Celestina Igbinosun
10:38amJul 29 at 10:38am
Mental Issues Essay Example
Week 9 Case Study Discussion
Carline, thanks for presenting such a touchy and typical case. This case study speaks to me in a way that indicates where this patient’s mental issues are rising. It is preferable to deal with the source of the problem than put a band-aid on it. I agree with the diagnosis of major depressive disorder for this patient especially knowing this issue has been going on for a long time and the patient has the diagnostic criteria as stated by DSM 5. The major non-pharmacological plan I will put in place for this patient is individual psychotherapy to allow the patient to open up and, at the same time, have the therapist assists her in gaining some self-confidence(Mental Issues Essay Example). After four weeks in therapy, I would have the patient invite her spouse for couples therapy. After three to six months of couples therapy, we would review/evaluate to see if there is any progress. The pharmacological intervention I would use is Remeron 7.5mg PO at bedtime because this will help with depression and insomnia since it is used as an off-label for insomnia. According to the FDA data access, Remeron (mirtazapine) is indicated for treating MDD; in geriatrics, use with caution, and the dose should be conservative, starting at the low end due to decreased clearance in the elderly (FDA, n.d.). In a study performed, Remeron significantly reduced the HAM-D scores from baseline with a significant effect noted from day seven compared to an SSRI (paroxetine); Remeron is an advantage to elderly individuals with difficulty swallowing because it has an orally disintegrating tablet formulation (Norman, 2021).(Mental Issues Essay Example)
“A 12-week weight loss intervention showed improved insulin resistance and cardiometabolic risk factors in obese older adults through exercise plus caloric restriction (Gill et al., 2015). In this case study patient is driven into binge eating due to depression and frustration from the behavior of her spouse. Working with a therapist, as we mentioned earlier, will help the patient deal with the behavior from her spouse and lead to a decrease or complete stop of binge eating. Having the patient focus on her diet by choosing to buy and eat healthy meals together with 30-minute activity, such as walking in the neighborhood three to five times a week, is a starting point. Changing one’s diet, especially for the elderly, is the central aspect of weight loss intervention (Gill et al., 2015).(Mental Issues Essay Example)
References
Gill, L. E., Bartels, S. J., & Batsis, J. A. (2015). Weight management in older adults. Curr Obes Rep, 4(3),
pp.379-388.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5387759/Links to an external site.
Norman, T. R. (2021). Antidepressant treatment of depress
Solution
Response to Celestina
Hello Celestina,
Excellent post! Thank you for sharing your discussion. Your post provided great insights into the diagnosis and management of MDD. I support your claims that mental health practitioners should identify and address the source of patients’ problems to elicit desired health outcomes. Specifically, Cognitive Behavioural Therapy (CBT) is an effective psychotherapy management for patients with MDD. Moloud et al. (2022) research shows that the mean scores of optimism and self-esteem improved significantly among MDD patients in the cognitive behavioral group therapy. Although the results portrayed increased self-esteem and optimism during the follow-up compared to before the intervention, the impact decreased over time(Mental Issues Essay Example). As such, dynamic and continuous cognitive behavioral group therapy will help improve the patient’s self-esteem and optimism. Psychological intervention alters a person’s thoughts and behavior. Notably, 8-12 sessions of CBGT are effective and are based on the connection of a person’s thoughts, behavior, feelings, performance, and physical state.(Mental Issues Essay Example)
Cognitive behavioral group therapy is preferred over individual therapy as it is cost-effective and allows patients to have interpersonal relationships to share their experiences and thoughts, thus improving the treatment outcomes. Cognitive behavioral therapy will also effectively treat elderly patients with MDD who may be highly predisposed to adverse drug interactions. One takeaway I learned from your pharmacological intervention is the ability of the medication to target more than one symptom in MDD patients(Mental Issues Essay Example). I agree that Remeron is effective for managing depressive symptoms and insomnia when administered during bedtime among elderly MDD patients (Huang et al., 2022). Secondly, health practitioners should also determine medications’ benefits and potential side effects. Remeron has a safe side effect profile and minimal drug interaction. Thus, the insomnia side effects are used to the practitioners’ advantage while improving appetite in managing patients struggling with weight loss (Huang et al., 2022).(Mental Issues Essay Example)
References
Huang, H., Wang, F., Chen, Y., Kong, S., Huang, Q., Lyu, D., … & Hong, W. (2022). Difference in the regulation of biological rhythm symptoms of Major depressive disorder between escitalopram and mirtazapine. Journal of Affective Disorders, 296, 258-264. https://doi.org/10.1016/j.jad.2021.09.050(Mental Issues Essay Example)
Moloud, R., Saeed, Y., Mahmonir, H., & Rasool, G. A. (2022). Cognitive-behavioral group therapy in major depressive disorder with a focus on self-esteem and optimism: an interventional study. BMC psychiatry, 22(1), 299. https://doi.org/10.1186%2Fs12888-022-03918-y
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