A 49-year-old Man with Worsening Depression

摘要

A 49-year-old man with a diagnosis of mood disorder not otherwise specified (NOS) presented to the psychiatric emergency room with worsening depression, suicidal thoughts, severe anxiety, and increased intensity of self-injurious behaviors. The patient presented with depressed mood, feeling of hopelessness, anhedonia, easy fatigabil-ity, and problems with memory and the inability to focus. The patient reported a long history of self-punishing behaviors, especially hitting himself with fists. The patient reported that this aggression toward himself is primarily for relief of anxiety, tension, and frustration.