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The Patient is Ellen Water: Depressive Disorder1. Patient DescriptionThe patient is Ellen Water, a 37-year old woman.She is single and has never been married. She currently works as a home health aide but has spent much of her life at school. Miss Water has a master's degree in psychology and two more unfinished programs one, a Ph.D. in sociology, the other a training course in physical therapy. 2. Symptoms a. Water's physchoterapist referred her for medication consultation because she is suffering from depression and panic attacks.
According to her record, she has been unhappy for most of her life, having attempted suicide when she was 14. There is no history of sexual abuse in her childhood or sexual assault in her adult life. b. The problem is distressing because it already prevents her from living a normal life. To claim that she has never been happy is the worst of them. There was also her inability to maintain relationships with others. Finally, there were the severe bouts of depression which could last for several months.
During the worst period, she would display a drastic change in behavior, particularly an abnormally elevated mood. c. If Miss Water is to be believed, her condition has been happening for most of her life.d. The case study reveal that the patient has never done anything about the problem. Except the case of the consultation and a previous treatment after a suicide attempt, she has never done anything to improve her condition and address her problems.e. The incentive for change in this particular case is quite low.
The patient lacks the disposition to be motivated or be passionate with something. The patient has displayed short interest in her endeavors.f. The problem has been recurring perhaps for most of her life.3. Differential DiagnosesThe patient's condition satisfies the requirement for depression diagnosis. First, there are serious mood episodes, where the patient has difficulty in sleeping, bouts of restlessness and lethargy and constant thoughts of dying. In addition, she also had attempted suicide.
The patient's record also show that she is not taking any medication, ruling out the occurence of depressive symptoms resulting from drug intake. Waters has also never taken any illegal drugs. Since she has no meaningful history of treatment, there is no record to show whether she suffered from other disorders such as dysthymic or schizophrenia, among other disorders.4. DiagnosisBased on the case facts, it appears that the patient has a 296.32 Major Depressive Disorder, Recurrent: Moderate. Miss Waters satisfies the diagnostic criteria for this condition particularly on account of her major recurring depressive episodes, lasting for several months.
The episodes cannot be categorized as schizophrenia, delusional disorder. In addition, such episodes are also not typified by Hypomanic and Manic episodes.5. Treatment OptionI will recommend antidepressant for the patient. She has never tried this option and this could be convenient in her case. If this would not work, the patient could choose hospitalization. This is likely given that her case is already quite serious and has been happening for a long time treatments done on her own might prove ineffective.
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