Saturday, July 02, 2011

Case #1

X is a 20 year old female who had been married off when she was about to give her last matric examination. According to her mother, who I had earlier mistaken to be her elder sister, explains how X used to be a lively, clever and intelligent girl before fights in her in laws' family broke out. Her husband began receiving death threats from their neighbors due to a fight with X's brother in law. The first time that her husband was threatened, her mother reports that X fell to the ground while conscious. Ever since then, X's mental health has deteriorated profusely. What initially began with disorganized affect (anger outbursts, crying spells, irritation and high levels of aggression), slight insomnia and lower productivity levels has now blossomed into a complete inability to do anything more than sit in one place all day and stare off into space. Her mother and grandmother report that she often talks to herself, refuses to eat (vomits if forced to eat) and communicate with others, has begun urinating without control, takes off her clothes in inappropriate surroundings, does not know her own name when asked (gives some other name), and breaks into bursts of screaming (yells out her husbands name). She does not show any signs of physical mobility. It was reported that she had to be physically hauled out of the rickshaw she was brought to the hospital in this morning.


She has been sitting in front of me for the past hour and has remained in a static position all this time: eyes closed, expressionless with the back of her head resting against the wall behind her. As her grandmother asks her if she'd like to drink water, X opens her eyes momentarily but closes them again. Thus, she remains conscious but the medicines that she was given the previous day seem to have had a hypnotic effect on her. The psychiatrist next to me tries to make some sort of communication initiative by speaking to her, calling out X's name, slightly nudging her- but there is no response whatsoever.


X's mother and grandmother look dejected and disappointed as they watch X in the state that she is in. They are all that she has left since her husband and in laws chucked her out of their house. the doctor recommends immediate hospitalization in the mental health ward I am working in, so that a proper diagnosis can be laid out. for now, nothing can be said as to what X is suffering from but from the looks of it, it seems like a symptom of post traumatic stress coupled with psychotic depression.


A follow up in the coming weeks is likely to reveal more.