Empty Nest- Mirrored in a growing mind: A Case Report

ABSTRACT We report a case of ‘depression’ with ‘empty nest syndrome’ to highlight the importance of parents for psychic development and of family support for effective management of psychiatric disorder.
A 21-year-old lady presented with history of feeling lonely for 2-years, sadness 1 year; and insomnia and death wishes 3 months. She was staying in her home-town with uncle as both parents went abroad 8 years back. She started missing her parents when she had frequent pain abdomen in last 3 years, she could not succeed in examination and friends were away from her. As her uncle and aunt were also busy preparing for abroad work, she increasingly felt lonely and empty in last 2 years.
With growing loneliness, she felt sad and worried. She reported losing interest, feeling weaker and having ruminating thoughts in last year. In between, she met a boy-friend whom she found supportive; but soon, she started worrying that her parents might not agree to this relationship. In distress, she slashed her wrists. Because of her condition, her parents started visa process, which eased for some time. Despite of visa progress, she could not sleep due to worrying thoughts. She expressed suicidal thoughts many times. And, her relatives brought her for psychiatry consultation, though reluctantly. With diagnosis of ‘depressive episode’, she was put on supervised Mirtazapine and Lorazepam. She was also provided psychotherapy which focused on coping and problem solving strategies addressing her ‘empty nest syndrome’, and family members were advised ‘suicide-precaution’.

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आभास भ्रम (Hallucination)

हप्ता दिन पनि भएको छैन, माया (परिवर्तित नाम) का श्रीमान् बितेको। बितेका श्रीमान् आफूसँगै बस्न आएको देखेँ भन्दै तिनी रोइन्। राति चर्पीमा जाँदा 'कालो बिरालो आयो आबुई' भन्दै सानो उमेरकी बुनु तर्सिइन् पटकपटक। देखाएको ठाउँमा केही हुँदैनथ्यो।
'भगवान् प्रकट भएर मलाई वरदान दिए, अब म यस देशको कल्याण गर्नेछु।' सुरुमा पूर्णमानको कुरा पत्याएर धूपबत्ती पूजापाठ पनि गरे तरपछि अरू असामान्य र अनियन्त्रित लक्षणहरू देखिएपछि सबलाई गाह्रो भयो।
कसैले केही नगरे पनि मलाई लात्ताले हान्यो भनी गोरे रिसाउँथ्यो। अरूले सम्झाउँदा झनै कराउँथ्यो। ऊ घन्टौंसम्म लुकेर पनि बस्नथाल्यो ।
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फोबिया (Phobia) अर्थात् डर

परिदृश्य ः

-    संसार जित्ने अदम्य साहस भएका नेपोलियन बिरालोदेखि डराउँथे रे ।

-    सानुनानु एक्लै सुत्न डराउँछे ।

-    धेरैलाई कुकुर, सर्प वा साङ्ला वा यस्तै कतिपय अरू मानिस नडराउने कितपतंग, जन्तुजनावरसँग अत्यधिक डर लाग्ने गर्छ ।

-    पहिले पहिले कार्यक्रम आयोजना गर्दै हिँड्ने मोहनजी (नाम परिवर्तन) लाई केही महिनायता अरू मानिसको अगाडि बोल्न, वा केही गर्नसम्म डर लाग्ने भएको छ ।

-    प्रिमिला मेडिकल एजुकेसन चाहन्थिन् तर इन्जेक्सनको डरको कारणले गर्दा फाइनान्सतिर लागिन् ।

परिदृश्यमा चित्रित गरिएका नेपोलियन, सानुनानु, मोहनजी, प्रमिलाजी र अरू धेरै मानिसलाई कुनै जन्तु जनावर, किटपतंग, वस्तु, रगत, ठाउँ वा अवस्थाप्रति प्रष्ट रूपमा डर भएको देखिन्छ । यस्तो डर (fear) लाग्ने मानिस आफूलाई के कुरामा डर लाग्ने हो सो कुरा र आफ्नो मनको आन्तरिक अनुभूतिसँग पनि भलिभाती प्रस्ट हुनेगर्छ ।
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