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躁狂症的心理治疗案例-给力心理
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躁狂症的心理治疗案例

躁狂症的心理治疗案例
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发表时间:2015-02-07 10:44:43 262 0 0

一、 背景资料

  一般人口学资料:小晴,女,17岁,某职业学校高二年级学生。

  外在表现:来访者在班主任建议下来到学校心理咨询室。她面色有些苍白,眼圈发黑,说话音调比较高,语速很快,一个话题接一个话题说,几乎不给我插话的机会。中途命令咨询师给她倒水喝,说口渴。

  主诉:已经两天两夜没有睡觉,吃了失眠症的药物也不想睡,躁狂症的症状也没有得到改善,脑子里控制不住地想事情,一桩接一桩。

  个人成长史与自我陈述报告:来访者是家中的独女,父母经常吵架,家庭经济状况不好,看不起父母,觉得他们没有能力挣钱,是生活的失败者。但是父母又很宠爱自己,凡事都要来征求自己的意见,同时又密切关注自己的一举一动,连玩电脑都要站在身后看。平时在学校的表现稍有些内向,个性、言行不张扬,对班级的工作能很好地配合完成。今天(20041012)上午政治课,轮到她作时政讲演,她足足讲了20多分钟还意犹未尽,主要内容和观点是:马克思辨证唯物主义关于“事物都有两面”很有道理,用来解释她一直费解的“双面伊人”,那就是“一半是天使,一半是魔鬼”。它是谁?就是班主任。班主任自诩对自己的孩子很关爱,但是对学生却分外苛刻,要求大家中午在教室自修,上课中途来到教室窗外偷看学生上课,等等。学生们把窗子用报纸贴起来,一为挡太阳,二为不让班主任偷看。来访者在课堂上批评同学的做法不勇敢,贴报纸这种抗争算得了什么,她几次要求大家把报纸拿掉,大家都不肯,她很窝火。后来老师中断了她的讲演,下午第二节课班主任让她到咨询室来。除了讲述今天上午上课的事情,来访者还滔滔不绝说了些其他的,概括起来有:1、家里人让她心里很堵,她已经两天没有睡觉了,很反感父母经常吵架,母亲精神有问题(事后了解到是精神分裂症)时常在吃药,平时特别爱唠叨,管头管脚,生活上照顾她无微不至,玩电脑都在她身后看着她,“他们两个已经无可救药了,我不想再理他们”。最佩服的是三阿姨,很能干,是个经理,自己父母太无能,都下岗了,很看不起他们。今天开始不回家了,想去同学家住。2、从小学起就认识的最好的朋友前不久跳楼自杀了,觉得生命真脆弱。3、认识的网友是大学生、大学教授,很有学问,跟他们聊天很舒服,在聊天中获得跟他人交流所没有的知识和人生体会,周围的同学太幼稚,平时都不可能跟他们这么深地交谈。咨询时间结束,中断来访者的陈述。

  他人反映情况:老师和同学觉得她今天的表现不对劲,她讲演的内容虽然头头是道,看似颇有道理,但有些偏激,有些话不太听得懂,跟她平常的为人态度很不符合。

  二、 分析、诊断与评估

  生理、心理、社会因素分析:来访者目前的表现是失眠,这与她长期的家庭人际关系紧张、家庭经济状况不良、学校师生关系不够协调等压力有关,好朋友最近的自杀也是其精神障碍的应激源。作为青春期的孩子,原本就处在自我同一性的矛盾中,面对自身无法克服的心理压力,加上一定的遗传因素,逐渐导致心理问题趋于严重。

  初步诊断:心境障碍躁狂发作。

  诊断依据:根据判断正常与异常心理活动的“三原则”,来访者个性的相对稳定性出现了明显异常,除了失眠等躯体化症状,还表现为思维奔逸、精神运动性兴奋,心境高涨等精神症状,自知力有所缺损。

  鉴别诊断:来访者除了思维奔逸,并未出现幻觉、妄想等重性精神病症状,症状也并未泛化,自知力基本完整,社会功能有所损坏。可排除精神分裂症。

  结论:来访者不属于学校心理咨询范畴,建议家长立即转诊专科医院。

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本文作者

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0岁
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公益助人

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收费助人

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长程个案

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续单率

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咨询时
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