Categorization of Symptoms of Acute Clinical Depression - Essay Example

 Case Study - Terry Categorization of symptoms On the basis of the case study presented; the symptoms observed may be categorized under four heading: those that are Affective or emotional, those that are cognitive, those that are behavioral and those that are somatic or physical. The observed symptoms are: Affective Behavioral Cognitive Somatic Irritable Moody Alcohol consumption (which is a distinct change from previous behavior) Reduced care for personal hygiene Reduced interaction with significant others; withdrawn Missing significant events (line deadlines for submissions) Lack of inclination to do things (like research, visit parents) that he did regularly before Increase in errors committed Lowered quality of work Excessive sleep Weight loss Lack of appetite Diagnosis A possible diagnosis for Terry is of an episode of Acute Clinical Depression. This diagnosis may be confirmed through formal testing. This diagnosis was made on the basis of the symptoms presented. Although Terry seems to have always been a recluse and given to being by himself; he has been considered a friendly person. His behavior when interacting with instructors shows that he has been experiencing some sort of negative mood. Depression is often manifested as irritation and ‘moodiness’. Not everyone with depression experiences sadness. The physical symptoms exhibited are also consistent with indicators for Clinical Depression. He seems to be experiencing weight loss, hyper-somnia (increased sleep) and loss of appetite. There are distinct behavioral changes; which meet the criteria for depression. There has been a reduction in personal hygiene and in interaction. Terry has also missed deadlines and stopped talking to his parents – the only people he was close to. These changes imply a lack of motivation to take effort; and underline the fact that goals that were previously very important to him are not being focused on. His increased drinking is also an indicator; especially as he used to pride himself on staying clean in respect to alcohol and drugs. This may imply a reduced pride in personal values. The quality of terry’s work is reduced and he is making a lot of errors. Given his past as a strong and diligent student who received a scholarship on the basis of his research and grades; this is very unlike him. The work he is doing is very important to his long term goals; and his lack of application to it shows that he may not able to keep up with the work; or may be losing inclination to pursue these goals at the moment. The information available and the symptoms observed make this the most likely initial diagnosis. They do not meet the criteria for anxiety or substance abuse related conditions. Rather, alcohol use seems to have developed after other symptoms appeared, and may be treated as a symptom in this case. Although there is a change in cognitive functioning; this seems to be associated more with reduced effort than reduced functioning, and so cognitive disorders may be ruled out. Likewise, there are no symptoms that point to psychotic conditions directly. The mix of symptoms is not consistent with the diagnosis criteria for Somatoform disorders, Dissociative disorders, Personality disorders, Sleep disorders or Sexuality related disorders. Treatment plan Having obtained Terry’s permission to deliver treatment that best suits his individual needs; it is necessary to first identify the various concerns that need to be addressed by the treatment. Depression affects neuro-cognitive functioning; and this can hinder all areas of productivity in a person’s life. This imbalance at the chemical level needs to be corrected. Also, it is necessary to identify the triggering point as well as the experiences that build up to the said triggering point that caused terry to experience a depressive episode. Given the drastic changes experienced by Terry, he may find the requirement of coping with therapy a further challenge on its own. Thus it would possibly be recommended that Terry be initially hospitalized for a short duration of about 2 weeks and be given pharmaco-therapy. The medicines will help restore the chemical balance of his brain; and he will be able to enter therapy with a better frame of mind. Medicines should be continued post discharge for at least 6 to 9 months; depending on Terry’s response to the same. The drastic changes in his life are probably the most likely trigger that caused terry to experience Depression. He may have felt overwhelmed with the combined needs of socializing with new people; sharing living quarters and a heavy work and study load while having stepped out of his comfort zone. He has always been a recluse; having more interactions with his work than with humans, save for his parents. Now suddenly, he had to constantly interact with house mates, instructors and fellow students. At the same time, the only people he was used to interacting with – his parents – were not easily accessible. The more he tried to address the situation; the more he got caught up in it. Given this understanding, terry needs help in learning how to deal with people; and interact effectively. He needs to be helped to adjust to his new experiences and find ways to use these experiences to fuel his goals rather than hinder them. He also needs help in reorganizing his goals and reprioritizing them. While Terry’s previous behaviors cannot be considered dysfunctional; they were not necessarily healthy. If he is to adjust himself to the experiences in his present circumstances; he needs to be helped to re-examine them and modify them as required. For this purpose, the use of Cognitive techniques like REBT could be optimal. Through REBT, the counselor would be able to challenge Terry’s ideas and new perspective could be built in collaboration. The counselor would help Terry examine the means he used to cope with stressful experiences; and evaluate their effectiveness. In collaboration, they would then be able to decide on which need modification or replacement; and decide on the alternative. Through the use of exercises and tasks (including homework), Terry will that be able to relearn the skills needed to function effectively in various aspects of his daily life. It is recommended that Terry continue to receive counseling for about six months in order to instill significant growth. It may be noted that prior to moving, Terry’s decisions and behavior allowed him to have minimal interaction with other people. As a result, it is likely that Terry may have lacking social skills and so be hindered in his interactions. While it is not necessary that he becomes an extrovert; it would help him greatly if he were able to interact with people around him without experiencing stress over it. Training him in Social Skills and requiring him to practice the same would ensure that Terry would here on be equipped to interact with people as he will need to in order to fulfill his goals. These elements would be helpful in helping Terry overcome the Depression; as well as make such changes in his life that would ensure that Terry is not caught in the same problems again. References Bayne, R., Bimrose, J.(1996). New Directions in Counselling . London: Routledge Garfield S.L. (1995). Psychotherapy: An eclectic-integrative approach (2nd ed.). New York: John Wiley & Sons.  Read More