Depressive Disorders Essay
Depression affects both the mental and physical wellbeing of an individual.it is considered to be one of the leading causes of disability with 300 million people estimated to suffer from the disorder globally. The Center for Disease and Control and Prevention (CDC) reported 10.4% and 5.5% of women and men respectively to have had depression between 2013 to 2016. Depression is a mode disorder that results in persistent feelings of sadness and loss of interest. It affects the feelings, thoughts, and actions which interfere with the normal functioning and conducting of activities. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), major depressive disorder is characterized by depressed mood, loss of pleasure and interest in activities, change of appetite and weight, sleep disturbance, loss of energy or fatigue, psychomotor agitation and feelings of worthlessness (American Psychiatric Association, 2013). Other symptoms include recurrent suicidal thoughts and reduced ability to make decisions, concentrate or think and five of them should be persistent for at least two weeks Depressive Disorders Essay.
HPI and clinical impression
The patient is a 21-year-old female African American patient who was found in his room attempting to commit suicide using benzodiazepenes and opioids medications. She confesses to have had suicidal thoughts since the age of 12 years as she was transitioning from childhood to adolescent stage. She does not like her body type and considers herself not to be beautiful. She was bullied in high school and has always felt worthless, unloved and lonely. Recently, she broke up with her boyfriend which was very traumatic Depressive Disorders Essay. Her depressive symptoms include feelings of worthlessness, insomnia, lack of concentration, anhedonia, loss of appetite and weight as well as feelings of sadness for the last two months. She also experiences persistent suicidal thoughts and has attempted suicide on three occasions.
Depressive disorder can be treated pharmacologically using medication. Multiple types of antidepressants drugs are employed to alleviate the symptoms of depression. These include Selective serotonin reuptake inhibitors (SSRIs) such as paroxetine, vilazodone, citalopram, fluoxetine and escitalopram (Stahl, 2014). Other antidepressants include Serotonin-norepinephrine reuptake inhibitors (SNRIs), Tricyclic antidepressants, atypical antidepressants and Monoamine oxidase inhibitors (MAOIs) among others. In this case, the patient will be treated using citalopram 20mg. this drug presents fewer side effects and has been confirmed to produce positive outcomes to depression patients. The dosage will be increased to a maximum of 4omg if the initial dose does not cause optimal results. The therapeutic end points include restoration of normal sleeping patterns, moods and activities as well as elimination of suicidal ideations. Depressive Disorders Essay. This is because; serotonin blocks the neurotransmitter receptors at the neuronal synapse thus restoring the normal state of the brain functions.
Psychological interventions for depression include talk therapies involving the individual patient, groups and families. This approach will be based on cognitive behavior therapy which seeks to modify the emotions, thought processes and actions of a depressed patient (Gabbard, 2014). Individual therapy will entail training on multiple techniques such as resolution of personal issues, recovery from mental illness and creation of desired changes. On the other hand, the patient will engage in group therapies which will engage him in coping efficacy skills and activities as well as promote open sharing and acceptance Depressive Disorders Essay. Family therapy will help in identifying the patient’s social needs and strategies to facilitate recovery at home. Cognitive behavior therapy will run for six weeks and is expected to improve the quality of the patient’s life, eliminate negative thoughts and promote coping as well as improve the resolution of personal issues.
Medical Management needs
Medical management needs for depressed patients include actions that minimize the need for medical services. these needs support the primary care providers and caregivers in improving the condition of the patient. As such, a collaborative relationship between the psychiatrist and the primary caregiver will help in the identification of the client’s needs and enhance timely delivery and assessment which improves quick recovery. Moreover, sharing of the information particularly on the client’s mental and family history will help the psychiatric provide an appropriate diagnosis guided by evidence. In addition, this will help in identifying and resolving the challenges encountered during treatment often regarding the client’s adherence to the treatment plan, side effects of medication and the rate of recovery. Electronic monitoring off medication will also ensure no medical errors take place as they seek to identify the optima dosage tolerated by the patient (Sadock, Sadock and Ruiz, 2014).
The community offers diverse types of support to mental patients. This includes setting up rehabilitation and nursing homes as well as financing their medical services through different community programs. Consequently, they set up community agencies that advocate for creation of awareness on depression, educate people on mental wellness, provide information on prevention and treatment and also condemn stigmatization of depressed patients. The patient will therefore benefit from these services which include free counseling, social support and access of information. Depressive Disorders Essay.
Follow up plan
The patient will be expected to visit the clinic after every two weeks. If the progress will be positive and no therapeutic changes are proposed, she will then be given monthly appointments.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer Depressive Disorders Essay
Stahl, S.M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.
To prepare for this Assignment:
Select an adult or older adult client with a depressive disorder you have seen in your practicum.
In 3 pages, write a treatment plan for your client in which you do the following:
Describe the HPI and clinical impression for the client.
Recommend psychopharmacologic treatments and describe specific and therapeutic endpoints for your psychopharmacologic agent. (This should relate to HPI and clinical impression.)
Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices Depressive Disorders Essay.
Identify medical management needs, including primary care needs, specific to this client.
Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.
Recommend a plan for follow-up intensity and frequency and collaboration with other providers. Depressive Disorders Essay.