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A Case Presentation on Depression

In recent times, depression has become one of the major health concerns globally. The

has been an increase in the number of people who have been reported with depression symptoms,

and its effects are often adverse, which has resulted in it being among the leading cause of

disability globally. Cases of suicide due to depression have increased in the last decade, showing

that relevant authorities must develop necessary solutions to address the problem. Studies have

shown that major cases of depression are shown by most patients in their twenties and fifties

(Park & Zarate, 2019). Additionally, the chances of getting into depression are higher in women

as compared to men. Some significant causes of depression are trauma, prior history of

depression, stress, divorce, separation from partners, and job loss.

Despite negative feelings and depression arising from similar causes, they are different.

This is because negative feelings are, in most cases, just a temporary response. Depression, on

the other hand, often persists for weeks, months, or even years. When not treated, depression can

grow to be a chronic illness in most patients. In this case presentation, a study will be conducted

on depression to understand the importance of running a treatment plan based on a patient's

history. Doing this will allow other practitioners to weigh in on whether the diagnosis and

treatment are correct and suitable for the patent. The case concerns Pi, a 52-year-old widow who

has been married for the last 30 years and has been in therapy for about eighteen months.

History of the Problem

Pi reports that she started exhibiting the symptoms of depression for over twelve years,

and these problems have, in the last three years, started getting worse. When her husband had his

first heart attack, Pi says it was frightening for her. After his husband's recovery, they both were

able to resume their jobs. A few months after returning to work, Pi started getting stressed as
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pressure from the local investors and management increased. This pressure was due to a poor

financial miscalculation that resulted in the company losing a lot of money, and as a team leader

of the financial team, the pressure was placed on her to find ways n which the company could

recoup the funds. This made her even start hating her job, which she claims was, at one point, her

dream job.

According to Pi, she started exhibiting moments of breakdowns and became obsessed

with wanting to kill herself six months after the saga at her workplace. She started becoming

afraid of people, even her husband, during this time. Additionally, she started having nightmares,

and at one time, she dreamt about her husband trying to stab her with a knife. This series of

nightmares continued for some time until she decided to seek therapy sessions at a local hospital.

During this time, she started getting better, but her productivity levels at her workplace had

reduced tremendously. Just when things were returning to normal, her husband suffered another

heart attack; this time, it was fatal, and he died. This was one of the lowest moments of her life,

and her depression worsened as a result. She became hopeless and had frequent thoughts of

suicide, and she also started experiencing moments of uncontrollable crying.

Psychiatric and Mental Health Diagnosis

Diagnosis of depression entails taking into consideration both the physical and mental

symptoms exhibited by a person. The specific symptoms of depression are also necessary to

diagnose and treat depression (Siniscalchi et al., 2020). Doctors can use contact us standard

questions to establish if a patient suffers from depression. Alternatively, a physical examination

can also be used to establish a person's health status; by doing so, a doctor can learn the distinct

factors that cause depression in a specific patient.

When a patient is found to have depression, the diagnosis must be confirmed by

following the DSM-5 criteria (Maurer et al., 2018). DSM-5 is used in the diagnosis and treatment

of different mental health disorders. Other mental health ailments should be considered if the

symptoms do not meet the criteria. A laboratory examination should be conducted on older

patients since they may have other conditions that have the same characteristics as depression.

Treatment plan

Treatment plans for depression are many and varied depending on the severity of the

case. According to Grover et al. (2019), the main options available are antidepressants,

electroconvulsive therapy, and psychosocial intervention. Antidepressant medications can use

during the initial stages of treatment for patients exhibiting a mild, moderate, or severe case of

depression. The selection of antidepressant drugs depends on the patient's preference, tolerability

to certain drugs, side effects, and even cost (Grover et al., 2019). The recommended

antidepressant drugs are serotonin reuptake inhibitors, tricyclic antidepressants, and mirtazapine

which should have their dosage started from small amounts as the patient's response is gauged,

and effects will determine how the proceeding dosages would be administered. Patients taking

this type of drug are to be monitored closely as the effects of this drug may be adverse to them.

Psychotherapeutic interventions are recommended as an initial treatment plan for patients

with mild to moderate depression n levels. The different clinical features considered when

determining which psychotherapy to use are psychosocial stressors and interpersonal difficulties.

The preference of the patient is also another factor that should be taken into consideration. In this

case, the types of therapy that can be implemented are cognitive behavior therapy, interpersonal

therapy, and family therapy. It is also advisable that a psychiatrist base the number of therapy
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sessions a patient is accorded depending on the needs of the patient and the severity of the

Depression (Grover et al., 2019).

Lastly, electroconvulsive therapy (ECT) is resorted to when other treatment forms have

proved unsuccessful. This procedure uses an electrical simulation technique to produce seizures

in the patient (Li et al., 2020). ECT is rarely used because it has many side effects compared to

other treatment methods. Some of the known side effects of this procedure are increased and

frequent headaches and muscle pain for those who undergo this process. Despite the side effects,

ECT has been found to be highly successful in defeating depression for its recipients.

Health Promotion and Patient Education

Education plays a significant role in the treatment of all the major depression cases that

are known. In this case, Pi and her family can be educated on how to address the illness best to

avert any stigmatization. Pi also needs to know the effects and expected results of any treatment

plan she may wish to implement. Family members are vital informants who can play a huge role

in ensuring medication compliance and offering social support to the patient, hence why their

education is essential.

Psychiatrists can be essential in teaching patients important details about depression and

ways to promote overall well-being. Some of the essential teachings a patient can be provided

with are signs and symptoms of depression, reinforcing the importance of taking medication and

therapy sessions, and finally, encouraging patients to avoid any triggers that might awaken their

depression episodes.

Peer Questions

1. What are some of the critical steps that can be taken to help patients with depression

based manage their condition?

2. What are some ways that can be used to assess the effectiveness of the treatment plans

available for treating depression?

References

Grover, S., Gautam, S., Jain, A., Gautam, M., & Vahia, V. (2019). Clinical Practice Guidelines

for the management of depression. Indian Journal of Psychiatry, 59(5), 34.

https://doi.org/10.4103/0019-5545.196973

Li, M., Yao, X., Sun, L., Zhao, L., Xu, W., Zhao, H., Zhao, F., Zou, X., Cheng, Z., Li, B., Yang,

W., & Cui, R. (2020). Effects of Electroconvulsive Therapy on Depression and Its

Potential Mechanism. Frontiers in Psychology, 11(80).

https://doi.org/10.3389/fpsyg.2020.00080

Maurer, D., Raymond, T., & Davis, B. (2018). Depression: Screening and Diagnosis. American

Family Physician, 98(8), 508–515.

https://www.aafp.org/pubs/afp/issues/2018/1015/p508.html

Park, L. T., & Zarate, C. A. (2019). Depression in the Primary Care Setting. New England

Journal of Medicine, 380(6), 559–568. https://doi.org/10.1056/nejmcp1712493

Siniscalchi, K., Broome, M. E., Fish, J., Ventimiglia, J., Thompson, J., Roy, P., Pipes, R., &

Trivedi, M. (2020). Depression Screening and Measurement-Based Care in Primary Care.

Journal of Primary Care & Community Health, 11, 215013272093126.

https://doi.org/10.1177/2150132720931261