presentation complete 100%

Week Seven: Focused SOAP Note and Patient Case Presentation Justina Awazi College of Nursing-PMHNP NRNP 6665- 26 PMHNP Care Across the Lifespan I Anna Lee Waldner April 16, 2023 Subjective: Chief Complain: “My anxiety and depression are obstructing my interpersonal relationships and education, I cannot keep on going like this. Sometimes I am manic and sometimes very depressed.” History of present illness: The patient is a 25 years old Caucasian male who presents in the clinic asking for help with his manic and depressive symptoms that are obstructive to his education and interpersonal relationship. The patient states, "I just need help because I have been trying to help myself with marijuana and alcohol, but it's not working." The patient reports that he has been struggling from one thing to another. He states it all started when his parents separated when he was 12 years old; even though they came back together, the damage was done. He reports a feeling of being abandoned by his dad, who left the house. He states that he noticed he was hyper, talkative, had a hard time concentrating or sitting still when he was younger, and thinks that it has carried on in his adult life. He reports being depressed starting at age 13. Report symptoms of hopelessness, low motivation, not wanting to get out of bed, irritability at little maters, sleeping 12 hours in 24 hours, waking up tired, and drinking alcohol to address his depression. He reported that at age 16, he was placed in the juvenile hall where other kids sexually abused him in there. At 17 years old, he was out of juvenile hall but engaged in using methamphetamine and having multiple sex partners. He explained that his reason for having multiple sex partners is to prevent one from breaking his heart. He states that he gets ashamed and embarrassed when abandoned, and he will go into depression spirals. He reports that his first manic episode occurred at the age of 19. He reports, "I felt I was on top of the world, felt up". During this period, "I will have lots of energy, will go for five days with two hours of sleep and sometimes with no sleep. He reported spending a lot of money on clothes and items not needed. He was spending more money than he had in his account on buying things he never used. He engages in multiple activities and never carries through. He reports engaging in multiple sexual partners and getting girls from social media just for sex. He reports being involved in a threesome just for fun. On some occasions, his family will take him to Psychiatric Emergency at the age of 22 because he has not been sleeping and paying attention .......................................................continued.............................................