A Case of Persistent Depressive Disorder - Assignment Example

Social Emotions and Behavioral Functioning Affiliation Question Persistent Depressive Disorder Sarah case presents many cases of depressive disorder; the persistence depressive disorder will have a number of clinical signs and symptoms. Firstly, Sara will report of long periods of sadness. It is a classical subjective historical information that has been obtained among many cases of dysthymia. Secondly, she will display a feeling of hopelessness with a chronic low self-esteem. Feeling of inadequacy, difficulty in keeping track with concentration, irritability and decreased energy are primary signs and symptoms of long periods of depression. In addition, the feeling of excessive guilt, hostility, and aggression and appetite changes will be common problems identified by the accompanying family members or friends (Horwitz & Wakefield 2012). Lastly, persistent depression will present with sleep disturbance, frequent physical complain and notably, suicidal ideation. In order to clearly define the Sarahs condition, it will be wise to consider the differential diagnosis. Notably, overview of different forms of bipolar disorders will give insight into the nature of this depressive disorder. Notably, this is a definitive persistent depressive disorder because the patient presents with Bipolar disorder can either be bipolar type 1 and type two. Bipolar one, the patient presents with at least one manic accompanied by disruptive behavior. Besides, Sarah does not have bipolar two disorders because she has no rapid cycling, cyclothymia and mixed bipolar. These conditions presents with alternating episodes of elevated moods and depressive episodes (Horwitz & Wakefield 2012). However, her depressive mood disorder will compromise the quality of her life just like all forms of bipolar mood disorders. It would be more cogent to investigate through history taking on the family and friends on possibility of Post Traumatic Depression (PTD). Sarah might have encountered a significant loss of someone or something she values most (Horwitz & Wakefield 2012). Question 2: Signs and Symptoms of Suicidal Ideation. One of the most striking symptoms experienced by patients with the persistence depressive disorder is suicidal tendencies. Some of the signs and symptoms that Sarah may experience or reported to occur by the family and friends includes persistent feeling of hopelessness. Besides, she will report bitterness, low self-esteemed, persistent sadness and self-mutilation behaviors. The drive for self-harm is a significant behavior of the patient. In addition, the significant others will report solitude and withdrawal from family members and friends (Horwitz & Wakefield 2012). One of the striking features of suicidal ideation is the patients withdrawal from the environment to self and tendency of staying in solitude. Horwitz & Wakefield (2012) states that the suicidal ideation has been seen to develop due to isolation attitude and consistent feeling out of place. Sarah reports long periods of persistent depression, the need for psychological therapy can help unravel the real cause of the psychological problem. Sleep disturbance, persecutory delusion and hallucination can be seen in patients with suicidal ideation. Furthermore, Sarah will present with excessive guilt of her inaction, omission or action that likely caused the patient into depression. Question 3: Mark Attention Deficit Hyperactive Disorder One of the most striking feature among the patients with Attention Deficit Hyperactive Disorder (ADHD) is a high level of distractibility. As a patient with ADHD, Mark will present with destructive home and classroom behavior. The parents and teachers will report the number of generalized and classical signs and symptoms. Firstly, the patient will present extreme distractibility and wandering attention; this is a common problem that often manifest both in school and home (Horwitz & Wakefield 2012). In fact, defines the reason for poor school performance due to inability to keep concentration level high during classroom. As a student, the teachers will complain of the patient lack of classroom concentration, inability to answer oral question without wandering off the topic and consistent incomplete tasks either classroom or co-curricular activities. Furthermore, parents, friends and teachers will report "zoning out effect" this means the patient has a history of paying attention and reporting incidences as they occurred. In addition, if not well understood, the patient can be subjected to physical punishment due to inability to complete school tasks. Notably, this condition is quite different from Oppositional Defiant Disorder, because the latter presents with open rebellious behavior despite the knowledge of what is expected of them. Besides, they have a tendency of confrontational behavior. Evidently, the parents and teachers will complain of student withdrawal and gang behavior. Both groups present with disruptive behavior, but the opposition deviant group have aggressive, rebellious behavior.Besides, the ADHD group have a tendency to overlook details, poor listening skills and inability to recall details of a discussion or event. The latter have no abnormality in cognitive abilities, but have open rebellious behavior which could be a largely environmental in origin (Horwitz & Wakefield 2012). Question Major Depression Disorder and Schizoaffective Disorders Schizoaffective Disorder (SAD) condition refers to a mental disorder characterized by thought abnormality and deregulated emotions. The patient presents with both the schizophrenia and mood disorders, both acting in the same patient. Unlike Major Depressive Disorder, this mental condition has both the bipolar manifestations and depressive symptoms (Horwitz & Wakefield 2012). In addition, this condition comprises of many psychiatric signs and symptoms ranging from unpredictability of depression and mania episodes. The patient will have episodes of elated moods interfaced with extreme depression. Besides, hallucinations, delusions and disorganized speech characterizes these patients. In addition, the two conditions differs because, in major depressive symptoms, patient chief complaint will include feeling of sadness, hopelessness and feeling of guilty. In SAD, the cause is mainly a genetic inheritance or a previous history of mania (Horwitz & Wakefield 2012). However, the two psychiatric conditions have striking similarities. In both cases, there are episodes of depression and labile moods. In additions they share similar symptoms such as feeling of extreme sadness, loneliness, hopelessness and both can lead to hallucination, delusions and suicidal ideation. At the initial stage, the definitive diagnosis is based on the ability to identify an elevated mood which is a striking difference of these two conditions. Besides, both diseases impairs ability to make rational judgment and people with either of this diseases will have difficulty in executing the activity of daily living including attending jobs and school performance will be compromised. However, unlike major depressive disorder, schizoaffective remains poorly understood (Horwitz & Wakefield 2012). Question 5: Chester Case Study Chester is one of the people struggling with the problem of Alcohol Use Disorder (AUD); this condition appears to be in its early stage. The fact that he misses work at least once a week due to partying and once a week fight with his wife is a clear manifestation of early stages of alcohol occupational and social relationship constraints. Alcohol Use Disorder (AUD) can be identified based on a number of criteria. Firstly, he meets criteria of the initial stages of alcohol use syndrome because he at least makes significant attendance to work; he has social gathering although on a drinking spree. In addition, he has compromised family relations (Horwitz & Wakefield 2012). Horwitz & Wakefield (2012) agrees that considerations in the diagnosis of AUD includes impaired academic and work performance. Besides, they have marked the denial of reality, depressed moods, squandering money on alcohol and irresponsibility behavior marked that often culminates in law breaking and reckless driving that causes accidents. In addition, the chronic AUD is seen when a person gets cognitive impairment when intoxicated. This is quite important in staging the phase of alcohol use syndrome. Chester case presents an example of an early smoker who is in the first stage towards undesirable eventuality. Based on the classical stages of alcohol dependence, Chester is in the process of going to a stage where he will completely become unable to perform any task without alcohol. Question 6: Hong case Study Provisional diagnosis Hong is certainly suffering from a psychiatric disease; her conviction on the peace mission in the Middle East and grandiosity of her Godly mission indicates a possible mental illness due to his disorganized and disturbed life processes Diagnosis to rule out Schizophrenia. Like many schizophrenic patients, she has delusions and hallucinations that God has been talking to her to execute the Middle East peace deal and that she is the primary solution to the situation. In addition, at 40 years there is high risk of development of schizophrenia caused by environmental stressors or genetic predispositions. Secondly, the likely diagnosis could be psychosis. The main reason for this empirical diagnosis is the report by the husband that the wife has been drinking a lot in the recent past indicating that it could be alcohol-induced psychosis. In addition, psychotic patients have fixed ideations and delusions, in this case Huong conviction that she is heading to Israel as directed by God to offer peace is quite striking relegation that could a psychosis. In addition, she has totally withdrawn for her home duties, keeps talking than usual; these are classical symptoms of psychosis (Horwitz & Wakefield 2012). Strengths of Huong Case The client was initially with good family relations and continues to support immense support from the husband. In addition, there are resources necessary to sustain her clinics and psychiatric sessions because of her hardwork in the family business before the onset of the disease. This will ensure sustainability of psychiatric costs; in addition the school of daughter is positive life improvement in the family support system. Weakness of Huong Case Notably, the clients have developed poor family relations characterized by negligence of chores, there is no mention of her family history or a relevant environmental stressor. Besides, the significant loss of insight could compromise health information and increase dependence. Besides, her increased drinking habits interlaced with her rebellious nature against her husbands direction are a potential health risk pattern. Lastly, her compromised sleep-rest patterns characterized by sleeping at 2am and conviction religious books could compromise her long term health habits. Potential Risk Factors Based on the patient conviction on the "peace mission" it is important to monitor her presence because the delusive mind could lead her embark on an endless journey to "Middle East." In addition, her ideation could lead to self and family negligence. Thus, she requires constant monitoring for execution of activities of daily living. Developmental Consideration The client is 40 years old, which is peak stage in onset of psychosis especially among females. She has certainly been an astute business lady whose development has been encouraging. As a parent with a child in college, the medication bills are likely to eat into the family income posing a significant threat to family income. The onset has been regular pattern indicative of a genetically-induced mental disorder. Cultural Considerations There are a negative stigma and poor community support to mentally ill patients. It will, therefore, affect the patient and family coping pattern. In addition, the business peers will have to be studied if they can offer a positive support group. References Horwitz, A. V., & Wakefield, J. C. (2012). All we have to fear psychiatrys transformation of natural anxieties into mental disorders. New York: Oxford University Press. Read More