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Major Depressive Disorder - Case Study Example

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Introduction: This case study concerns Isabel, a 28-year-old mother of two, who was hospitalised with depression when her second child was six months old. He is now two and severe symptoms have returned, necessitating further hospital treatment. Her history and symptoms indicate a wide range of treatments and the need for support from all relevant agencies…
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Major Depressive Disorder
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Major Depressive Disorder

Download file to see previous pages... She feels worse in the mornings, guilty and hopeless, with suicidal ideation and has developed increased psychomotor retardation. She thinks she is ruining her family, who would be better off without her. These signs and symptoms indicate that she has Major Depressive Disorder (MDD), as defined by criteria in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) (American Psychiatric Association [APA], 2000). The criteria state that more than one important aspect of MDD, such as sustained depressed mood, anergia, anhedonia, disturbed appetite and sleep, psychomotor retardation, suicidal thought, negative thought, hopelessness, or poor concentration, should be present for no less than two weeks and not related to somatic effects, caused by substance abuse or adverse reactions to medication.
Depression is the most widespread disorder in relation to mental health. According to World Health Organisation [WHO] (2001), people suffering from depression account for 5 to 10% of the population. The 'Bettering the Evaluation and Care of Health' survey (AIHW, 2007) reported that it accounted for 33.7% of mental health disorders managed by general practitioners in Australia in 2003-04. Most studies show that the development of MDD has a higher incidence in females than males in their life time, being found in females twice as much as in males (APA, 2000; Varcarolis, 2006, pp.326-327; WHO, 2001). Typically, MDD is more likely to occur in females aged between 20 and 40 years old (WHO, 2001). Causes assumed include responsibilities of multi-tasking, for instance, domestic and office work, wife and parenting roles, or the menses might contribute to the prominent prevalence of depression in females (APA, 2000; WHO, 2001). However, race, earnings, education or matrimony are not related to the frequency of MDD (APA, 2000; Varcarolis, 2002. p.454; WHO, 2001).

2. Pathophysiology of depression:
Depression arises due to multifactorial causes, including biochemical, cognitive, hereditary and environmental factors, and sleep abnormalities (Varcarolis, 2002, pp.456-460; Varcarolis, 2006, pp.330-333). In Isabel's case, a reasonable assumption would be that the major pathophysiologic causes might be biochemical, cognitive factors, and sleep abnormality.
There are many studies to indicate that biochemical imbalance can cause depressive disorders, in relation to certain neurotransmitters, mainly serotonin, noradrenaline and dopamine in the brain, which are known to play a role in the regulation of mood (Varcarolis, 2002, pp.456-460; Varcarolis, 2006, pp.330-333). The dysfunctional regulation of serotonin is related to decreased sex drive, appetite and sleep disturbance, as serotonin is particularly important in controlling sleep, appetite and sexual drive (Varcarolis, 2006, p.331; Zarate & Charney, 2003, pp.464-468). Reduction of noradrenaline can lead to loss of energy, interest, concentration, and decreased sexual drive (Varcarolis et al., 2006, pp.460-464; Zarate & Charney, 2003, p.464-468). The depletion of dopamine can be associated with loss of motivation and interest, because it contributes to the stimulation of the system of circuits of motivational behaviour in ...Download file to see next pagesRead More
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