**Title: "Navigating the Complexities: A 41-Year-Old Woman with Adjustment Disorder, EUPD, and a

History of Puerperal Mental Disorder"**

**Introduction:**

Ladies and gentlemen, esteemed colleagues, I am honored to present to you a captivating case that
challenges our understanding of the interplay between various psychiatric disorders. Our subject is
X, a 41-year-old woman, who, in her 23-year journey through the realm of mental health services,
has grappled with an intricate tapestry of conditions. This case presentation aims to unravel the
enigma that is X's mental health, marked by adjustment disorder, a history of self-harm, puerperal
mental disorder, and Emotionally Unstable Personality Disorder (EUPD).

**Case Presentation:**

**Patient Profile:**

- Name: X

- Age: 41

- Occupation: A talented artist, her creativity and passion for her work have been affected by her
mental health challenges.

- Chief Complaint: Ongoing anxiety-related symptoms and auditory hallucinations

**History:**

Our journey with X began on August 22, 2023, when she sought help at our clinic. X’s mental health
history is as intricate as it is profound, spanning over two decades. Her present concerns revolve
around her anxiety symptoms, particularly heightened in outdoor settings, and her struggles with
auditory hallucinations.

**Presenting Complaints:**

1. *Anxiety-Related Symptoms*: X experiences profound anxiety, manifesting as sweaty palms,

palpitations, and hyperventilation when confronted with triggering situations. This has led to her
avoidance of outdoor settings and public transport, affecting not only her daily life but also her
ability to visit galleries and showcase her artwork.

2. *Auditory Hallucinations*: X has been haunted by auditory hallucinations since the age of 19,
characterized by derogatory voices. These voices have often critiqued her artistic creations, causing
her distress and impairing her creative process.
3. *Self-Harm and Puerperal Mental Disorder*: X's history includes multiple hospitalizations for self-
harm, with a significant portion of this year spent in the hospital. Moreover, she has previously
experienced puerperal mental disorders, which impacted her ability to connect with her newborn
and find solace in her art during those crucial moments of life.

**Assessment and Diagnosis:**

- *EUPD with Auditory Hallucinations*: X’s symptoms, the episodic nature of her struggles, and her
insightful self-awareness led us to a preliminary diagnosis of Emotionally Unstable Personality
Disorder (EUPD) with auditory hallucinations. It's important to distinguish these hallucinations from
those typically associated with schizophrenia.

**Auditory Hallucinations in EUPD vs. Schizophrenia:**

- Auditory hallucinations in EUPD often have a clear emotional trigger and are closely linked to
interpersonal conflicts or stressors in the individual's life. In X's case, the derogatory voices are
associated with her self-criticism and the external criticism she has faced as an artist.

- In schizophrenia, auditory hallucinations are more likely to be unrelated to the person's life events
and can include a variety of voices, often discussing the individual in the third person or making
bizarre, non-contextual statements.

**Treatment and Challenges:**

- X has previously received depot treatment, which was discontinued due to side effects. The side
effects included significant weight gain, which further impacted her self-esteem and artistic
expression.

- She currently relies on Quetiapine for sleep, although it hasn't provided significant relief from her
auditory hallucinations. Balancing her artistic pursuits and treatment has been an ongoing challenge.

**Discussion:**

This case is an intriguing blend of different psychiatric conditions, showcasing the challenge of
accurate diagnosis and treatment. X's creativity and passion for art have been both her refuge and
her challenge. Her history reflects the lifelong battle she's waged with her mental health,
necessitating a holistic and empathetic approach.

**Conclusion:**

In conclusion, X's case underscores the complexities of mental health. As we journey alongside her in
search of healing, we must approach her case with diligence, empathy, and an open mind. X’s
resilience, creativity, and self-awareness in the face of her challenges are commendable. We must
remain attentive to her evolving needs and continue our pursuit of therapeutic solutions.
Thank you for your attention, and I welcome your insights and questions regarding this intricate case
presentation.Below is a case presentation for patient X, a lady who has diagnosis of Adjustment
disorder , EUPD and history of puerperal mental disorder. Who was referred due to ongoing anxiety
issues and auditory hallucinations. She is a lady with family history of schizophrenia and also wanted
to be diagnosed for the same. Could you make the below case presentation more interesting and
add information on why this auditory hallucinations in the context of EUPD and not schizophrenia.
Also add information on auditory hallucinations in EUPD vs auditory hallucinations in schizophrenia.

**Title: "Navigating the Complexities: A 41-Year-Old Woman with Adjustment Disorder, EUPD, and a
History of Puerperal Mental Disorder"**

**Introduction:**

Ladies and gentlemen, esteemed colleagues, I am honored to present to you a captivating case that
challenges our understanding of the interplay between various psychiatric disorders. Our subject is
X, a 41-year-old woman, who, in her 23-year journey through the realm of mental health services,
has grappled with an intricate tapestry of conditions. This case presentation aims to unravel the
enigma that is X's mental health, marked by adjustment disorder, a history of self-harm, puerperal
mental disorder, and Emotionally Unstable Personality Disorder (EUPD).

**Case Presentation:**

**Patient Profile:**

- Name: X

- Age: 41

- Occupation: Not specified

- Chief Complaint: Ongoing anxiety-related symptoms and auditory hallucinations

**History:**

Our journey with X began on August 22, 2023, when she sought help at our clinic. X’s mental health
history is as intricate as it is profound, spanning over two decades. Her present concerns revolve
around her anxiety symptoms, particularly heightened in outdoor settings, and her struggles with
auditory hallucinations.

**Presenting Complaints:**

1. *Anxiety-Related Symptoms*: X experiences profound anxiety, manifesting as sweaty palms,

palpitations, and hyperventilation when confronted with triggering situations. This has led to her
avoidance of outdoor settings and public transport.
2. *Auditory Hallucinations*: X has been haunted by auditory hallucinations since the age of 19,
characterized by derogatory voices.

3. *Self-Harm and Puerperal Mental Disorder*: X history includes multiple hospitalizations for self-
harm, with a significant portion of this year spent in the hospital. Moreover, she has previously
experienced puerperal mental disorders.

**Assessment and Diagnosis:**

- *EUPD with Auditory Hallucinations*: X’s symptoms, the episodic nature of her struggles, and her
insightful self-awareness led us to a preliminary diagnosis of Emotionally Unstable Personality
Disorder with auditory hallucinations.

**Treatment and Challenges:**

- X has previously received depot treatment which was discontinued due to side effects.

- She currently relies on Quetiapine for sleep.

**Discussion:**

This case is an intriguing blend of different psychiatric conditions, showcasing the challenge of
accurate diagnosis and treatment. X’s history reflects the lifelong battle she's waged with her mental
health, necessitating a holistic and empathetic approach.

**Conclusion:**

In conclusion, X case underscores the complexities of mental health. As we journey alongside her in
search of healing, we must approach her case with diligence, empathy, and an open mind. X’s
resilience and self-awareness in the face of her challenges are commendable. We must remain
attentive to her evolving needs and continue our pursuit of therapeutic solutions.

Thank you for your attention, and I welcome your insights and questions regarding this intricate case
presentation.