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Clinical Case Report: Depression Essay (Critical Writing)

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Updated: Jun 15th, 2022

Introduction

People’s well-being is a complex phenomenon that focuses on physical, psychological, and social components. If a person experiences a problem with any of them, their life quality deteriorates. As psychological issues, they are widespread in the modern world, and depression is a typical example. According to Lewis et al. (2019, p. 904), the condition will be the leading cause of disability in developing nations in 2030. Furthermore, Kuehner (2017) claims that women have this mental disorder two times more oftener compared to men. Multiple factors contribute to the given state of affairs, and this fact means that depression should deserve sufficient attention. That is why it is necessary to take a comprehensive approach to analyze the issue. What are the typical symptoms of depression that are also found in the patient video, and what are the diagnostic criteria? How is it possible to describe the etiology of the given condition? What are the treatment guidelines considering the disorder under analysis? Thus, the case report will present the answers to these questions.

Depression Symptoms

In the beginning, it is reasonable to comment on the typical clinical features of depression. The given mental disorder is well represented in research, meaning that multiple scholarly articles consider the topic. For example, the study by Peres et al. (2017) focuses on depression symptoms. The scientists indicate that hopelessness, sadness, changes in appetites, fatigue and sleep disturbance are the typical clinical features of the condition under analysis (Peres et al. 2017, p. 6). It means that the mental disorder implies both physical and emotional symptoms. Additionally, Fitzpatrick et al. (2017) expand the number of potential clinical signs. Further features include little interest in the world, decreased self-esteem, low energy, and others (Fitzpatrick et al. 2017, pp. 6-7). All these symptoms indicate that depression significantly affects people subjecting them to multiple adverse consequences. As a result, depressive individuals cannot be fully-fledged members of society and even their families. It is so because their mental health issue catches all their attention.

Since the paragraph above has offered typical depression signs, it is reasonable to identify whether some of them are present in the case under analysis. A video by Coelho (2020) depicts a woman who is sitting in a flat. A state of disorder is evident after watching the video because the dishes are dirty, the clothes are lying on the floor, and the table is overloaded with multiple objects. These facts can demonstrate that the woman has decreased self-esteem. Furthermore, she can be considered hopeless and sad because she is crying. Appetite problems are also present because there is some food in front of the woman, but she draws no attention to it. Moreover, the presence of sertraline on her table also indicates that depression is a possible diagnosis because this medication reduces depressive symptoms in twelve weeks (Lewis et al. 2019, p. 904). However, this information is insufficient to claim that the woman is suffering from depression because different mental disorders have similar symptoms. Consequently, it is necessary to use specific and relevant criteria to find the answer.

Considering the claim above, one should focus on the professional documents, and the World Health Organisation’s (WHO) guidelines are a suitable option in this situation. It refers to the ICD-10 classification that presents criteria for medical specialists to make the correct diagnosis. According to the WHO (1993, p. 94), two weeks is the minimum duration of a mental disorder to qualify for a depressive episode. The video makes it impossible to state the precise duration of the woman’s condition, but the presence of dying plants on the table indicates that it is close to two weeks. Furthermore, hypomanic or manic symptoms are absent, meaning that it is possible to talk about a depressive episode. Now, it is necessary to determine its severity which can be mild, moderate, or severe.

The WHO’s guidelines provide all the necessary information to make a specific diagnosis. The video shows that the woman has decreased energy and no interest in anything. Furthermore, it seems that she has feelings of excessive guilt and a change in appetite. The presence of dirty dishes shows that the woman used to have a decent appetite, but the current food in front of her does not evoke any interest. According to the WHO (1993), these symptoms allow supposing that the person has a mild depressive episode (F32.0). This conclusion is essential since it can help choose the most appropriate treatment approach to achieve the best health outcomes.

Etiology of the Condition

Since it is challenging to determine the etiology of the condition from the video at once, it is reasonable to identify the possible options found in the scholarly literature. Since it has already been mentioned that depression is a significant issue for the healthcare industry, it is not a surprise that many peer-reviewed articles address the topic. That is why this section will present all possible causes and conclude regarding which ones are the most suitable for the given case.

Firstly, it is necessary to mention that biological factors represent the etiology of depression. According to Anushivarani et al. (2018, p. 6373), they are alterations in hormonal regulation, immunological disturbances, fluctuations in biogenic amines, genetic factors, and others. This information demonstrates that numerous internal processes are responsible for developing this condition. For example, it is a popular idea that changes in serotonin levels can be interpreted as a depression cause since this neurotransmitter deals with relaying signals from one area of the brain to another. It results in the fact that various people consider bad brain chemistry or chemical imbalance the leading element of depression etiology. There is some reasoning behind this claim, which leads to the fact that clinical assessments are a valuable instrument to determine whether a person has this specific mental disorder. It is useful to analyze a patient’s blood sample to identify whether the values of some chemicals are elevated or lowered.

Secondly, one should mention that social factors can also become depression causes. The article by Hellman (2018) demonstrates that the environment can subject a person to mental disorders. It refers to the fact that the ambiance of the family determines whether people are more exposed to depression. For instance, it was shown that living with family members who abuse substances increases the chance of developing a mental condition (Hellman 2018, p. 150). Furthermore, people can often experience depressive symptoms when one of their relatives has a gambling addiction (Hellman 2018, p. 150). It is possible to assume that being in close contact with a person who has depression also increases the probability of experiencing its symptoms. This claim has a direct connection to the idea that a family history of mental disorders leads to an individual being at risk of suffering from possible symptoms.

Thirdly, it is worth emphasizing that psychological factors also contribute to developing depression. These factors encompass a wide variety of events and conditions that affect people’s feelings, emotions, and thoughts. Thus, Anushivarani et al. (2018, p. 6373) report that adverse life events and environmental stress are typical causes of depression. It is so because the loss of a family member or a quarrel with a friend can lead to depressive symptoms. Psychodynamic factors are included in this group of causes since the condition under analysis can develop if people fail to establish healthy relationships with the desired individuals. Additionally, Anushivarani et al. (2018, p. 6373) note that cognitive distortions have a direct relation to depression etiology. These phenomena are habitual negative thoughts that determine how people approach and interpret various situations. Disqualifying the positive is a typical example of cognitive distortion. It occurs in those cases when people only focus on adverse aspects of a situation, meaning that they cannot identify and value good events.

The information above has demonstrated that multiple factors constitute the etiology of the condition under analysis. It is impossible to mention that any of them is more influential than the others, meaning that each of them can equally result in depression. It allows supposing that every sphere of life provides individuals with sources of mental disorders, which explains the international spread of psychological conditions. In other words, since personal relationships, blood and brain chemistry as well as specific genetic background can result in depression, virtually no one can feel protected against the given condition. This information also denotes that sufficient attention should be drawn to every specific case to ensure that the causes are correctly established, which is necessary for the selection of an appropriate treatment approach.

When it comes to the patient video, it is challenging to determine a specific factor that has contributed to depression. Firstly, the video does not depict the woman’s clinical assessments, making it impossible to exclude biological factors. Secondly, social factors are not evident in the video, but it does not mean that they do not affect the patient. Thirdly, psychological factors that could be caused by an adverse life event are likely to be present in the case. It refers to the fact that the presence of felt pens and for “For My Mum” postcard allows supposing that something tragic has happened to the woman’s child. Although the psychological factors are more presented in the case, it is reasonable to consider applying the biopsychosocial model in the management of the condition under analysis to implement a comprehensive treatment approach.

Depression Treatment Guidelines

To begin with, one should explain what a biopsychosocial management approach is. According to Babaola et al. (2017, p. 291), this approach stipulates that mental health issues are caused by biological, psychological, and social factors, while no group has a predominant role over the others. In essence, this model stipulates that it is challenging to mention that a specific element is responsible for a condition since their combination results in a mental disorder.

When it comes to offering guidelines, it is essential to rely on evidence-based and reliable information. That is why it is reasonable to consider the National Institute for Health and Care Excellence (NICE) recommendations. These guidelines ensure that the most effective and suitable solutions are offered to achieve the best health outcomes. This resource is also essential because it mentions particular actions based on a specific depression type. However, it is worth noting that every depression case, irrespective of its severity, should imply common management steps. It refers to providing information, obtaining informed consent, supporting families and others (NICE 2009). These activities are essential because the depressive symptoms denote that people should be particularly approached to address their issues. The steps also make it possible to establish contact between a patient and a practitioner, which is significant because a trust-based relationship will allow the patient to disclose all the relevant information without doubt.

Since the case under analysis implies mild depression, the first step is to recommend general measures. According to the NICE (2009) guidelines, it is essential to make the woman address her sleep hygiene. Although the video does not show whether she has some sleep issues, patients with depression typically report such problems. Thus, it will be essential if the patient sleeps sufficiently, which is possible by avoiding excess eating and alcohol drinking. If the woman does not want an intervention, it is possible to provide her with information about the course of depression and arrange a further meeting. These simple measures can be useful if the patient has an evident desire and internal strength to overcome the impact of depression.

In contrast, if the patient wants to overcome the issue but does not know how to act, she should agree to participate in the intervention that implies a few possible options. Firstly, it is suitable to recommend “individual guided self-help programs based on the principles of cognitive-behavioral therapy (CBT)” (NICE 2009). This psychosocial intervention implies the provision of written materials and the assistance of an experienced practitioner to help the patient interpret the information and apply it. Secondly, it is possible to use computerized cognitive behavioral therapy (CCBT) that relies on a computer program to monitor the patient’s behavior, thoughts, and outcomes (NICE 2009). This option also implies specific tasks between sessions, which is considered more beneficial for patients. Physical activity programs in groups are also a practical step to address mild depression because this approach can provide the patient with social support. All these low-intensity psychosocial interventions should last for approximately twelve weeks to ensure that they affect the condition and generate positive results.

Since the previous paragraph has considered a psychosocial management approach, it is reasonable to comment on the biological factors of the biopsychosocial model. As has been mentioned, it is not known whether the woman has some issues with brain or blood chemistry. That is why she should be advised to stop taking sertraline. It is so because antidepressants should be prescribed if a person previously experienced moderate or severe depression, the symptoms are present for two years or other interventions are useless (NICE 2009). As a consequence, the absence of these conditions can denote that the intake of the drug will bring more harm than benefit. The biological factor indicates that it is not necessary to take medications unless there is clinical justification to prescribe some of them.

Conclusion

The paper has demonstrated that depression is a significant and widespread mental disorder in the modern world. Numerous people suffer from this condition, which exposes them to multiple symptoms. Even though different mental illnesses have similar symptoms, it is not challenging to diagnose depression because there are specific criteria to cope with the task. It refers to the World Health Organisation’s ICD-10 guidelines that are helpful for medical professionals to make the correct diagnosis. As for the case under analysis, the leading symptoms are decreased self-esteem, appetite problems, reduced energy, and a loss of interest. The report has also commented on the etiology of the condition. Evidence from scholarly articles has revealed that biological, psychological, and social factors cab become depression causes, which emphasizes the significance of the given issue.

Based on the information above, the paper offered specific steps to manage the patient’s depression. The National Institute for Health and Care Excellence guidelines were consulted to generate the most effective course of action. The proposed solutions can be considered adequate since they meet the requirements of a biopsychosocial approach. It refers to the fact that the low-intensity interventions address the psychosocial aspects of the issue, while the recommendation to avoid medication can improve a biological domain.

The information above denotes that the questions highlighted in the introduction have been answered in detail. The answers can be considered reliable since they are supported by the evidence from professional guidelines as well as scholarly and peer-reviewed articles. To conclude, the paper shows that a depression case can be effectively managed if diagnostic and treatment options are attentively selected and followed and if a multi-faceted approach is utilized.

References

Anushivarani, M. et al. 2018. Depression from the perspective of modern and Persian medicine. Electronic Physician 10(2), pp. 6372-6376. Web.

Babalola, E. et al. 2017. The biopsychosocial approach and global mental health: synergies and opportunities. Indian Journal of Social Psychiatry 33(4), pp. 291-296.

Coelho, N. 2020. Clinical case 1 MET461 anxiety and depression. Web.

Fitzpatrick, K. K. et al. 2017. Delivering cognitive behaviour therapy to young adults with symptoms of depression and anxiety using a fully automated conversational agent (Woebot): a randomised controlled trial. JMIR Mental Health 4(2), pp. 1-11. Web.

Hellman, M. 2018. Social causes of depression, anxiety and stress. Nordic Studies on Alcohol and Drugs 35(3), pp. 149-151. Web.

Kuehner, C. 2017. Why is depression more common among women than among men? The Lancet Psychiatry 4(2), pp. 146-158. Web.

Lewis, G. et al. 2019. The clinical effectiveness of sertraline in primary care and the role of depression severity and duration (PANDA): a pragmatic, double-blind, placebo-controlled randomised trial. The Lancet Psychiatry 6(11), pp. 903-914. Web.

National Institute for Health and Care Excellence [NICE]. 2009. Web.

Peres, M. F. P. et al. 2017. Anxiety and depression symptoms and migraine: a symptom-based approach research. The Journal of Headache and Pain, 18(37), pp. 1-8. Web.

World Health Organisation [WHO]. 1993. The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research. Geneva: WHO. Web.

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