Psychological Assessment on Dexter Morgan - Case Study Example

Psychological Assessment on Dexter Morgan Case Study Morgan is a 30-year-old female who is working as a medical resident ata large referral hospital. At school, Morgan was an excellent student who graduated with honors at both college and medical school studies. Morgan was able to pass so well because of her ability to set high standards for herself and always worked hard towards fulfilling them. In the few cases she failed to achieve, she criticized herself while trying to find what led to that failure. This changed drastically in that of late, she feels herself an unworthy person who cannot achieve as much as she did in the past. For two months now, Morgan has complained of fatigue all the time resulting in very little concentration at work. Her workmates have expressed concerns that she speaks in high tones, she argues a lot and is irritated and withdrawn to herself over petty issues. This is unlike the person they knew a few months back who was warm, friendly, and very social. On a number of days every week, she calls in sick and remains at home watching movies contrary to her earlier working years when she could be off duty only during off days. At home, Morgan’s husband is lost for words over these changes in his wife who of late has lost interest in sex besides repeatedly tossing for up to three hours every night while on the bed. On a number of occasions, the husband has found her talking over the phone with her best friend in some cases crying, a thing that has worried him a lot. On a number of occasions, his attempts to make her open up what could be the issue have borne no fruits as she dismisses him off harshly. On a daily basis, Morgan gets feelings of dissatisfaction with her current life and wishes she were never born at all, or she wishes she could die though she has not contemplated suicide. The reasons for frustration is that she feels that she has all the rights to be happy without struggling too much yet she can’t see herself having a smooth ride in life. A number of her friends from well-off families are doing well in life without working even half as she does make her feel very dissatisfied with life. Morgan has never indulged in any substance abuse, and her prowess resulted from hardworking alone. In the family, there are no histories of any mental related illness making her parents a worried lot. Psychological Assessment This is a case of a Major Depressive Disorder. According to Pearson (2008), its symptoms include the following; Depressive mood as demonstrated by the constant crying over telephone calls while pushing off her husband. While moody, Morgan is always sad, has a feeling of hopelessness in life, has a feeling of being an underachiever who may not make it in life, and feels let down by life, in general. This moody behavior and lack of interest in the job and home have resulted in Morgan being unproductive, removed, and unreliable to her workmates, supervisors, and even her husband (Steinberg, 2012) Loss of interest in activities the person had pleasure doing in the past. In our case, Morgan has lost interest in her job and feels like better of sleeping at home as opposed to working. In addition, Morgan has lost interest in sex and does not like talking to her husband; she has lost faith in having a good life with him(Steinberg, 2012). The change in sleep patterns as demonstrated by Morgan when she repeatedly tosses in bed for long hours before she catches sleep. Restlessness and the feeling of not doing enough to lift own standards of living. Constant fatigue and loss of enthusiasm while dispensing duties at her job and her social life. Inability to make proper decisions, inappropriate thinking, and lack of concentration most of the times. The suicidal ideas, which include a feeling of dying or the feeling of not being born. There is no one major known cause of the Major Depressive Disorder though a combination of factors lead to its rise that include environmental factors, seen and acquired responses, life happenings and bodily biochemistry (Sandler, 2000). In the case of Morgan, The main causes are that she has not led the kind of life she ought to live just like her friends do and working hard without achieving targets (Brogaard, 2012). Treatment To treat this condition, physicians can use psychotherapy, medication or a combination of both (Sandler, 2000). Cognitive behavioral therapy (CBT) has been particularly successful in treating all kinds of depression among all classes of patients given that it addresses the originating negative thought patterns and limitation beliefs associated with the current condition. Depression results because of imbalances in brain chemicals. Applying a medication to the patient will have an effect of restoring back those imbalances into shape hence reducing or ending the condition. In many cases, selective serotonin reuptake inhibitors are given to the patient to balance the serotonin in the brain. From past studies, in few cases does medication work alone, and that is why physicians combine medication with therapy (Sandler, 2000). In addition, the nature of depression makes application of medicine to be based on trial and error such that if one discontinues medication, the symptoms are likely to occur. In some cases, medicine brings about side effects that could give rise to many other conditions. For Morgan, her case appears to be severe given the constant suicidal feelings and in that respect, the doctors should consider hospitalization where they shall administer a combination of therapy and medication to bring her brain serotonin cells back to balance. In addition, Morgan should indulge in regular exercises, meditation, and eating food supplements to heal her condition completely. Benefits The benefits of receiving treatment on this condition are many. To begin with, Morgan shall appreciate her current condition as a medical practitioner who is married and living the kind of life she leads currently. In addition, she will appreciate what she owns and can access instead of comparing herself to other people whose social life, and economic background differs with hers. On the same note, Morgan will acknowledge the kind of input she is giving her job and family life, and she will become social once again to her husband and colleagues at work. Once fully treated, she will appreciate her job roles and will start going back to work with a lot of enthusiasms and she will stop taking off days just to remain at home sleeping or watching movies. Once treated, she will reclaim her lost spirit of performance and the new Morgan will start giving herself high working targets, which she will accomplish with ease and in case she falls short of her target, she will not feel worthless, instead, she will congratulate herself for her effort and revise the targets accordingly. History According to Brogaard (2012), both the core criterion symptoms applied to handling major depressive disorder and the requisite duration of two weeks has not changed from the way they were being handled in DSM-IV. What was formerly criterion C falls under criterion B that is the clinically significant distress in social, occupation, among other aspects of the individual’s life. The presence of mixed features in an episode of the major depressive disorder raises chances that the medical condition exists in bipolar spectrum. The treatment of MDD involves a clear analysis of the suicidal feelings the patient has since sociality has been of critical concern in psychiatry. DSM 5 guides the clinician on how to handle cases with suicidal thinking and plans among other risk factors when coming up with the ideal medication and treatment for that person (American Psychiatric Association, 2013). DSM-5 has issued a new specifier that details the presence of mixed symptoms to guide in the treatment of each case. Research conducted on previous cases especially through Dell et al (2011) pointed out that anxiety is relevant to prognosis and treatment hence a very important element in decision-making. The “with anxious distress” specifier enables a clinician to gauge the seriousness of anxious distress in all cases of MDD. Ethical issues The clinician has to maintain aspects of confidentiality in the diagnosis and treatment of this medical condition. The patient may feel offended if the doctor divulges the nature of this condition to interested parties who may use such information to their advantage. By that, the clinician has to inform the patient about the normal level of confidentiality and divulge information that is only required by the law. The clinician has to obtain an informed consent from the husband, parent, or guardian of Morgan to start applying medication. With this consent, the person signing will understand the benefits and risks associated with the care to be accessed by the patient. The clinician has the duty to care about the final welfare of the patient and shall apply medication that has no known side effects (Sandler, 2000). The clinician shall not apply the medication on a trial basis to this patient and in case of change in medication; he has to communicate with the guardian. In case the clinician has a feeling that the condition is beyond his capacity to handle, he should communicate immediately to the family members and provide to them an alternative to the treatment or refer the patient to a more equipped center (Dell et al., 2011). References American Psychiatric Association. (2013). Highlights of Changes from DSM-IV-TR to DSM-5. American Psychiatric Publishing. 4-14. Pearson, C. (2008, December 8). Understanding Dissociative Disorders through Dissociative Signs and Symptoms-He hyPlace. Retrieved from http://www.healthyplace.com//wermany/understanding-dissociative-disorders-through-dissociative-signs-and-symptoms/ Ryan, C. (2012, February 13). Being Dexter Morgan I Psychology Today. Retrieved from http://www.psychologytoday.com/blog/sex-dawn/201202/being-dexter-morgan. Sandler, M. E. (2000). Career decision-making self-efficacy, perceived stress, and an integrated model of student persistence: A structural model of finances, attitudes, behavior, and Career development. Research in Higher Education, 41, 537–580. Brogaard, B. (2012, May 9). The Making of a Serial Killer | Psychology Today. Retrieved from https://www.psychologytoday.com/blog/the-superhuman-mind/201212/the-making-serial- killer Steinberg, P. (2012, December 25). Our Failed Approach to Schizophrenia - NYTimes.com. Retrieved from http://www.nytimes.com/2012/12/26/opinion/our-failed-approach-to- schizophrenia.html?_r=0 Dell, J.et al. (2011, October 21). Journal of Trauma & Dissociation. Retrieved from http://www.isst-d.org/downloads/GUIDELINES_REVISED2011.pdf Read More