Case 6 Mike Jones Mike Jones is a 23 year old single heterosexual Latino male currently employed part time and resides with relatives of his ex girlfriend He is seeking treatment for a chronic depressed mood that has been present since age 15 Mike describes feeling that his depression was exacerbated by substance use particularly when he was crashing from Ecstasy He sleeps very little and has recurrent thoughts of death characterized by morbid content Currently he describes feeling numb and not motivated to do anything he lacks direction and goals in life The only thing he enjoys is the sensations of partying and the thrill of excitement like in sex or partying Mike says nearly all of his past relationships are very brief and he has difficulty connecting with other people or maintaining friendships in a non sexual context He reports a history of trauma beginning in childhood physical abuse severe emotional abuse and neglect by his stepfather and mother who was a violent alcoholic In addition Mike also witnessed domestic violence between his mother and her boyfriends stepfather Client s primary social support network consists of his ex girlfriend who has supported him financially and provided him with housing Answer the following questions in the text box below 1 What is the most fitting diagnosis for Mike Jones The most fitting diagnosis for Mike would be Trauma Related disorder complex PTSD This was not a short term trauma for him and has been going on for a long time up until now that he is 23 This repetitive trauma has caused him to have insomnia Loss of self value disconnect from most of the world and avoidance of people and activities 2 What other information would you want to know about Mike Jones I would like to know why Mike is only being treated with depression I would also like to know as he is being treated why is he continuing to have problems and still not wanting to have a normal life and is still staying away from regular people and only interacting with ex girlfriends which is for very short time and for sexual relationship purposes only I would also like to know if he is still thinking of dying and also is he still taking substances 3 What is one cultural factor that may be influencing Mike Jones s presentation diagnosis Due to lack of support from his parents and being abused in the past Mike has been using substances and in deep depression Although he is being treated he is still trying to stay away from people unless it is with his girlfriends for sexual purposes only His relationships are short and he can t support himself He is counting on other people to help him get by He is still depressed and has dying thoughts He is still struggling in having a lasting relationship with people and finding ways to support himself