Mental Health Nursing: Therapeutic Approaches to Depression

This case study examines a patient, Louise, suffering from major depressive disorder (MDD) and admitted to an acute admission ward exhibiting symptoms of worthlessness, displeasure, and self-harm. The essay emphasizes the importance of establishing a therapeutic relationship with Louise to promote her holistic recovery and wellbeing. It highlights the prevalence of depression, its common symptoms, and potential causes such as past trauma. The paper discusses strategies for building trust, displaying empathy, and applying interventions like antidepressants, lifestyle changes, and psychotherapy to facilitate mental health recovery. The study concludes that a focused therapeutic approach is crucial in helping Louise overcome her depressive symptoms and improve her overall mental health. Desklib offers a variety of study tools and resources to aid in understanding mental health nursing.

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

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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

3MENTAL HEALTH NURSING
foster the relationship. Self-awareness of feelings that arise in a relationship and the capability to
communicate them will help her to build trust upon the healthcare staff. Being concrete and clear
in the goals of the intended treatment will make her understand that the interventions are being
applied for betterment of her mental health (Gossman and Miller 2012).
The complex and multidimensional concept of empathy encompasses cognitive,
emotional, moral and behavioural components. Displaying empathy will make Lousie realize
that her situation is being accurately perceived and understood (Raab 2014). Furthermore,
demonstration of a positive regard for her will imply respect that will signify that she is worthy
of being cared for. It will make her identify willingness of the staff to improve her mental state.
Furthermore, displaying attending behaviour by interviewing Lousie, suspending value
judgments such as labelling drug usage or inappropriate sexual behaviour of the client as bad,
and helping her develop their strengths will also facilitate therapeutic relationship.
Mental health recovery refers to the journey of transformation and healing that enables an
individual suffering from mental disorder to live a successful and meaningful life in the society.
It also facilitates achievement of complete potential. Mental health promotion in Lousie can be
accomplished through providing relief for her symptoms (Szasz 2013). Administration of
antidepressants such as, selective serotonin reuptake inhibitors (SSRIs) as primary medications
will help in reducing her depressive symptoms. Most common antidepressants that can be used
are fluoxetine, bupropion and citalopram (Renoir 2013). Furthermore, lifestyle changes such as
recommendation of moderate physical exercise can be implemented to enhance her mental
recovery. Smoking cessation and abstaining from alcohol consumption will effectively promote
her wellbeing. Other interventions that can be applied in this setting include psychotherapy
(Killaspy et al. 2012). It has been found to exert similar benefits as antidepressants and will

4MENTAL HEALTH NURSING
reduce the recurrence of depressive symptoms. Encouraging Lousie to get adequate sleep and
follow a dietary modification will facilitate easy recuperation (Dihoff and Weaver 2012).
Furthermore, there is a need to educate her family members and friends on the underlying factors
that have contributed to this mental disorder. Involving them during her treatment and
encouraging them to give feedback will reduce the stigmas that are most commonly associated
with mental illness (Tew et al. 2012). Talk therapy is another major approach that will provide a
better understanding of the insecurities and fears experienced by Lousie, thereby helping in
development of appropriate interventions (Gehart 2012).
To conclude, it can be stated that depressed mood is most commonly identified as normal
and temporary reactions to sudden life events, such as, financial loss or death of a beloved friend
or family member. Furthermore, it also manifests itself as side effects of certain physical
disorders or drug usage. Depressive symptoms are manifested by Lousie in the form of her
inability to maintain self-esteem and worth. Furthermore, the traumatic experience of abuse
might have altered the structure and chemistry of the brain, thereby sensitizing stress response
system. This made Lousie overly responsive to a wide range of environmental pressures. Thus,
an effective therapeutic relationship will help in her recovery.

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