Larry is a seventy two-year old married male, living in rural Minnesota, seeking services because his wife is concerned with his mood. “I don’t know what she is so worried about. I am the same that I have been since I can remember. I can be sad, but everyone gets sad sometimes. Its not like I am gonna kill myself.” He reports medical issues with his heart that are currently being monitored by his primary care physician. He had all of his teeth removed by the dentist three years ago and replaced by dentures due to the lack of dental care throughout his life. He denies any use of prescribed medications or illegal substances.
Larry reports being married for 49 years, in what he described as a “roller coaster” marriage. He and his wife have three adult children and four grandchildren. However, he does not have contact with any of his children or grandchildren on a regular basis. “They don’t want to see me. I made some mistakes, but it really couldn’t have been that bad.” When asked about the “mistakes” that were made, Larry changes the subject to his abusive father. “I thought you wanted to know about me, not my children. Not a one of them cares about me. In fact, I don’t plan on having a funeral. Screw them! They can pretend to like me on their own time.”
After graduating high school, Larry enlisted in the United States Navy. Two years later, he was “let go” with a dishonorable discharge. Larry reports that the dishonorable discharge, “was not his fault.” “I don’t know why this happened. I didn’t do anything wrong. I was married, had one kid and then I had no job.” His employment history continues to include several manual labor jobs with a pattern of moving to a different state on a yearly basis. “I like change. It never hurt anyone to move around.” However, he has stayed in the same home, with his wife, since 1999 in a small “fixer-upper” home.
He works forty hours a week at a local company and has secured health insurance for the first time since being enlisted in the Navy. Financially, he and his wife continue to live “paycheck to paycheck” with some weeks being “lean.” Larry reports that he has a lot of life stress and enjoys drinking every night after work to be able to “unwind.” When asked how much he drinks each night, he replied, “Oh, it depends. I spose it could be 10 beers a night. I take five Excedrin every night so I can get up in the morning and go to work. Sometimes on the weekend it could be more. I like to drink some beer after mowing the lawn. Is that a crime?” “I don’t have a problem with alcohol. I like it very much!” Larry denies any law enforcement involvement due to alcohol use. “I always drink at home.”
Larry’s wife reports that he has always had a temper. “When he drinks it is worse. He won’t tell you that he has physically and emotionally abused me and the kids. He sexually abused our daughter too.” She has witnessed Larry taking a loaded shotgun and claiming that he plans to “make it all end.” “He has never done it. Just talks about sometimes when he drinks at night.” She reports that he spent one night in jail after the local police were called due to his temper, drinking, and abuse to son. “He was so mad at me. I had 24 hours to sign the paperwork to have him sent to the state hospital for testing. I just couldn’t do it. He would have been so mad when he got back from the state hospital.” ” I just wish that his mood was better. He can be so irritable at times.”
Symptoms to support the diagnosis:
Psychosocial or environmental issues: