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Name: Mrs. Leslie Tilman Gender: female Age: 32 years old T- 97.6 P- 97 R 22 149/98 Ht 5’3 Wt 245lbs Background: Recently had her first child two months ago. Currently married; stay at home mother after working in retail for 5 years. Grew up with both parents, one sister in Omaha, NE. Completed education through bachelor’s level, studying physics. Previous employment included research science as well as high school substitute teaching for 5 years prior to birth. No previous suicidal gestures; has uncle who committed suicide via GSW. She denied drugs/alcohol; uncle was opioid abuser. Hx of HTN-prescribed labetalol 100mg twice daily, admits to missing doses due to forgetting. No legal hx. Allergies: codeine

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Mrs. Tilman, your husband isextremely worried about you.
MRS. TILMANYes, I know that.
Does coming her bother you?
TILMANYes. Yes it does. I’ve never been to ashrink before. I don’t think I need to be here now.
I’d like to ask you a few questions if that’s ok.
TILMANYeah, that should be fine.
Sleep?
TILMANI can’t sleep much. But that’s to be expected.
How so?
MRS. TILMANThebaby. It cries a lot.
And what wakes you?
MRS. TILMANWell I’m usuallyalready awake.
\You have trouble sleeping?
MRS. TILMANJust falling asleep.Especially after the baby cries.
What’s the baby’s name?
TILMANJessica.
Beautiful name. How old isshe?
TILMANTwo months.
How has your appetite beenlately?
\MRS. TILMANI don’t know. It’s not big, butI want to lose weight after the pregnancy.
You aren’t comfortable with the way you look?
MRS. TILMANI’m terrible.Alright. I look terrible, I feel terrible. My body is bloated.I have lines on my face, bags.I look disgusting.
What do you do to lose weight?
MRS. TILMANWell, I want to run, but… I don’tget out much.
Why?
MRS. TILMANCause I’m stuck at home.I have to take care of the baby, all day long.I guess I should just get used to it. This is my life now all day long, stuck at home with the kid.
MRS. TILMANWho could afford one? Especially withhaving to pay for the kid.
Have you said any of this to your husband?
MRS. TILMANTo Rick?
DR. GREYUh huh.
MRS. TILMANNo. I couldn’t.He’d be so disappointed in me.How could I even tell him that I felt this way.That I wanted out.He comes home from work and… he plays with Jessica.This perfect family.
How has your relationship been?
MRS. TILMANNot good.
What’s happened since Jessica was born?
ILMANIt’s notadded much.I mean it is my fault. I can’t stop crying.All the time. [she cries] Sometimes I don’t even knowwho the baby is.And I yell a lot.Things just upset me. Everythingand anything he does lately just upsets me.
For instance?
MRS. TILMANWell…Well the other day he came home and changed her diaperbut he threw the dirty diaper in the wrong trash can and he didn’t tie it up in the bag the way he was supposedto.
And that upset you?
MRS. TILMANYeah. And Itold him, and I was yelling so he started yelling.So yeah. That’s our marriage right now.
Have you been sexually active since Jessica was born?
MRS. TILMANNo. Notreally. I have no drive or desire.Rick keeps wanting to but I just… I push him away.
Andhow is your social life?
MRS. TILMANNon-existent.I haven’t seen my friends in forever.They came over to see the baby but that’s about it.I might as well get used to it.I can’t go out anymore.She’s too young for a baby sitter, and even then we couldn’t afford one.I had to quit my job.
Were youforced to quit?
MRS. TILMANNo. They gave me maternity leave, but… but I figuredthis is never going to end. I might as well leave now.
Do you do anything for yourself? Something to relax, somethingcreative?
MRS. TILMANNo. I tried writing.I liked writing but…I don’t know, I…nothing moves me.
Youcan’t write now?
MRS. TILMANI have no inspiration, and it’s notfun. I know I’m going to be interrupted soon anyway. Before Jessica,I could write for hours a night. I hated anyone disturbing me. [she cries]Now I can’t have twenty minutes. And you can’t tell ababy to hold on with wanting her lunch. For an hour.When she’s hungry, she’s hungry.
Do you regret having a child?
MRS. TILMANNo.I…I’m just not sure.I’m not sure, okay.
Are you happy?Does anything give you pleasure?
MRS. TILMAN[Shakes her head] No.[she cries].Look, please, I…I know I’m a mother now. I.[sigh]I don’t know how to put this, I feelterrible. [Cries harder]. I don’t want to be a bad mother. I love mydaughter. But I don’t know… I don’t knowwhy I say these things. It’s just reallydifficult… and Rick, I see Rickand he has this look. It’s this look,its like I know what you’re thinking.It’s like he’s judging me.It’s like he knows I’m not normal. I mean, what’s wrongwith me? Sometimes I can’t even hold my own child, I… I,she’s crying and I can’t… I can’t touch her.And when I give her milk it disgusts me.I don’t know what to do.I don’t know what’s wrong with me.I don’t know what’s wrong with me.[She reaches for a tissue]
Mrs. Tilman, do you have thoughts of suicide or death?
[she shakes her head yes]
Have you acted upon them?
MRS. TILMAN[she shakes her head no] No.I couldn’t. I couldn’t do thatto Rick or Jessica. And then I feel guilty again.It’s this… this endless cycle.I’m not happy and I want to get outand if I get out, then I would just… I would just…just ruin everyone and that makes me more unhappy.

“,Applied Sciences,/files/nrnpprac6635comprehensivepsychiatricevaluationexemplar1-docx-8263021

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