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LieutenantDuckMaster771
Case #3: The Case of Mark Mark is a 34 year old single Asian…
Case #3: The Case of Mark
Mark is a 34 year old single Asian American man who lives with his mother and works as an
accountant. He is seeking treatment because he is very unhappy after having broken up with his
girlfriend over three weeks ago. His mother had disapproved of his marriage plans, ostensibly
because the woman was of a different religion. Mark felt trapped and forced to choose between
his mother and his girlfriend, and because “blood is thicker than water,” he had decided not to go
against his mother’s wishes. Nonetheless, he is angry at himself and at her and believes she will
never let him marry and is possessively hanging on to him. She is a very domineering woman
who has always “told me what to do,” says Mark. He is afraid of “making waves” with her
because she might throw him out of the house and he would have to fend for himself. Although
he views himself as being weak, he also says that he really loves his mother and “she’s been there
when no one else was.” He vacillates and thinks that she may have been right about his
girlfriend.
Mark works at a job that is several grades below what his education and skills would allow him
to do. He has turned down promotions because he didn’t want to take on the added responsibility
and was afraid to supervise other people, for fear of offending them. He also didn’t want to have
to work independently on projects.
He has two close friends from childhood and meets with one or the other of them every day for
lunch. If either friend misses a day for any reason he feels “lost” and gets worried his friend
doesn’t like him anymore.
Since he broke up with his girlfriend he has been feeling very despondent. He’s had difficulty
getting enough sleep almost every night. He’s also been losing weight because he doesn’t feel
like eating that much. This is of some concern because Mark has been diabetic since childhood
and although he generally does a good job of monitoring his blood sugar level and administering
insulin, not eating regularly makes it harder for him to maintain an even level. Mark complains
because his mother then gets especially worried about him and becomes more intrusive. He
admits that the reason he stays at home with his mother because of his diabetes and his fear that
it would get way out of control if he did not have his mother overseeing and monitoring his
diabetes management.
Mark used to play cards with his friends on Friday night but he has skipped the last two weeks to
stay home with his mother. “I just don’t have the energy to go out.” He still is functioning all
right at work but he finds it increasingly difficult to make decisions whether at work or not.
“Even about small things, like what kind of bread to buy. I just ask Mom what she wants.” He
denies any suicidal ideation but reports that this is the second time he has felt this down. “Two
years ago, I was going out with another girl and the same thing happened. As soon as Mom met
her, it was like that was it–they hated each other. Mom would never let me hear the end of it, so
I just stopped calling Martha. But she probably wasn’t right for me either.” He says, “After that I
could barely get out of bed in the morning for about four months. But then I just gradually got
over it.”
Please provide correct diagnosis. There is more than one correct answer.
Case #3: Mark
Principle Diagnosis
a) _____293.83 (F06.32) Depressive Disorder Due to Another Medical Condition with major
depressive-like episode
b) _____309.21 (F93.0) Separation Anxiety Disorder
c) _____307.42 (F51.01) Insomnia Disorder with non-sleep disorder comorbidity
d) _____250.01 (E10.9) Diabetes Mellitus without complication type 1 not stated as
uncontrolled
