A woman with Depression Assignment

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A woman with Depression Assignment

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Decision Tree

The purpose of this paper is to read, assess, and analyze a patient presenting with depressive-like symptoms. The patient presents as a first initial visit. Her presentation and reported history suggest a diagnosis of a cyclothymic disorder and an appropriate treatment plan must be created based on the diagnosis assumed.

Decision #1

Which Decision did you select?

The first decision that I made was to diagnose this patient with cyclothymic disorder. A woman with Depression Assignment. This patient meets criteria for a diagnosis of cyclothymic disorder based on her persistent depressed mood with periodic episodes of feeling “on top of the world,” going 3 days without much sleep and then finally feeling fatigued stating that she eventually “crashes,” her decreased ability to concentrate when she feels sad, and inability to get things done with periodic “bursts of energy.”

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

A woman with Depression Assignment

A woman with Depression Assignment

I selected this diagnosis because the patient meets criteria, according to the DSM-5, for cyclothymic disorder. The patient reports she has been struggling with these symptoms for years and an individual with cyclomania must have had the symptoms for at least 2 years with many episodes of hypomanic symptoms and depressive symptoms without meeting criteria for an episode of either. Also, cyclothymic disorder can have a significant negative impact on functioning in the individual’s social, occupational, or other facets of their life. No other mental illness meets criteria in the DSM-5 with this presentation (American Psychiatric Association, 2013). Because Stefanie does not meet criteria for either hypomanic episode or major depressive episode and because she is not using substance while exhibiting these symptoms, she meets criteria for cyclothymic disorder

What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

I was hoping to confirm a diagnosis for this patient so she could be treated accordingly with the appropriate medication based on her symptoms. The patient is not getting an adequate amount of sleep and is not completing daily required tasks by allowing them to pile up. The instability in her mood can be managed with a medication to help stabilize her mood which is why a proper diagnosis is so important.

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Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different? A woman with Depression Assignment.

I expected that this patient would get some clarity by receiving her diagnosis. It may help her make sense of her behaviors and why she struggling in certain areas of her life, This could also give her hope that her troublesome symptoms can be alleviated with pharmacotherapy treatment options.

Why did you select this Decision 2? Support your response with evidence and references to the Learning Resources.

The second decision that I made was to start this patient on 10 mg of Abilify by mouth daily. Cyclothymic disorder is similar to bipolar disorder and is treated accordingly. Abilify is FDA approved for acute mania/mixed mania, and bipolar maintenance. It works by decreasing dopamine when dopamine is high and increasing dopamine output when dopamine levels are low (Stahl, 2014). Abilify is a good choice because it tends to work sooner than mood stabilizers and can take effect as soon as 1 week.

What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

By starting this patient on 10 mg of Abilify, I was hoping that this patient would haveremission of her symptoms. I was hoping she would be able to get some consistent sleep, her mood would be improved mood and more consistent without random ups and downs, and that she would be able to consistently complete more goal directed activities on a daily basis.

Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?

After Stefanie returned to the clinic in four weeks for a follow-up, she reported that her mood was more stable. I did expect the Abilify to stabilize her mood at least some. The patient reported, she has not felt as sad which goes hand in hand with her mood being more consistent. Stefanie reported that she felt lightheaded upon standing up for the first two weeks of taking the medication which is a common side effect so that was not too surprising. Common initial side effects include dizziness, insomnia, akathisia, activation, nausea, vomiting, and orthostatic hypotension (Stahl, 2014).

Decision #3

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

Stefanie reported orthostatic hypotension after the initial doses for the first 2 weeks but reports that the symptoms have subsided. Therefore, I made the decision to maintain the current dose of Abilify. Orthostatic hypotension is a common side effect when starting the medication and should just be monitored. At this point, because it has not happened in a few weeks and the medication seems to be working well by stabilizing her mood, maintaining the current dose of Abilify at this point seems like the appropriate choice.

What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources. A woman with Depression Assignment.

I was hoping that the patient would not have any more dizziness upon standing and that the medication would continue to relieve her symptoms related to her cyclothymic disorder and stabilize her mood. It appears to be working well without major side effects at this point.

Ethical considerations might impact treatment plan

An ethical consideration to keep in mind with this patient is her potential to not comply to treatment and medication regimen. Individuals with cyclothymic disorder can have irregular moods and unpredictable behaviors which can make it hard to tell what the patient might do or decide to do. She also could start feeling better and stop taking her medication which would not be productive or benefit a positive prognosis. Before starting a medication, the pros and cons of taking the medication need to be weighed out and the potential side effects must be considered (Newhouse-Oisten, 2017). Considering the patient’s medical history or problems should be considered ethically. For example, if the presents with diabetes mellitus already, an antipsychotic for this disorder may not be the best decision with its potential for negative metabolic effects. Also, monitoring the patient for any movement disorders after taking the medications is important as the patient could potentially develop a movement disorder that could be life-long and interfere with their quality of life.

Conclusion

In conclusion, this patient ended up being diagnosed with cyclothymic disorder. She did not meet criteria for bipolar or depressive disorder. Her symptoms were interfering with her daily life as she was not sleeping or getting daily tasks performed appropriately. Her up and down mood swings was confusing for her as well, and all of her combined symptoms made her want to seek treatment and tell someone what was going on with her. Abilify was the chosen pharmacological treatment options as it can help to stabilize her mood and allow her to get some more consistent sleep.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders

(5th edition). Wahsington, D.C: Author.

Laureate Education. (2017d). A young woman with depression [Interactive media file].

Baltimore, MD: Author.

Newhouse-Oisten, M. K., Peck, K. M., Conway, A. A., & Frieder, J. E. (2017). Ethical

Considerations for Interdisciplinary Collaboration with Prescribing Professionals. Behavior analysis in practice, 10(2), 145–153. https://doi.org/10.1007/s40617-017-0184-x

A woman with Depression Assignment

A woman with Depression Assignment

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.A woman with Depression Assignment.  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

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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.A woman with Depression Assignment.
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. A woman with Depression Assignment.

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