Depressive Disorder, Coursework Example

DSMV II Diagnosis with facts are Depressive Disorder 300. Symptoms include depressive mood accompanied by mood disorders. Symptoms may be recurrent or acute. Three percent of people with this disorder commit suicide. There are symptoms of poor concentration and tend to withdraw from situations, insomnia including loss of sleep.

Rationale for Diagnosis include lack of desire to have sex after birth of child and change of activities since prior to birth of child. Appears to be not related to post-partum depression because there are other factors associated with depression such as sexual abuse before childbirth. Further post-partum depression is usually severe and the mother may have issues taking care of the child. They usually last for a few months are until the child is one year old.

Discuss alternative diagnosis Adjustment Disorder 309.4 due to birth of child with mix of emotions or conduct. There could be a combination of a Mood Disorder 296.90 which could explain the lack of desire for sex, depression. If you feel down for more than two weeks and have issues adjusting to life on life’s terms you may have an adjustment disorder. With mood disorders these encompass a chemical imbalance which may be set off by stress related symptoms.

Theory Based Treatment Plan is cognitive therapy and depression medication. There is no substance abuse because it was a isolated event. Since she could have a depression and mood related disorder it is highly likely she should be on some mood stabilizing drugs along with cognitive therapy. Her issues seem to deal with depression and unresolved issues of being sexually abused at a younger age. Social support is always the best avenue with combined medication and cognitive therapy if the depression is clinical.

DSMV II Diagnosis of Major Depressive Disorder 296.2 is when a person is depressed for a period of longer than two weeks. The symptoms are related to a change of the person’s personality of normal kind.

Thomas Szasz has long contended that psychiatry is a “pseudoscience” and, as such, it is dangerous to ascribe to it the expertise and authority to prescribe drugs.  CCHR, which Szasz co-founded, has taken the position that psychiatric drugs do not “cure” anyone.  A review of this case in that light would conclude that prescribing drugs would not produce an effective treatment strategy.  Rather, therapy would seek to place this case within its social context and address the manifestations of the patient’s problem through a dialogue aimed at achieving a humane understanding of her underlying emotional needs.

In Family Psychopathology: The Relational Roots of Dysfunctional Behavior, L’abate cites a study that showed mothers with a background of sexual abuse tended to look to their children for emotional support to an undue extent.  A cognitive therapy approach may go far toward helping her develop support and coping mechanisms that could address her emotional needs before she exhibits such symptoms when her child becomes old enough to serve as an unhealthy emotional crutch.

The rationale for this this diagnosis is the fact she states she is depressed and she has become violent with her husband by shooting him in the hand. When she panicked it could could have been due to an Anxiety Order 300.0. People with this disorder often aimlessly and concurrently worry about everyday life situations and are unable to calm themselves down without anxiety medication. Often therapy helps to reduce the main issues that are the leading causes that factor the anxiety. It is normal for people to worry about certain situations in their life, however when a person has anxiety disorder they may go into panic attacks just for the simple reason of crossing a bridge or being afraid of heights. They must learn to deal with these situations as normal people do. That is why medication and cognitive therapy are often combined to treat the disorder. Often ativan and zanex are used to treat the disorder to calm the person down and to aid them with sleeping.

Alternative Diagnosis could be Bi-Polar Disorder most recent episode depressed 296.5. Though she does not have any genetic disposition to have Bi-Polar according to the scenario. We can assume for the situation of this scenario that there may be some depression and Bi-Polar tendencies in her family. Signs of bi-polar disorder are slumps of depression accompanied by mood changes and swings to mania which can be violent and dangerous. Some mania cause psychotic symptoms if the bi-polar is serious enough and not treated with the correct medication. Even haladol has been used to treat psychotic symptoms for those with bi-polar when they are in a manic phase. Another good medication is Saphris which has just been approve in the United States. The drug was made in the United Kingdom and is being distributed in the United States now. It is a very mild psychotic medication to be used in times of high stress and can be combine with other medications.

The theory based treatment plan is medication and cognitive therapy. The medication for major depressive disorder is a combination of depression pills and mood stabilizing pills. For bi-polar disorder may be Pritiq for depression, Topomax for mood stabilization, Lithium Carbonate for mania, Ativan for anxiety and Seroquel to aid with sleeping associate with anxiety and moodiness. Sometimes sleeping pills may be used as an aid for depressive disorder and bi-polar disorder. If the bi-polar disorder is serious such as Bi-Polar II shock treatment can be used as a primary source of treatment when the patient is not responsive to medication and counseling.

Some disorders are temporary or acute such as depression caused by factors or stressors in life and anxiety disorders. A patient can take their medication and go through treatment and be normal again. As with severe depressive disorder and bi-polar disorder these diagnosis are often chronic and require the use of medication for the rest of a person’s life. There is much hope though when the correct combination of medications are used and if  cognitive therapy is added if needed. It is important for the family and friends to support the patient for them to get through the rough times and if they are major depressive and bi-polar it is very important for the family and friends to understand the disease to avoid the triggers such as stress and negativity.

A Szasz-inspired outlook would seem to be highly appropriate in this case.  The patient’s situation appears to be just the kind of scenario Szasz has so often written about.  Specifically, that the institutionalization of apparent psychiatric disorders have too often been diagnosed superficially without taking into consideration mitigating circumstances, external motivators and behavior that is basically isolated and incidental.  For instance, the parole officer’s determination to pursue a substance abuse-related explanation seems almost a knee-jerk reaction to the case.  Given the subject’s history, it’s difficult to believe that there aren’t issues related to personal insecurities, fear of abandonment and similar avenues at least worth investigating.

L’abate’s insistence that behavioral “imperfections” do not automatically equate to “badness” would incline me to concur with the first therapist’s assessment.  In this case, it is almost self-evident.  To all appearances, this woman has a reasonably well grounded personality and, barring other such instances, an otherwise apparent ability to cope well with troubling life events.  Minus a pattern of irrational behavior, a reading of L’abate would have me seeking out external “actors” that could be addressed/treated through appropriate behavioral therapies.

References

Theory-Based Treatment Planning for Marriage and Family Therapist (Diane R. Gehart and Amy R. Tuttle)
Family Psychopathology – The Relational Roots of Dysfunctional Behavior (Luciano L’abate) http://www.szasz.com Thomas Szasz Materials (be sure to search this
site widely).

Help Guide Org Anxiety Attacks and Disorders Retrieved November 20, 2010 from, http://helpguide.org/mental/anxiety_types_symptoms_treatment.htm

DSMV Diagnoses and Codes: Alphabetical Listing Retrieved November 20, 2010 from, http://www.dr-bob.org/tips/dsm4a.html