Assignment on depression PDF

Running head: DEPRESSION
DEPRESSION
Name of the student:
Name of the university:
Author note:

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DEPRESSION
History of Presenting Complaint
This is the case study of Nancy, a 27 year married woman living with her husband
and their two sons. Nancy is currently unemployed but her husband does casual work. Nancy
was admitted in mental health acute inpatient ward after her husband noticed deterioration in
her mental state. Her Husband reported that she was suffering from insomnia for about two
weeks and exhibited a withdrawn behaviour along with flattened mood and suicidal ideation.
Her husband felt worried as well as fatigued due to the care that he needed to provide to his
wife. She used to cry and feel sad. She has lost interest in the day-to-day activities. Nothing
seems to excite her, not even the joy of her children. She no more enjoys being a part of any
social gathering that she used to enjoy previously. However she is still putting on weight and
her current weight is 20 kgs more than what she had been recommended. She prefers fast
food and undertakes a fatty diet. She suffers from fatigue and loses her energy after short
errands. She feels nervous, worthless and guilty. She has become indecisive and has been
unable to make sound decisions. On admission, she reported suicidal thoughts.
Patient History /Family and Social History
Neurologically, the patient reported no significant history of problems during her
growth. Nancy was born in a family of 4 which consisted of younger brother, younger sister,
a father aged 57 years and a mother aged 52 years. Her childhood history is characterised by
instability and stressful episodes. Her parents were engaged in domestic violence frequently
due to her mother’s binge drinking habits. The family separated when she was 11 years and
her mother left her and did not return for several years. Nancy’s mother used to communicate
with them over the phone but she did not seek time to visit them. She returned when Nancy
was 18 years old. Being the eldest sibling, she took the responsibility of raising her younger
siblings and conducting other house chores. Nancy reported a period of desperation when her

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DEPRESSION
mother was away. She started feeling neglected and overworked. Her father took the full
obligation of taking care of the children financially. He used to work for prolonged hours
and seemed frustrated. Nancy always feared to communicate her frustrations and feelings
with her father. This is because she felt that he was not strong enough to take more stress.
When she was of the age of 19, she was sharing a romantic relationship with a boy and then
she got married. She had her first child when she was 22.
Nancy experienced a minor accident in the house that affected her. As a result, she
was not going to work and therefore her employment contract was terminated. She still did
not express her concerns of increased family burdens due to lack of enough finances.
Psychiatric /medical History
Nancy reported beginning treatment of postpartum depression 7 months ago after the
birth of her second son. She realised that she was suffering from depression when she was
pregnant and her suffering continued even after the child was born. Nancy felt like crying all
the time in the first three months of her pregnancy, experienced reduced energy, and always
felt sad and tired. She had lost control of her life. She sought medical help after suffering
from the same feelings post the birth of her son. Her GP prescribed six months dose of Paxil
at 20mgs and Zoloft 50mg daily. Nancy ended up discontinuing the medication upon
realising that her situation was not getting better. According to her, she experienced no
significant differences before and after the medication but she suffered from side effects. She
experienced dry mouth from both medications. However, she admits that she used to sleep
better after the medications were taken. Nancy complained of persistent menstrual flows that
went on for nine days. In addition, Nancy complained to have been on birth control pills
when she conceived her second son. She, therefore, refers to herself as an exceptional person
on which pills do not work.

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DEPRESSION
The Paxil tablet
People with depression, panic attacks and anxiety disorders tend to have an
unbalanced concentration of serotonin in the brain. The Paxil tablet rectifies this imbalance
and thereby helps to calm the patient. Paxil is therefore meant for treating depression, Post-
traumatic stress disorder (PTSD), anxiety disorders and premenstrual syndrome 9.
Zoloft
Zoloft belongs to the category of drugs called selective serotonin reuptake inhibitors
(SSRIs). It is used to balance the concentration and action of serotonin in the brain. Zoloft
treats depression, anxiety and obsessive-compulsive disorders 9.
Diagnosis
Based on the presented findings, Nancy was diagnosed with a moderate single-
episode major depressive disorder. Nancy was placed on inpatient treatment order level 1
(ITOL1) following medical assessment. She was initially refusing treatment stating that she
wanted to go home. Her conditions were showing features of major depressive disorder.
Major depressive disorder is a mental health condition that is characterised by persistent
depressed mood or loss of interest in activities that affected activities of daily living 13 . She
has reported lack of pleasure and loss of interest in the main events in her life. She also
complained of changed sleeping patterns. She also complained of experiencing guilt and lack
of self-worth. her decision-making process was seen to be impaired and she also could not
concentrate. She had no suicidal attempts but expressed concerns of wanting to escape from
her current situations. Nancy has been experiencing the depressions symptoms for more than
two weeks in a row. It has created a major deficit in her functioning, occupation and social
life 5. She is hopeless and always sad. This positions her to cry often. Therefore, depression