Nursing Diagnoses in Psychiatric Nursing Care Plans and Psychotropic Medications

can occur within days, hours, or even minutes. Often these depression, which may give way periodically to anxious agitation or inappropriate outbursts of anger. 1. 3. 2. individuals exhibit a single, dominant affective tone, such as sense of rage that is sporadically turned inward on the self Common symptoms include the following:iors. When clients are clinging to another individual, they Chronic depressionality disorder commonly exhibits a pattern of interaction with with this disorder that before the inclusion of borderline personality disorder in the Clinging and distancing.others that is characterized by clinging and distancing behav-diagnosed as depressed. Depression occurs in response to feelings of abandonment by the mother in early childhood (see “Predisposing Factors”). Underlying the depression is a & Sadock, 2007).and externally on the environment. Seldom is the individual aware of the true source of these feelings until well into long-term therapy.may exhibit helpless, dependent, or even childlike behaviors. Inability to be alone. with feelings of loneliness, emptiness, and boredom (Sadock donment, clients with borderline personality disorder have little tolerance for being alone. They prefer a frantic search for companionship, no matter how unsatisfactory, to sitting. Depression is so common in clients Because of this chronic fear of aban- The client with borderline person-DSM, many of these clients were Personality Disorders ●^281
2506_Ch16_275-309.indd 0281 2506 Ch 16 275 - 309 .indd 4. 5. 0281 need to talk, or from whom they seek constant reassurance. Splitting. Acting-out behaviors, even self-mutilation, may result when is common in people with borderline personality disorder. It arises from their lack of achievement of object constancy and is manifested by an inability to integrate and accept both posi-to spend all their time, with whom they express a frequent tive and negative feelings. In their view, people—including themselves—and life situations are either all good or all bad. they cannot be with this chosen individual. Distancing be-Manipulation.haviors are characterized by hostility, anger, and devaluation they so desperately fear, clients with this disorder become masters of manipulation. Virtually any behavior becomes an acceptable means of achieving the desired result: relief from of others, arising from a feeling of discomfort with closeness. Distancing behaviors also occur in response to separations, confrontations, or attempts to limit certain behaviors. Deval-uation of others is manifested by discrediting or undermining their strengths and personal signifiThey overidealize a single individual with whom they want Splitting is a primitive ego defense mechanism that In their efforts to prevent the separation cance. 1 10/1/10 9:36:57 AM 0 / 1 / 10 9 : 36 : 57 AM