Mental Health Nursing: A Case Study on Anxiety Disorder

Running head: MENTAL HEALTH NURSING
Case Study 3
Name of the Student
Name of the University
Author Note

1MENTAL HEALTH NURSING
Depression refers to a prolonged state of aversion and low mood that prevents individuals
from participating in all kinds of activities, thereby affecting the behaviour, thoughts, sense of
wellbeing and feelings of the concerned person (Martin, Neighbors and Griffith 2013). In this
case scenario, a thorough evaluation of the symptoms presented by Lousie signifies that she is
suffering from major depressive disorder (MDD). The essay will illustrate the manifestations of
this psychological abnormality in her behaviour and will also establish strategies that can be
adopted to establish a therapeutic relationship, with the primary aim of promoting her mental
health.
According to statistical studies, depression has been found to be extremely prevalent and
widespread among all psychiatric disorders found in the UK (Mentalhealth.org.uk 2018). Reports
published in 2016 indicate presence of depression among 3.3 out of 100 people (Polanczyk et al.
2015). Most common symptoms manifested among patients suffering from depression are
exhibition of low mood, inability in experiencing any kind of pleasure, ruminating over previous
incidents, feelings of worthlessness, regret, and hopelessness. Self-hatred, helplessness and
delusions are also observed (Da Silva et al. 2012). The case scenario involves Lousie who has
been transferred to an acute admission ward. Upon admission, it was found that she is depressed
and socially isolated. She exhibited depressive symptoms of worthlessness and displeasure. Cuts
and bruises on her wrists illustrate presence of self-destructive or suicidal behaviour. Research
evidences suggest that self-harm is not a mental disorder; rather it is a behaviour that indicates
lack of abilities to cope with mental distress (Hawton, Saunders and O'Connor 2012). It refers to
purposeful injury that makes a person harm oneself. This might have made her inflict self-harm.
Furthermore, research studies indicate that more than 40% patients suffering from depression
have been subjected to physical or sexual abuse in their childhood (Lindert et al. 2014). This can

2MENTAL HEALTH NURSING
be correlated with a similar incident where Lousie was sexually abused by her Uncle. Thus, there
is a need to foster therapeutic relationship with Lousie in order to promote her holistic recovery
and wellbeing.
Therapeutic relationship forms an essential aspect of psychoanalysis and helps the
healthcare professional to study the unconscious mind of the patient. It is generally categorized
into three components namely, transference/countertransferance, working alliance and real
relationship (Sucala et al. 2012). Establishment of this relationship will principally involve active
involvement of Lousie. Depression makes a client vulnerable in a variety of ways and results in
psychological weakeness. Thus, a good therapeutic relationship will help her feel better and will
create significant impacts on reversal of her depressive symptoms. In order to effectively engage
with the patient, it is essential to develop a relation based on trust, affection, respect, power and
professional intimacy (Gelso 2014). There is a need to consider Lousie’s current mental state of
helplessness and apathy, in order to promote a healthy relationship. Emphasis will be put on
several aspects of verbal and non-verbal communication as communication tools that will
facilitate strengthening of bonds, thereby producing positive results. Regular monitoring
activities of the patient will act as the first step in this procedure (Theodoridou et al. 2012).
Most often, people suffering from major depressive disorder are found to be non-
cooperative and stubborn. This makes them show non-compliance to treatment and interventions.
This can be ascertained by the fact that she has been transferred across several health services
due to lack of engagement. Under such circumstances, while considering the severity of
depression, there is a need to develop collaboration on the major rules of therapeutic relationship.
All kinds of opinions and counselling advices will be focused on the needs and problems of
Lousie (Browne, Cashin and Graham 2012). Adequate display of empathy and genuineness will