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Transcript of the Patient Interview and Patient History

Transcript of the Patient Interview and Patient History

5OFF CAMERA Mrs. Tilman, your husband is extremely worried about you.


00:00:20MRS. TILMAN Yes, I know that.


00:00:25OFF CAMERA Does coming here bother you?


00:00:25MRS. TILMAN Yes. Yes it does. I’ve never been to a shrink before. I don’t think

I need to be here now.


00:00:35OFF CAMERA I’d like to ask you a few questions if that’s ok.


00:00:40MRS. TILMAN Yeah, that should be fine.


00:00:40OFF CAMERA How have you been feeling health wise?


00:00:45MRS. TILMAN Fine. No health problems.


00:00:45OFF CAMERA Sleep?


00:00:50MRS. TILMAN I can’t sleep much. But that’s to be expected.


00:00:50OFF CAMERA How so?


00:00:50MRS. TILMAN The baby. It cries a lot.


00:00:55OFF CAMERA And that wakes you?


00:00:55MRS. TILMAN Well I’m usually already awake.


00:01:00OFF CAMERA You have trouble sleeping?


00:01:00MRS. TILMAN Just falling asleep. Especially after the baby cries.


00:01:05OFF CAMERA What’s the baby’s name?


00:01:10MRS. TILMAN Jessica.


00:01:10OFF CAMERA Beautiful name. How old is she?


00:01:15MRS. TILMAN Two months.


00:01:15OFF CAMERA How has your appetite been lately?


00:01:20MRS. TILMAN I don’t know. It’s not big, but I want to lose weight after the pregnancy.


00:01:25OFF CAMERA You aren’t comfortable with the way you look?


00:01:30MRS. TILMAN I’m terrible. Alright. I look terrible, I feel terrible. My body is bloated. I have lines on my face, bags. I look disgusting.


00:01:45OFF CAMERA What do you do to lose weight?


00:01:50MRS. TILMAN Well, I want to run, but… I don’t get out much.


00:01:55OFF CAMERA Why?


00:01:55MRS. TILMAN Because I’m stuck at home. I have to take care of the baby, all day long. I guess I should just get used to it. This is my life now all day long, stuck at home with the kid.


00:02:10OFF CAMERA You don’t have a nanny?


00:02:10MRS. TILMAN Who could afford one? Especially with having to pay for the kid.


00:02:15OFF CAMERA Have you said any of this to your husband?


00:02:20MRS. TILMAN To Rick?


00:02:20DR. GREY Uh huh.


00:02:20MRS. TILMAN No. I couldn’t. He’d be so disappointed in me. How could I even tell him that I felt this way. That I wanted out. He comes home from work and… he plays with Jessica. This perfect family.


00:02:50OFF CAMERA How has your relationship been?


00:02:55MRS. TILMAN Not good.


00:02:55OFF CAMERA What’s happened since Jessica was born?


00:03:00MRS. TILMAN It’s not added much. I mean it is my fault. I can’t stop crying. All the time. [she cries] Sometimes I don’t even know who the baby is. And I yell a lot. Things just upset me. Everything and anything he do lately just upsets me.


00:03:35OFF CAMERA For instance?


00:03:40MRS. TILMAN Well… Well, the other day he came home and changed her diaper, but he threw the dirty diaper in the wrong trash can and he didn’t tie it up in the bag the way he was supposed to.


00:03:55OFF CAMERA And that upset you?


00:03:55MRS. TILMAN Yeah. And I told him, and I was yelling so he started yelling. So yeah. That’s our marriage right now.


00:04:10OFF CAMERA Have you been sexually active since Jessica was born?


00:04:10MRS. TILMAN No. Not really. I have no drive or desire. Rick keeps wanting to but I just… I push him away.


00:04:20OFF CAMERA And how is your social life?


00:04:25MRS. TILMAN Non-existent. I haven’t seen my friends in forever. They came over to see the baby but that’s about it. I might as well get used to it. I can’t go out anymore. She’s too young for a babysitter, and even then, we couldn’t afford one. I had to quit my job.


00:04:55OFF CAMERA Where you forced to quit?


00:05:00MRS. TILMAN No. They gave me maternity leave, but… but I figured this is never going to end. I might as well leave now.


00:05:10OFF CAMERA Do you do anything for yourself? Something to relax, something creative.


00:05:15MRS. TILMAN No. I tried writing. I liked writing but… I don’t know, I… nothing moves me.


00:05:30OFF CAMERA You can’t write now?


00:05:35MRS. TILMAN I have no inspiration, and it’s not fun. I know I’m going to be interrupted soon anyway. Before Jessica, I could write for hours a night. I hated anyone disturbing me. [she cries] Now I can’t have twenty minutes. And you can’t tell a baby to hold on with wanting her lunch. For an hour. When she’s hungry, she’s hungry.


0:06:05OFF CAMERA Do you regret having a child?


00:06:05MRS. TILMAN No. I… I’m just not sure. I’m not sure, okay.


00:06:20OFF CAMERA Are you happy? Does anything give you pleasure?


00:06:30MRS. TILMAN [Shakes her head] No. [she cries]. Look, please, I… I know I’m a mother now. I. [sigh] I don’t know how to put this, I feel terrible. [Cries harder]. I don’t want to be a bad mother. I love my daughter. But I don’t know… I don’t know why I say these things. It’s just difficult… and Rick, I see Rick and he has this look. It’s this look, it’s like I know what you’re thinking. It’s like he’s judging me. It’s like he knows I’m not normal. I mean, what’s wrong with me? Sometimes I can’t even hold my own child, I… I, she’s crying, and I can’t… I can’t touch her. And when I give her milk, it disgusts me. I don’t know what to do. I don’t know what’s wrong with me. I don’t know what’s wrong with me. [She reaches for a tissue]


00:08:15OFF CAMERA Mrs. Tilman, do you have thoughts of suicide or death?


00:08:20[she shakes her head yes]


00:08:25OFF CAMERA Have you acted upon them?


00:08:30MRS. TILMAN [she shakes her head no] No. I couldn’t. I couldn’t do that to Rick or Jessica. And then I feel guilty again. It’s this… this endless cycle. I’m not happy and I want to get out and if I get out, then I would just… I would just… just ruin everyone and that makes me more unhappy.





Name: Mrs. Abrianna Tilman

Gender: female

Age: 27 years old

Vital Sign: T- 98.6 P- 88 R 18 154/92 Ht 5’1 Wt 230lbs

Background: Recently had her first child two months ago. Currently married; stay at home mother after working in community library for 5 years. Grew up with her mother after her parents divorced when she was 16; has two sisters in Troy, Alabama. Completed education through bachelor’s level, majoring in English Literature. No previous suicidal gestures. Brother committed suicide via gunshot wound (GSW). She denied drugs/alcohol; brother was addicted to methamphetamines. Hx of HTN-prescribed Trandate 100mg twice daily, admits to missing doses due to forgetting. No legal hx. Allergies: Penicillin (PCN)

Symptom Media. (Producer). (2016). Training title 8 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.org/watch/training-title-8




Learning Resources


American Psychiatric Association. (2022). Bipolar and related disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?url= https://dsm.psychiatryonline.org/doi/full/10.1176/appi.books.9780890425787.x03_Bipolar_and_Related_Disorders


American Psychiatric Association. (2022). Depressive disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?url=https://dsm.psychiatryonline.org/doi/full/10.1176/appi.books.9780890425787.x04_Depressive_Disorders


Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.

· Chapter 8, Mood Disorders

· Chapter 31, Child Psychiatry (Section 31.12 only)

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