Prof. Dr. Jane Doe – the mathematics professor

Identifying information:
Prof. Dr. Jane Doe, male, aged about 47 years was brought to the hospital with the complaints mentioned below. His wife, aged about 42 years and son aged about 13 years had been devastated observing the patient’s behavior. On the outside, the patient had been working as a guide and a senior professor, mathematics department at Bingle University. Jane Doe was awarded as one of the best professors of the decade.

Presenting complaints/ reasons for hospitalization:
Aggressive behavior.
Disturbed and reduced sleep and appetite.
Low occupational and academic output.
Disorganized and repetitive speech.
Irritated almost all day – every day.
Affect and mood observed to be abnormally sad, irritated, frustrated and scared.
Ticks.
Crying inappropriately when alone.

NOTE:  The above-mentioned complaints were observed in the patient in the past 2 months and no medical investigation or treatments were imposed on the patient.

Information collected:
Patient’s wife explained about the patient’s abnormal behavior since a couple of months. She clearly explained that Jane Doe was not sleeping at night and was constantly forcing her to wake up and turn the alarm off. She added to it that he destroyed all the clocks in the house. “When I asked him the reason, he said that he was hearing the alarm tone continuously.”
She adds to it that she had never seen him behave in this way any day before. When probed about negative history of the patient and his family, it was understood that his younger brother had committed suicide during his late adolescence. She also adds details about Jane Doe’s father’s alcoholism and violent behaviors which led to chronic mental illness to which he had denied to take treatment. According to the wife, Jane Doe is always an emotional person and takes things too seriously and worry about everything. To make the psychologist understand it better, she gave an incident as an example: “Jane Doe, my son and I were boating in the lake – the Golden Inn resort. My son was feeding the fishes in the pond while Jane Doe was teaching him tricks to make fishes come to the surface. During this process of feeding the fishes, Jane Doe, by mistake dropped the plastic bag that had nothing inside. It was a 2 inch / 2-inch pen drive cover which didn’t even have the pen drive. He worried about it and was feeling guilty for 3 days.”
She adds to it that Jane Doe is presently not meeting any of his co-workers, students or research supervisors on purpose and she explained that Jane Doe claimed that they take away his ideas and thoughts to become successful.
Patient’s son explained that Jane Doe was helping him with his studies and was the source of motivation. He acknowledged that Jane Doe was not giving his health a priority since the day he has been observing Jane Doe. “My dad always worked on his math for his next paper. He had never slept/ rested properly since ages. We once had a conversation where he started sobbing like a small kid. The reason was – his thesis was purposefully being rejected and he was being targeted by the university people and his batchmates. He claimed them to be jealous and that has an impact on his career and research.” Said Jane Doe’s son.

Information collected are reliable.

Source of information:
 Patient’s wife and son were interrogated to understand the patient’s history.

According to the patient:
“I am like this because my research supervisors, university director and my batchmates gave me a lot of mental tortures. They get to know what I think and they write the research papers. They think that I dint know about this.”

Line of treatment:
Reference to psychiatrist for medication.
Family therapy for parents and caretakers to make them understand the importance of medication and accepting the patient for his present condition.
Psycho educating the client about the importance of medication.
Hospitalization for 4 days and advising for monthly follow-up.

Diagnosis:

Schizophrenia.
According to Prof. Dr. Jane Doe, he had been under extreme pressure with respect to his occupation and academics. He acknowledged that he had been pressurizing himself to achieve another Ph.D. which was having a lot of competition. He adds to it that this competition was extremely unhealthy and had a negative impact on his psychological health. He continued saying that it was after Jane Doe’s research supervisor threw his paper works in his face and asked him to quit the research even if his works were intact. Jane Doe acknowledged – “I couldn’t sleep the whole night and the incident that happened that afternoon is still fresh in mind and I am not able to concentrate on my studies or work.”
Hallucination: Hallucination is nothing but the ability to perceive a stimulus in the absence of it. To be more non-technical, people who hallucinate, hears voices that nobody else hears, sees things/ shadows/ people/ animals/ characters which nobody else could see, can smell something which nobody else could smell. Because, these stimuli are not present in real world. For Prof. Dr. Jane Doe, it is auditory hallucination. He complains hearing alarm noise.
Delusion: Delusion is a false, unchangeable concrete belief a person holds, to which he/she has no proper evidences to prove it to be true or normal. For Prof. Dr. Jane Doe, it is delusion of thought withdrawal where the patient believes that his seniors and co-workers are withdrawing thoughts from his mind as a result of which they are progressing in their research and he is here without progressing.
Positive symptoms: Excessive inappropriate talking and social interaction. Sadness and crying inappropriately.
Negative symptoms: For Prof. Dr. Jane Doe, they are, lack of interest in daily activities, reduced occupational output, lack of social and personal relationship, sleep and appetite.

Etiology/ causes for the present illness: It was observed and understood clearly from the history of the patient that he had been vulnerable to psychological illness because of genetic conditions. The risk factors that made Prof. Dr. Jane Doe more vulnerable were the constant occupational pressure and academic pressure (as he was working on his second research paper.)
 It is clearly understood from Jane Doe’s son’s information that the incident that triggered a psychotic vibration was when Jane Doe’s paper work were thrown away by his research supervisor who criticized and humiliated him in front of his batchmates and juniors. Jane Doe had been spending sleepless nights since the day he had started working on his second research. This resulted in a disturbance in his vital functioning which include blood pressure, thyroid stimulation hormones, other hormones and biochemical equilibrium was disturbed. Triggering factor triggered excessive worrying which resulted in degeneration of brain cells, auditory hallucination, positive and negative symptoms.

Present:
It has been 2 years since his illness has occurred. Client is not responding to any medication or any therapies. It is observed that the client has gained complete insight about his present illness and is ready to take treatment but the medication and psychotherapy has been showing no effects on the client. He was later sent to take up a brain MRI and reports read that his brain cells were degenerating as a result of which he has been facing biochemical imbalance which resulted in psychosis. Prof. Dr. Jane Doe has been in a mental health care centre where he has been under surveillance and constant care. His family visits him monthly once and spends a week’s time with him.