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III.

ANAMNESIS

Anamnesis is the act of remembering the medical or developmental


history of the patient. It does not simply refer to the past, rather, it makes
present in the future. It functions to form a background against which can
client functioning maybe measured and to gain an understanding of the
clients past, present and potential functioning.
It is from the Greek work that derived from Anamimneskein, Anamme
which means to remind, while Ana + mimneskein means to recall.
Essential date are all required through verbal interactions, hospital
records and informatics who know the patient. We started on May 31, 2016
at 7:00 in the morning and the last day of gathering our data was on June 3,
2016 at around 3:00 in the afternoon during our home visit.
Considering the ethical conduct of confidentiality, we chose to call our
patient as Patient JP. She was born on July 13, 1985. She is 31 years old. She
was confined first time at Southern Philippines Medical Center- Institute of
Psychiatric and Behavioral Medicine, Female Ward, last 2002; second time
was 2009; and from then on, they used to revisit the hospital and admission
became a regular basis.
A. Informants
These are individuals who gave vital information regarding the present
and past condition of the patient. These individuals come to know the patient
for a number of years, they are her relatives, neighbors and friends.
The information that we gathered from these informants give us a valid
picture of the circumstances surrounding the patients condition and further
provided us crucial data for us to understand more deeply the
psychodynamics of our identified patient.
To preserve the principle of confidentiality, we thereby withhold the
true identity of Patient JPs mother, father and son. Thus, we shall address
them with the pseudonyms Mother XYZ, Father ABC, and Son Moon
respectively.
Informant No. 1
Name: Mother XYZ
Address: Purok 5, Acacia, Tubod, Carmen, Davao del Norte
Relationship to the Patient: Mother
Length of time known to patient: 31 years

Apparent understanding on the present illness of the patient:


kadtong 2002, nalibog lagi ko anang bataa na kay di siya
katulog, mahadlok siyag mga taokana pud laging bataa, di jud mag sturya
ug naa siyay problemanaa kaisa nga nag sige nalang siya ug hilak,
mangutana kog unsa iyang problema, mosulti lang man ug wala man daw,
gipangutana hinuon ko niya ug palangga bad aw nako siyagiingnan nako
nga palangga gyud nako siya kay anak man nako siya.
Other characteristics and attitudes of the informant:
Mother XYZ is cooperative and talkative, she knows how to start
and end a statement. She is consistent with her answers. She is very open to
issues and questions, except when we asked about the patient being raped
during high school days. She showed hesitations talking about the issue.
Informant No. 2
Name: Father ABC
Address: Purok 5, Acacia, Tubod, Carmen, Davao del Norte
Relationship to the patient: Father
Length of time known to patient: 31 years
Apparent understanding on the present illness of the patient:
Nalibog ko, wala man unta na siya nag sakit-sakit sauna, wala
man pud mi lahi nga ing-ananatingala lang mi anang nag high school na
siya, nay panahon nga mutipas na siya ug sturya, naa pud daw siyay makita
nga mga tao, miskan wala gud
Other characteristics and attitudes of the informant:
Father ABC showed willingness to answer the questions given.
Hes vocal about disappointment to what had happened to the patient but
not anger as he said. He never showed hesitations as he answer every
questions.
Informant No. 3
Name: Son Moon
Address: Purok 5, Acacia, Tubod, Carmen, Davao del Norte
Relationship to the patient: Son
Length of time known to patient: 11 years

Apparent understanding on the present illness of the patient:


Nagsakit man akong mama, sa insurance man na niya sa Majar
trabaho (pertaining to the insurance company where her mother worked)
sayo na kayo siya mumata kay para mag-zumba, tag alas dose or taga ala
una siya sa kadlawon mulakawgimingaw na ko niya kay wala nay sabaan
sa among balay, wala napuy naga sayaw-sayaw

Other characteristics and attitudes of the informant:


Talks freely about the patients, he shows concern, empathy and
willingness in helping her mother to the fast recovery.
B. Family Tree
a. Maternal and Paternal Lineage
Looking at the parents grand lineage, it reveals that in the
paternal side, 2 of them has diabetes and hypertension while on the
maternal side, the brother of her mother had asthma and died in a tunnel in
Diwalwal, as Father ABC said, ning sulod man gud to siya ug tunnel, unya
maglisod biya kag ginhawa ana sa sulod kay tungod sa chemical, mao to
iyang gikamatyan. No mental illness has been known and recorded on the
paternal and maternal side. Wa man jud intawon mi kaliwat na buang,
ambot lagi anang akong anak ui, added Mother XYZ.
Father
When asked about Father ABCs traits, Mother XYZ answered strikto
gyud na iyang papa, mamunal gyud na kay naa pud nay kasuplada among
anak, di gani ko mulaban sa iyaha kay kusog amn pud mag tubag-tubag sa
ako
Father ABC has 2 brothers and a sister among the 4 siblings, and he is
the youngest. He originated in Cotabato.
As the head of the family and the father, he supported his family in the
best way he can. According to Mother XYZ, Father ABC is a very hard working
man, he doubles his shift at work in TADECO just to provide their needs. sa
wala pa na naing-ana akong bana, pirti gyud tamong paningkamot duha kay
gipaskwela biya na namo sila sa Maryknoll mag-igsuon mother XYZ added.

Father ABCs vices were cigarette smoking, alcohol drinking and


occasionally, Last 2. But father ABC never came to a point that their
budget for food and necessities were spent for his vices. He knows how to
balance as he said. He stopped all of these vices at the age of 40 years old
because he became a pastor in their church.
Father ABC shared that his greatest disappointment is Patient JP. Wala
gyud ko nagdahum anang bataa na nga maing-ana siya. Grabe gyud biyang
paning kamot anang iyang mama para lang gyud lagi makahuman gyud sila,
bright gyud biya untang bataa...nakatigum na unta mi para sa among
itukuray nga balay, unya naing-ana man siya, nahurot among kwarta sa
iyang tambal father ABC with emotional voice.
Mother
Mother XYZ originated in Butuan City. She had a brother and she is the
oldest. She is medium built, talkative, cooperative and showed willingness in
answering the questions and providing information.
Mother XYZ is working hard for the family, especially now that her
husband cannot work due to very poor eye sight brought by diabetes. As
verbalized by Mother XYZ patay-patay gyud kog trabaho ani kay pang
sustiner sa tambal sa ilang papa, mayo nalang karon kay naa nay naga
tabang ana akong anak nga iyang Honey Bunch.
In terms of disciplining her children and grandchildren, she is not into
physical way, instead she is more verbal. Isog man si lola pero palangga
man ko Son Moon said.
Siblings of Patient JP
Patient JP has two brothers, she is second among the three siblings.
According to patients JP, she is close to his two brothers but closer to the
eldest. They fight to simple things as times. di gyud na sila naga away
sauna kay pag makabalo ko sila man tulo akong bunalan father ABC added.
Attitudes and beliefs of their parents were adopted by patients JP
especially the charcteristics of her mother. She said to have been influenced
and grew up as talkative, good in handling people and money.
c. Subject
Prenatal
Mother XYZ and her family accepted her pregnancy and was happy
when they knew she was pregnant. According to mother XYZ, she was not
able to have prenatal check-up because healthcare facilities were distant
from their house, she even gave birth to patient JP in their house with the

help of a mananabang. She did not experience sickness during pregnancy,


she doesnt drink alcohol or involved in any vices.
Though pregnant, she still does her job and leaves the house early for
work. She works at TADECO according to her, grabe gyud ko makatrabaho
sa una mam nga nagbuntis ko ana niya kay naningkamot lagi mi, mutrabaho
gud kog doble, sauna nga mag pack mig saging unya kay usahay mag abuno
pa kog mocap kay kadtong mag abuno pila lang kaoras, mga isa or duh aka
oras isa naman ka shift imong sweldo.
Birth
Patient JP was born on July 13, 1985 and was delivered by a
mananabang in their house. According to mother XYZ, there were no
complications present during and after her delivery. She also added that the
labor lasted for just less than an hour.
Infancy and Childhood
Patient JP was breastfed her mother just for 45 days after delivery.
Accordig to mother XYZ, pagka anak nako sa iyaha 45 days ra gyud nako a
siya napa dede sa akong totoy kay nag balik dayon kog trabaho, sugod ato
ginabilin nalang namo siya sa yaya or usahay sa iyang lola.
Her first tooth erupted during her 6 months. She was able to crawl
between 7-8 months. At the age of 9 months old, she had her first mama
sound. She started to walk with support when she was 1 year old.
Psychosexual
Patient JP got awareness about her own sex identity at the age of 6 as
evidenced by urinating on the comfort room sitting though observing her
brothers observing doing such but standing. She also covers her body every
time private parts are partially exposed. Lakin-on man na siya sauna kay
kani laging siya lang isa babae, ang mga pantalon sa iyang mga kuya, iya
pong panu-utonmao nang pagka abot niya ug grade 1 giingnan nako siya
nga: nak, dili n aka mag sige ug suot-suot ug pantalon kay panglalaki man
na father added with smile.
She had her menarche at the age of 14. She had her regular periods
that lasts for 4-5 days. nagkatawa gani ko ana niya, kay una na siya gidugo
naa man na siya sa skwelahan, pirti daw na niyang hilak sa skwelahan ana
iyang kuya, gipaabsent nalang pud na sa iyang kuya kay ganahan man sad
to mu-absent mother XYZ added.
Playlife

Patient PJ plays both toys for girls and boys. She used to play with her
brothers but can also play with other girls of her age. As verbalized by her
brother, pag makig dula na sya sa amo sauna, pirmi gyud mi ana mag lalis
kay di gyud na magpaalas. At the age of 10, she lied low playing that much
because she was given responsibility in their business, as her mother said
bilib pud ko anang bataa na kay kaya gyud niya ang mga trabaho na akong
ginahatag sa iyakanang siya ang mag asekaso sa palit sa humay, kanang
mg budget sa kwarta kaya gyud na niyapag mag kinwintahay, tama man
pud, mabalanse man pud gyudmahadlok lang pud ko usahay kay basin
makaaway, grabe pud biya na siya ug baba.

School History
Patient JP started schooling at the age of 7 and was enrolled as grade 1
student, she hasnt attended kindergarten nor did nursery level and she left
school at the age of 17.
She completed her elementary level at Tubod Elementary School and
finished high school at Maryknoll. Patient JP has not graduated with a degree
because she stopped when she was second Year College at North Davao
State College taking up Fisheries.
Patient JP is a very diligent student. She excels in class especially
during high school years. She is actually loved by her teachers because of
her assertiveness. Though bullied by her classmates in high school due to
their economic status and her looks, she still managed to graduate High
school with flying colors. Naa gani kaisa nga napatawag gyud mi sa
Guidance kay nangawat daw na siya sa canteen sa school ug burger, kay
nagpalibri daw na sa iya iyang mga classmates, unya nakulang daw to iyang
kwarta, nangawat nalang daw siya kay di daw siya amiguhon ug di daw siya
manglibre as verbalized by mother XYZ.
Religious and Social Adaptability
Patient JP is Catholic by faith, they dont go to church on a regular basis
but verbalized that she really does believe in God and has strong faith to
Him. She never forgets to pray before meals and every time she receives
blessing and even in a not so good situations.
According to her brother, she is a kind and a generous friend. She can
easily adopt to any kind of people. She is fun to be with because of her over
flowing confidence. But despite these positive traits that patient PJ has, she
also has this impulsive behavior, every time she sees people not acting

according to what she expect, she tend to confront and sometimes, bad
words just come out of her mouth and becomes physical and violent. As she
said pag maglagot ko sa tao, labi nag awayun ko, dili jud ko mosugot nga
wala koy Makita nga dugo, di jud ko magpalabotmag supok jud akong ulo
ug makakita kog bata or anak nako nga dili magpatuo, mahapakan gyud
nako ug taman-tamannaa gani kaisa nga nasagpaan gyud nako akong
mama atubangan sa mga doctor diri sa SPMC kay naglagot ko, gigamit niya
akong pangalan para makahiram ang ug kwarta.
Occupational
Patient have lots of experience working. She once worked as an
Insurance agent, and worked part-time dealing or selling avon products.
Lately, she worked as Utility in Panabo City Hall. She does a lot of work, she
even experienced selling barbeques and bananaques. Shes good in personal
relation and she is good in convincing people. She became an area
supervisor in the said insurance company. Nahimo na siya ug area
supervisor ba, wala gani ko katuo sa sugod hangtod ako na mismong mga
kaila ang nag ingon nga kuyaw jud daw kayo mag explain akong anak kay
makumbinse gyud daw lagi sila mother XYZ said so.
Marital History
Patient PJ had a lot of relationships after 2002. She had her first serious
relationship by year 2005 with a Muslim. They were blessed with a child. But
their relationship did not last long, according to father ABC, nagbulag to sila
sa iyang bana nga Muslim kay iyang ginakulata kay gamay ra daw ug
sweldo, mao tong pagkabalo sa pamilya sa lalaki nga ginakulata siya sa
akong anak, gikuha siya sa iyang mga igsuon ug giuli sa Cotabato, inlove
biya kaayo to sa akong anakmao tong didto sa Cotabato, nag guol intawon
ug mayo ang lalaki, nag sige nalang dawug inum, nadepress, hangtod sa
namatay to tungod sa sakit sa liver. Now, their child is left under the care of
her father and mother.
By year 2006, she had another relationship with a security guard, and
eventually got married, they were blessed with two children. They separated
from the roof of their parents and started their own in Rollys subdivision
owned by their family. Even against her will, her husband decided to move
her parents with them. Problems arise, such as conflict between her in-laws
and her, unemployment, scarcity in terms of finances, and she was abused
physically by her husband. Until one day of 2009, she commited suicide by
stabbing her abdomen with a lagaraw but did not succeed. She was then
admitted to IPBM-SPMC and underwent psychiatric evaluation and made her
qualify to be admitted to mental hospital.

After 2009 when she was discharged from the mental hospital, she
worked in an insurance company where she met another man, 68 years old,
widowed, and financially capable. hangtod sa nakaila nako ang akong
honey bunch, tiguwang na pero palangg kaayo ko mam, iya kong ginabsita
diri sa hospital tapos magdala ug mga grasyadi ko madawat sa iyang
pamilya sauna pero kadugayan nadawat raman pud ko mam, okaw man
iyang mga anak patient JP said with her proud voice.
ONSET OF ILLNESS
Patient JP was 17 years old when one of the most traumatic event
happened to her. She was trying to apply as a cashier in a mall in Davao City,
Mag aplly man unta kog cashier or sales lady ato diri maam. Unya pag uli
nako kay niuban ko sa akoang bagong kaila nga amiga unya mao to maam
gibaligya ko niya. Na rape ko, as verbalize by Patient JP.
Since then, changes in Patient JPs personality and behavior was
observed. Dili naman siya muistorya sa amoa, unya natingala mi nganong
mahadlok na siya ug tao ato kung pangutan-on sad namo siya unsay
problema dili pud siya musulti. Mao to giingnan ko sa akoang kumare nga
ipadala didto sa Hospital kay dili man daw tanan ipa admit didto kay buang
mas maayo daw nga ipa check sa daan para makahibalo g naunsa siya. Isa
ra sad mi kaadlaw ato nakagawas dayun mi pagka ugma, gihatagan mi ug
mga tambal, as verbalized by Mother XYZ.
On the year 2005, Patient JP had a relationship with a Muslim and they
were blessed with a baby boy. Her violence worsen at this time, Ginakulata
man to niya ang Muslim kay gamay raman gud to ug sweldo unya
pagkahibalo sa mga igsoon atong muslim nga mangulata akoang anak gidala
nila didto sa Cotabato, mao to na depress unya sigeg inom namatay, as
verbalize by Father ABC. She successfully delivered their baby even if his live
in partner died.
A year after she met a man who became her husband, Naminyo jud
siya unya nagka anak sila ug 2, babae ug lalake, as verbalized by Mother
XYZ. Patient JPs husband is a member of Iglesia ni Cristo and she decided to
convert also her religion. Patient JP strive hard to earn a living for her family
and her husband also works as a security guard in a certain institution until
he stop working and only Patient JP was the one to look for money for her
children and her husband and her mother in-law and her 2 nephew. The first
12 months of their relationship went well until another problem arise,
Padunggan man gud ko sa akong Ugangan maam nga kung dili na kaya
magbalot nalang, as verbalized by Patient JP. Dili man gud na siya gusto
nga musagol didto sa ilaha ang iyahang ugangan maam, as verbalized by
Mother XYZ.

Because of too much stress and conflict with her mother in-law Patient
JP committed suicide inside the comfort room using a lagaraw, Nangihi man
daw to siya maam unya dugay daw kayo nigawas sa CR mao to natingala
iyahang ugangan gisulod unya mao to nakita nga nag dunggab siya gidagan
dayon sa Regional sa Tagum, as stated by Mother XYZ. Because of too much
humiliation and shame Patient JPs husband left her together with her 2 kids,
this event added more stress and this deeply affected her. Permi nalang ko
mag suroy sa dalan maam mamunit ug basura ilahi nako ang malata ug dili
malata, as verbalized by Patient JP. Patient JP become more irritable than
usual and was becoming more hostile.
Patient JP was always wandering. She walks with no sense of direction.
Magsuroy ko maam akoang tapukon ang mga bata sa plaza manghatag ko
ug lollipop, maingnan ko ug milyonaryong mini, as stated by Patient JP.
Since then admission and discharge became a regular basis. Dili man
gud na siya naga inom ug tambal maam ginalabay niya didto sa bintana, as
stated by Mother XYZ.
After election when she saw Duterte leads the presidential race.
According to Patient JP she decided to roam around with a motorcycle
because she is too happy to announce that Duterte might win as the
President. Her workmates noticed that she is too happy and decided to admit
her since they knew the mental problem that Patient JP has. Gipaadmit ko
nila maam kay nag drive man ko ug motor, natingala gani ko maam kay wala
man koy sala. Nag drive raman ko ug motor tingala ko naa na dayon pulis sa
akoang likod.
On May 11, 2016 the social worker decide to bring Patient JP to the
hospital for the reason that her euphoria was out of control. She was
admitted at eaxactly 12:15 in the afternoon. Patient JP was admitted in the
SPMC-IPBM FemaleWard with the diagnosis of Bipolar 1 Disorder, Most
Recent Episode of Manic with Psychotic Features.