Case study of patient

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Case Study Questions: Jane Sullivan

Question One

I would diagnose Jane with depression. Depression is a mental disorder that is characterized by continuous loss of interest in certain activities or depressed moods that cause significant disruption of daily activities (Jokela et al., 2016). The reason behind this diagnosis is based on the Jane’s symptoms as well her past history. The patient looks exhausted and tired. She is teary and states that she has no place to go and what to do about her life, something that indicates that she is helplessness about life. Depression in the patient is also marked with the extreme sadness that has been caused not only by the death of her husband, but also her parents. Based on the history of the patient, she states that she felt the same when she lost her father some years ago and she was diagnosed with depression. The patient is also lonely as she says that those who should be close to her also have certain problems that has forced her to stay alone or with the midwife only. Based on the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) for depression, the patient qualifies to be diagnosed with depression (Zimmerman, 2018).

Question Two

My biggest concern in this case is the depressed moods. According to the study conducted by Elhai et al. (2015), depressed moods can cause several harms including inability to handle daily activities. In this case, depression is the reason Jane cannot only take care of her own, but also people around her, particularly her 18 month-old son. If she continues to exhibit depressed moods, she is likely not to eat, a factor that will endanger the life of her unborn baby as well as her own. It is in this context that despite the loss of her husband, her moods should be stabilized in order to accept the loss and perform daily activities as she used to do. As indicated by Zimmerman (2017), emotions such as sadness, anxiety and stress have the ability to increase particular hormones in a woman’s body that can affect the unborn baby’s developing brain and body.

Question Three

In order to manage depression that Jane is currently experiencing, certain pharmacological and non-pharmacological interventions are required. Pharmacological interventions are medications that have the ability to stabilize moods, also known as antidepressants. One of the best pharmacological agents for this patient is sertraline. This is anti-depressant that belongs to the class selective serotonin reuptake inhibitors (SSRIs) (Chen et al., 2016). The drug assists people to recover from depressive symptoms by altering chemical composition of the brain. For this particular patient, I would start with the lowest dose of sertraline that is 50gm a day and increase the dose based on the response of the patient. It is important to note that the maximum dose for the drug is 200gm and should be changed when the patient is not responding. On the same note, the drug can also be changed when side effects are severe (Cuomo et al., 2018). The expected outcome after four weeks include reduced mania and depressive symptoms. For example, the patient should be able to concentrate and sleep well at night. The client should also reduce the rate at which she thinks about the trepidations of the past as well as the future.

One the other hand, non-pharmacological interventions that I would like to use in this case is psychotherapy. One of the most psychotherapy intervention that I would use is cognitive behavioral therapy (CBT). According to Sadock and Ruiz (2018), cognitive behavioral therapy is a method of psychological treatment that is effective for a wide range of psychological problems. Its major aim is to change one’s negative interactive and thinking methods. Particularly, it is premeditated to decrease troublesome and destructive behaviors by enlightening clients about the coping skills to manage or handle the problematic feelings and situations. By using cognitive behavioral therapy, the client is able to learn how to modify or change his negative thoughts, interrupts the cycle of depressive and mania episodes, and eliminate destructive thoughts.

Question Four

A decision to use antidepressants during pregnancy is majorly based on the balance between benefits and risks. One of the major risks is birth defect that may occur when the child is exposed to antidepressants. While the risk of birth defects and other complications is low among mothers who take antidepressants, using some antidepressants has extreme risks (Chen et al., 2016). It is in this context that Jane’s pregnancy influences my decision to use a pharmacological agent that has the lowest side effects not only to the mother, but also to the unborn baby. Based on the side effects, it is important to note that sertraline is one of the most effective antidepressants with the lowest side effects to pregnant women, hence it is likely to cause no or little complication both to the mother and the child (Cuomo et al., 2018). Additionally, exposure to the medication must be minimized to prescribing a single medication also known as monotherapy at the lowest level in the event that the mother is in her first trimester.

Question Five

Just like his mother, James needs intervention for an effective and normal development. Basically, according to Erikson’s Stages of Psychosocial Development, James belongs to Autonomy vs. Shame/Doubt. In this stage, the child begins to explore their own world and learn to control their own environment (Cherry, 2018). It is in this context that she keeps on looking at her mother’s eyes when she is crying and able to identify that his dad is unavailable. One of the most effective interventions for James is providing ultimate affection and attention. However, as it is, this is lacking since his mother is depressed and has lost interest in certain activities such taking care of the kid as well as her own. If no affection is given to James, he is likely to act strangely and develop certain condition such as avoidance disorder at an early age. Additionally, the mother should avoid exposing James to issues or conditions that reveal to him that things are not normal to avoid growing with low self-esteem.

Question Six

There are certain benefits that a widow and children of dead military personnel enjoy. However, laws differ from one country to the other. In the United States, the spouse and children get death gratuity. This is a sum of $100,000 that is paid to the next of kin of the military officer who died in line of duty (Hosek et al., 2018). This amount is tax free and not a subject to inflation. Secondly, there is a death pension that is given to the surviving spouse and children (Nuttman-Shwartz et al., 2019). Additionally, there is basic allowance for housing for the children and the spouse for a period of one year. Alternatively, the spouse and the children are allowed to remain and live in government houses or military quarters for a period of one year, after which they should leave. In this case, Jane qualifies for such benefits only if they were legally married since a marriage certificate is an important factor in ensuring that they get the services. In this regard, she should not get worried about the place she is going to stay since she is allowed to rent or live in the military premises for a period of one year.

Question Seven

There are various support groups that are meant to assist young widowers and widows in my community.  The support groups have several benefits including emotional support to those grieving as well as financial support to assist the families that have been left behind. Additionally, in my community there is Tragedy Assistance Program for Survivors (TAPS). This is a non-profit organization in the United States that has its branches in several parts of the country (Dooley et al., 2018). The main function of this organization is to provide care and support to families and friends of the bereaved. It was founded in 1994 by Bonnie Carroll after the death of her husband and other seven individuals who were died in a plane crash in Alaska.