Week 5: Depression Case Study.

1. What information, if any, would you like to know that was not included in the case?

Additional information related to the well-being and ages of the children with specific information related to the direct care and supervision of the children. The client relates that the children care for themselves related to meals. Additional information related to the competency of the patient to care for the children could give more information related to degree of impairment as well as insight of whether there should be concern for children. Depression is associated with decreased or negative parenting and has long-tern effects on children’s mental and physical health (n.d., 2009).

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2. Which psychiatric symptoms are a treatment priority for this case?

Suicidal thoughts and safety of the patient and the children is the primary concern and establishing a safety plan as well as identifying persons either family or friends that are available and willing to be supportive with increasing suicidal ideation. Sense of hopelessness and lack of joy in patients’ life and feeling of guilt for spending less time with her children is of high priority.

3. What are the non-pharmacologic issues in this case (problems/complaints that cannot be addressed by medication)?

Poor appetite, diet and weight loss as well as lack of exercise and social interaction at home and at the client’s job. Lack of exercise can lead to increase in obesity, poor diet, diabetes, metabolic abnormalities which all will increase depression. The positive effects of regular exercise for those that suffer from depression including providing an outlet to lessen thoughts of depression and stimulate positive self-emotions (Murri, et. al., 2018).

Medication Choice 1

4. List one medication that would be appropriate for this case. Include the name and starting dose.

Sertraline 50mg by mouth daily with increase up to 200mg taper as needed for effect (Woo & Robinson, 2020).

5. Describe your clinical decision making. What is your rationale for choosing this medication? Also, include the mechanism of action for this medication choice, and the neurotransmitters and areas of the brain in which the medication is proposed to act on.

Sertraline is cost affective choice as the patient relates difficulty with money. Cost with discounts is around ten dollars in the U. S. thought the cost in the U. K. has increased 500% over the past 2 years (Robinson, 2021). Sertraline inhibits reuptake of 5HT serotonin with limited effect on dopamine and norepinephrine uptake (Woo & Robinson, 2020).

6. What laboratory testing/monitoring is needed for safely prescribing this medication?

No monitoring required other than monitoring for mood symptoms or allergic reactions as well as increased suicidal thoughts (Woo & Robinson, 2020)

7. Are there any contraindications or safety issues associated with this medication?

Caution in those with bleeding disorders as can interfere with platelet aggregation. Caution in those with cardiac histories related to prolonged QT interval. Monitor closely in children and elderly for increase or initial suicidal thoughts (Singh & Saadabadi, 2021)

Non pharmacologic Interventions

8. What non-pharmacologic interventions do you recommend? Do you recommend including but not limited to psychotherapy, complimentary and holistic therapies

Exercise, dietary modifications, psychotherapy to include group therapy to integrate social understanding and networking for the patients with others that suffer from depression.

Safety Risk Assessment

9. What are the safety concerns, if any, associated with this case? How will you address safety?

Safety concern related to harm to self with increased feelings of worthlessness or side-effect from beginning antidepressant. Monitor for sighs of serotonin syndrome (Woo & Robinson, 2020).

10. When would you follow up with this patient?

7 days in person as well as providing contact information to patient and family for emergent or escalating symptoms.

References:

Singh HK, Saadabadi A. Sertraline. [Updated 2021 Aug 6]. In: Stat Pearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547689/

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours. Week 5: Depression Case Study.

Week 5: Depression Case Study.