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Mr. and Mrs. Comstock are both patients of your practice Mr. Comstock is treated for depression

Mr. and Mrs. Comstock are both patients of your practice Mr. Comstock is treated for depression

Mr. and Mrs. Comstock are both patients of your practice Mr. Comstock is treated for depression


Mr. and Mrs. Comstock need an environment that is safe for both of them while they grieve the loss of Mrs. Comstock’s previous personality. Mr. Comstock needs to take a leave from work because his whole focus right now is trying to provide care for his wife’s physical and social needs, which is emotionally very draining for him.

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Your wife’s agitated, inappropriate behavior is showing a marked and sudden increase in frequency. Medication that you have been taking for years has helped you manage depression. However, it does not control your symptoms completely and may be losing its effect. The fears and anxieties about your wife’s increasing agitation are of great concern, as it is difficult for you to cope with this change in her behavior. At the same time, your social isolation increases due to the fear of others struggling with Mrs. Comstock’s condition. You feel the need to keep a close eye on her at all times to make sure she is safe. This is not sustainable because of your work responsibilities and, in fact, can put a terrible burden on your relationship with her.

He is having symptoms of a manic episode secondary to her medical condition—her dementia. Since her episodes are becoming more severe, she is also at increased risk for another major depressive episode. Mr. Comstock is encouraged to call his primary care physician’s office and be seen as soon as possible to begin treatment with medications that can minimize the manic and depressive symptoms and also minimize the occurrences of these symptoms.


Mr. and Mrs. Comstock are both patients of your practice Mr. Comstock is treated for depression, which is largely secondary to his wife’s progressive dementia. He is trying to take care of her but finds it very emotionally difficult. Previously very active, they have become socially isolated as their friends are not comfortable around Mrs. Comstock’s progressively obvious dementia symptoms. Mr. Comstock’s brother and his wife were visiting yesterday, and it became very uncomfortable. Mr. Comstock said they were having a conversation about a recent election and his wife suddenly became extremely agitated and started acting out inappropriately; she was yelling and broke a figurine from the table; she finally left the room. He said this has not happened before—that usually she participates in conversations, even if sometimes she jokes too much or changes the subject. The PMHNP discusses with Mr. Comstock that it sounds as though his wife:

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