Introduction
Kel presents several signs and symptoms that need to be assessed for further diagnosis. Despite having some hopes and dreams about the future, she feels that her ideas are “ridiculous,” and every thought becomes upsetting and drains the energy out of her. As time went on, she found it labor-intensive even to get out of bed in the morning and get to work. The lack of energy has prevented her from completing everyday tasks ranging from going grocery shopping and preparing meals to keep herself appear presentable. In her interactions with others, Kel has preferred to stay quiet and avoid making contact, which has also been reflected in her work. The woman’s state got more alarming when she stopped answering calls and emails from her sister, who got increasingly worried. Kel said to her sister that she felt worthless and that her life did not go how she wanted, but she had no energy to do anything about it.
Discussion
Kel’s case requires consideration of her primary and secondary diagnoses. The primary diagnosis for Kel is depression, which, according to DSM-5 diagnostic criteria, is defined as major depressive disorder or clinical depression (American Psychiatric Association, 2013). It is a common mood disorder associated with persistent and debilitating feelings of sadness and hopelessness, as well as the loss of interest in the activities that a person used to enjoy (American Psychiatric Association, 2013). DSM-5 and ICD-10-CM state that an individual must experience five or more symptoms during two weeks, and at least one of the symptoms should be either a depressed mood or loss of interest or pleasure, which both apply to Kel (American Psychiatric Association, 2013). In addition to these two symptoms, Kel has significant weight loss, fatigue and loss of energy every day and feelings of worthlessness.
Differential diagnoses for Kel include borderline personality disorder (BPD) and generalized anxiety disorder (GAD). In BPD, the duration of low mood does not last as long as in depression, and there are periods of instability during which the mood can fluctuate. It is characterized by problems functioning in everyday life because of the way a person thinks and feels about themselves and others, including self-image and self-worth issues, difficulty managing emotions, as well as patterns of unstable relationships (American Psychiatric Association, 2013). In GAD, patients experience excessive anxiety and worry, fatigue, impaired concentration, restlessness, and difficulty sleeping (American Psychiatric Association, 2013). Some of the symptoms do apply to Kel’s reported condition.
Conclusion
The treatment plan for Kel can include a combination of pharmacologic and non-pharmacologic interventions. CBT is the recommended approach to therapy because it can help develop a more balanced and constructive way to handle stressors, thus helping the patient recover from challenging mental health conditions or unwanted behaviors. Kel will have to attend regular sessions with a designated mental health provider and continue seeing them for as long as needed to improve her mental health state. During CBT sessions, the patient will be encouraged to reflect on their life events and reactions, enabling them to replace negative thought patterns with constructive ones. If deemed necessary and appropriate, Kel may be referred to a psychiatrist who will prescribe medication such as Selective serotonin reuptake inhibitors or Selective serotonin & norepinephrine inhibitors. In case of suicidal ideation, the Patient Health Questionnaire (PHQ-9) can be implemented, which is the main screening tool for depression that addresses passive suicidal ideation.
Reference
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.