Case Study on Anorexia

Introduction

According to research done by health practitioners, mental health of a patient is based on the psychological as well as their emotional well-being. For an individual to be mentally set, they should be ready to adjust their emotions and behaviors necessary to sustain the stress and conflicts in our day to day life experiences. Therefore, According to Townsend & Morgan (2017), an individual who can adjust to stress and daily conflicts is mentally healthy, perhaps, the person must be cognitively ‘sound’ to carry out active duties of the body. Nevertheless, a person who is mentally healthy can perform well at an acceptable level of their emotions and behaviors. An individual who is mentally fit exhibit traits such as; having a zest for life and a balanced approach to the daily human activities.

On the other hand, the World Health Organization (WHO) has incorporated various definitions of mental health. Social workers are indebted to provide care and services to those patients who are mentally ill. According to statics done, 50% of the world’s population is suffering from one form of mental disorder or the other. Some of the causes of mental disorders include; genetic inheritance, stress and drug abuse. In contemporary society, stress is the central course of the mental disorder. For instance, in the case study, Vadoma is diagnosed with Anorexia at the age of 17, she does not want to eat, and she substituted school meals for packed lunch which she rarely eats. Vadoma is losing weight rapidly, and this worries her parents, however, this essay seeks to critically discuss and reflect on Vadoma’s case study on Anorexia.

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First, Vadoma is a patient suffering from Anorexia. It is an eating disorder and perhaps one of the conditions characterized by various habits of dietary consumption and also distress over the shape of the body. In most cases, this affects teenage below 25years. Besides, there are various forms of an eating disorder; these forms include; Anorexia Nervosa and Bulimia Nervosa. According to Leehr & Krohmer (2015), the causes of eating disorders range from environmental factors such as family and peer pressure, biological factors to psychological factors. In this accord, it is paramount that I as a social worker in, Child and Adolescent Mental Health service (CAMHS), it is my responsibility to help Vadoma gain weight and get over her traumatizing experiences from physical abuse or the past.

Vadoma is starving herself and does not want to eat; her weight is way much below the expected weight level of a 17-year-old woman. Her parents are worried about her condition, Vadoma is avoiding food and pretends to be addicted to vegetarians, she wants to be left alone in her room, and perhaps she has lately been performing poorly in schoolwork. A patient suffering from anorexia has a negative misconception of being fat hence some of them avoided mirrors. Anorexia can be fatal due to depression; it may lead to death. Vadoma had tried committing suicide when she took a large quantity of paracetamol tablets and anti-depressants. The objectives when dealing with such patients is to achieve them gain weight which is what Vadoma is trying to avoid. Anorexia patients should try regaining weight as early as possible because that is the goal of a social worker when dealing with such patients.

However, Vanoma can be portrayed as an individual who is anti-social and does not interact with people more often. Perhaps she has a minimal circle of friends. She does not interact with her friends physically; they use social media to contact, Vadoma on the other hand, is also using social media to explore on dietary websites. Perhaps, reading success stories of her fellow people who have recovered from eating disorder will assist Vadoma in improving rather than forcing her to be admitted in the hospital. From the Mental Health Act (MHA) assessment notes, it depicts that Vadoma has Anorexia meaning she has low-self-esteem, hence, does not value the communication and interaction with the others resulting to her small circle of friends. Reading successful stories of the people who have recovered from the same eating disorder she is suffering from, will aid in boosting her self-esteem. Besides, this will give the patient, high confidence that she needs to recover, those stories act as motivation for Vadoma.

Anorexia patients in most cases do not admit that they are sick. They do not want help from their parents or friends. Vadoma did not wish to be assisted by the parents; she loved being isolated and spent time alone in her room until when the parents and friends noticed her extreme weight loss and the suicidal attempt that is when she accepted that she is sick. During one of the visits to their house as a social worker, through her question response, I notice that she did not want to give more information regarding her situation perhaps; she did not want to talk much about her condition. Nonetheless, she preferred keeping her problems to herself. Even though the patient denies the problem, she is facing, deep inside she feels out of control. Furthermore, she feels absent from her life, Vadom had an inner voice that she was able to control during her initial stages of the eating disorder. At 14, Vadoma could control her inner voice when it instructed her not to eat. Overtime, controlling her inner voice became very challenging. Currently, she has subjected herself to vegetarian to avoid gaining weight. Besides, she has also substituted school meals with packed lunch so that she could not gain weight. Vadoma has two divisions of self; the public persona which is always competent and in control, the other one is the hidden self, the hidden problem of eating disorder, I feel sympathetic towards her plea because it has affected her mind up to the extent that she cannot preserve the duality experiences.

Additionally, the parents and friends of anorexic patients should be close to them and offer a listening ear. According to research, talking to patients and listening to their problems assist in taking away their pain and pressure. Friends should encourage Vadoma positively for her to cope with life. Being one of the psychiatric illnesses, anorexia has a very high mortality rate due to long duration in starvation. Vadoma has a disturbed eating habit, having restrictions to food and adapting vegetarian is a clue to Anorexia disease. She has stated extremely rigid schedules for food, “During this period, she has hidden her eating problem, and presented to her family as a committed vegetarian, on a harsh diet. To control her food intake, she had substituted her school meals for a packed lunch, which she usually did not eat.” However, Vadoma had no concept that what she was doing was affecting her parents and friends; she saw it as a regular routine. Patients with Anorexia have extreme methods of controlling weight loss as stated by Rohdem & Marti, (2015). Vadoma decides to focus on vegetarian.

From my point of view, many adolescents who suffer from Anorexia are at risk of anxiety and depression. Vadoma being one of the victims got into depressions and tried committing suicide. The tension and depression can occur after undergoing the treatment. The best treatment for Anorexia patients is taking them to the center of medicine where they will receive help. Taking them to doctors is also another way of helping the Anorexic patients. In this accord, Vadoma is referred by her family’s GP to (CAMHS) where she will be assessed mentally; this assessment indicates that a period of hospitalization will benefit Vadoma by giving her time to recover from Anorexia. Professionals should join hands in helping Anorexic patients because there is no problem or shame to seek professional help. After going through Vadoma’s medical records I discovered that she is suffering from Anorexia as well as obsessive behaviors related to her schoolwork, somber mood was felt in the air, I sympathized with Vadoma. A psychiatrist is suggesting Vadoma should be admitted in the hospital to aid her in recovery, her refusal to be admitted will lead to forcefully admission as per the MHA. However, Vadoma is on the list to attend to a specialist dealing with women suffering from Anoxeria. The decision of the psychiatrist on forceful admission of Vadoma into the hospital in case she refuses is unethical; as a social worker, I must assist the patient get treatment.

Moreover, Anorexic patients should learn to trust their doctors. Family doctors can be the first to diagnose the severity of the problem just as Vadoma’s mother took her to GP who gave a referral on (MHA). However, concerning this a nutritionist will be of assistance in balancing her diet. Perhaps, they can assist in teaching the patient of the proper eating habits as well as how to stick to a proper and healthy diet. Another specialist to help in Vadoma’s journey to recovery is a therapist; they will provide counseling sessions to the patient in the presence of her parents, this will aid in decreasing stress levels in her mind. A therapist will give a significant boost towards Vadoma’s recovery. Being honest with the therapist will make it efficient in discovering the root problem of the disorder.

As a social worker, my responsibility is to help Vanoma recover her weight as well as assist in overcoming distress. That is my core objective, and, I can achieve it through sessions of counseling and other treatment plans with the patient. Having, a one-on-one counseling session with my client is the best in making my objective. Therefore, I decided to visit Vadoma at her home, traveler’s site. I was shocked by Vanoma’s physical presentation, her body mass index was critical, and it shocked me, I sympathized with her, but she seemed okay with it. During the interview, I asked her questions, but her response was guarded. Therefore, from her reaction, I discovered there was something else she was hiding. Besides, her response gave me the impression that she wished the interview to end immediately and I leave. The next day I received a call from Vadoma’s niece stating that Vadoma’s family are undergoing physical abuse. From my perception, her allegations might be true because the physical violence in the family has led to Vadoma’s distress and as a result, she develops Anoxeria, one of the mental health conditions. She is undergoing stress and discomfort, some of the physical factors resulting in Anorexia.

Various factors are leading to the development of Anorexia include; psychological, environmental, sociocultural and biological factors as stated by Brownell &Walsh (2017). In psychological factors, the victims are driven by perfectionism. They want to be satisfied, therefore, seeking to control the food intake in their body. Perhaps, perfectionism leaves this patience unquenched of their thirst for thinness. Most of the patients who develop eating disorders are characterized by low self-esteem and low self-worth. OCD behaviors might also be exhibited regarding their food diet. Environmental factors leading to the development of Anorexia is evident when an individual grows up in a family that faces criticism from their neighbors due to the shape of their bodies. Furthermore, peer pressure and bullying can as well influence one’s eating habits. Bullying lowers the self-esteem of an individual, and this is part of the eating disorders characteristic. Many environmental factors can contribute to developing anorexia. Low self-esteem makes the victims feel like they are not good enough. Perhaps trauma and abuse are also causes of Anorexia; Vanoma’s niece is concerned with the physical abuse in Vanoma’s family hence subjecting Vanoma to an eating disorder. Most of the patients diagnosed with Anorexia are anxious.

Furthermore, the influence from sociocultural can also play a vital role in determining weight loss and weight gain in the society. According to the western culture, unrealistic thinness is praised and prized; it has created the notion that being thin is healthy; thinness is depicted as the ideal body for everyone. Self-worth and thinness is sometimes associated with success in various cultures hence perpetuating the increase in desire to be thin. The victims are at high risk of developing, eating disorder.

Genetic and biological factors also can contribute to the development of eating disorders among teenagers. Eating disorders are sometimes inherited; it runs in generations Smith & Cook (2016.). For instance, if there is an immediate family member who is suffering from Anorexia, then it is likely that one of the future generations will be predisposed to the disease. The similarity in the chromosome may increase the susceptibility of the disease to the next family generation. Moreover, if the hypothalamic-pituitary-adrenal axis (HPA) part of the brain is altered it causes eating disorders because it is one of the components in the brain that regulates stress.

As a social worker, there are various strategies and interventions to be used in assisting individuals with eating disorders. Regarding this, I will offer counseling sessions to Vanoma and take part in care planning too, as stipulated by Ágh & Sheehan (2016). Besides, I will write various reports to be used by mental health officers to review tribunals and liaise with the other psychiatrists as well as approved mental health professionals in Mental Health Acts assessment (MHA). I will also fight for the rights of the patients, such that; the relevant NHS trust should provide access to independent advocacy to the involved patients suffering from Anorexia. In the community, a social worker will form groups or carry out one-on-one discussion just like what I did with Vanoma. Perhaps, Vanoma’s mental health was destabilized by the physical abuse and stress she was going through hence leading to an eating disorder.

According to Fischer & Bulik (2015), it is the responsibility of a social worker to provide services to people who are suffering and particularly, a patient with mental illness. As a social worker, decisions should be made based on the behaviors of the patient and not on isolated incidents. For instance, the consultant psychiatrist at a CAMHS makes a decision basing on the behavior exhibited by Vanoma; she states that Vanoma be admitted in hospital informally, and if she refuses then she should be admitted forcefully as stated in (MHA).

Additionally, social work has employed core interventions in the treatment and management of Anorexia. According to Lock & Grange (2015), these interventions include; Psychological and psychopharmacological interventions. Psychological therapy is depicted as a crucial intervention in addressing adolescent’s behaviors and cognitions. Most of the families view psychological interventions essential in treating their adolescent children. However, physical treatments in adolescents include nutritional interventions as well as psychopharmacological interventions. In many cases, treatment options are discussed with the patient so that he or she can choose which one is appropriate for them. With the ambivalence of eating disorder being inherent, engagement and putting efforts during motivational enhancement can be of assistance in maximizing the chances of the patient adhering to the treatment given. According to Worden (2018.) the statistics done indicates that 96%vof the Anorexia patients can choose the type of therapy that wants to receive; therefore the provision of their admission is under the (MHA) act in 1983 and children Act of 1989.

Family interventions have been used in treating eating disorders among the members of the family. One of the first family treatment was published in 1987. The family and relatives should give support to the patient with an eating disorder for her to live a positive life. The family therapy that was published was studying patients that had undergone weight restoration, and to achieve the weight restoration they were assisted by a specialist in eating disorder. According to this study, it states that among the adolescents present, 21 of them who had a short duration of the disease gained their weight in courtesy of family therapy, it was concluded that family therapy was more superior to individual counseling.

There are pharmacological interventions by the social workers. In pharmacological interventions, the treatment aims to allow the Anorexia patient to produce weight as well as improve their quality of life. With Pharmacological, they alleviate depression and anxiety, which are the typical characteristics of a patient suffering from Anorexia In this intervention three primary treatments are provided these includes; anti-depressants, antihistamines, and antipsychotics. Vanoma knew that she was suffering from the inside, the inner voice could no longer be controlled. Therefore she took a large quantity of antidepressants which is drug abuse to reduce her stress and mental illness experiences. However, according to research, there is insufficient evidence to prove the effectiveness of the above drugs in weight gain. Perhaps there is no evidence to portray the significant difference between taking the antidepressant drugs and placebo weight of the patient. There is also insufficient evidence to depict whether antihistamines has an impact on weight compared to placebo weight of the victim during the treatment. In this intervention, there is inadequate evidence in determining the acceptability of the drug treatment — no evidence to determine whether the victims less or more accept antihistamines as compared to placebo or not. There is also insufficient evidence in deciding whether antidepressants, antipsychotics or antihistamines are capable of producing risks and side effects to the people with an eating disorder.

Social service intervention has been used as strategies in solving the problem of Anorexia in adolescents. Most of the patients with eating disorders are being presented first in primary care. While those that are suffering from Anorexia are being referred to the secondary concern, in most cases, it is in the mental health services. In there, there are also services offered involving the eating disorder specialist and general psychiatric services. Perhaps, there is patchily distribution of specialist dealing with the eating disorder. In contemporary society, most Anorexia patients are treated on an outpatient basis only a few receive inpatient treatment which also varies from one patient to another. Besides, the objective of medical admission might be to achieve successful progress towards recovery. Inpatient services are offered in general medical hospitals while an outpatient is usually within the psychiatric hospital. Entries of Eating disorder patients are preferred to be done in hospitals where the staff is more experienced in treating the disorder.

In summary, mental health diseases are highly subjective. Anxiety is depicted as usual in human beings although it can become a significant cause of the tremendous suffering that millions of people in the world undergo. It is shocking to discover that a teenager is subjected to physical abuse by the family and they are not saying anything about it, Vanoma’s niece requested for discretion. Stress should be avoided as it is the primary cause for mental health disorder as stated by Segal & Smyer (2018); hence, counseling sessions should be adapted to assist in minimizing stress in human life.

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Reference

  • Brownell, K.D. and Walsh, B.T. eds., 2017. Eating disorders and obesity: A comprehensive handbook. Guilford Publications.
  • Ágh, T., Kovács, G., Supina, D., Pawaskar, M., Herman, B.K., Vokó, Z. and Sheehan, D.V., 2016. A systematic review of the health-related quality of life and economic burdens of anorexia nervosa, bulimia nervosa, and binge eating disorder. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 21(3), pp.353-364.
  • Fischer, M.S., Baucom, D.H., Kirby, J.S. and Bulik, C.M., 2015. Partner distress in the context of adult anorexia nervosa: The role of patients' perceived negative consequences of AN and partner behaviors. International Journal of Eating Disorders, 48(1), pp.67-71.
  • Leehr, E.J., Krohmer, K., Schag, K., Dresler, T., Zipfel, S. and Giel, K.E., 2015. Emotion regulation model in binge eating disorder and obesity-a systematic review. Neuroscience & Biobehavioral Reviews, 49, pp.125-134.
  • Lock, J. and Le Grange, D., 2015. Treatment manual for anorexia nervosa: A family-based approach. Guilford Publications.
  • Rohde, P., Stice, E. and Marti, C.N., 2015. Development and predictive effects of eating disorder risk factors during adolescence: Implications for prevention efforts. International Journal of Eating Disorders, 48(2), pp.187-198.
  • Segal, D.L., Qualls, S.H. and Smyer, M.A., 2018. Aging and mental health. John Wiley & Sons.
  • Smith, V., Chouliara, Z., Morris, P.G., Collin, P., Power, K., Yellowlees, A., Grierson, D., Papageorgiou, E. and Cook, M., 2016. The experience of specialist inpatient treatment for anorexia nervosa: A qualitative study from adult patients’ perspectives. Journal of Health Psychology, 21(1), pp.16-27.
  • Townsend, M.C. and Morgan, K.I., 2017. Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis.
  • Worden, J.W., 2018. Grief counseling and grief therapy: A handbook for the mental health practitioner. Springer Publishing Company.

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