Document Clinical Obervations about Joan - Case Study Example

Running Head:Mental Health Name: University: Course: Tutor: Date of Submission: Document clinical obervations about Joan Mental health care practice is one of the challenging nursing practices today. Analyzing thoroughly Joan’s emotional health case it is evident that she has clinical problems related to mental health. There are various mental disorders but as far as Joan case is concerned she is suffering from depression. Depression is a serious mental health disorder which actually differs from occasional short periods of sadness since it is consistent hence it does not interfere with individual daily functioning (Happell, 2009, pp.20-80). The term depression actually can be confusing in any normal circumstances as most of time is usually used to describe normal emotional reactions hence this illness maybe hard to recognize as its symptoms are easily attributed to other causes (Muir , Fisher , Dadich, & Abello, 2008,pp.1-16). There are several of depression and they include Major depression, Dysthymia and postpartum. As per Joan case in particular she is suffering from major depressive disorder which is a condition normally characterized by a long lasting depressed mood, comprehensive loss of interest or pleasure commonly known as anhedonia in almost all social activities (Elder, Evans,& Nizette , 2009,56-78).In addition she is suffering from personal disorder in particular anxiety. Personal disorders is seen as a group of psychiatric conditions in which a person’s long-term chronic behaviors, emotions and thoughts tend to be very different from the expectations which in the end causes serious problems related to their relationships as well as work. As the case of Joan, many patients suffering from personal disorders are always anxious which is eminent in Joan’s case. Anxiety is a personal disorder which is uncontrollable hence in some cases it leads to excessive apprehension and unpleasant fear with no apparent external reason. Major depressive disorder is a serious mental disorder which has profound effects on an individual’s quality life (Femi, 2008, pp.20-30). Unlike normal bereavement which occurs at an occasional episode, major depression disorder usually is perceived to cause lengthy period of gloom, hopelessness and in extreme cases it may rob the sufferer the ability to take pleasure in social activities or relationships which were previously enjoyed as per Joan’s current situation(Happell,2009,pp.20-80). Major depression is usually caused as a result of specific individual life stressors and this has been triggered by Joan’s unhappy life both at home and work as well as painful experience she has experienced a couple of years back. Major depression disorder is in some cases limited to single episodes of depression hence this condition becomes chronic when an individual experiences many episodes of depressed mood (Millon, 2004, pp.78). Problems associated with the disorder Family dynamics tends to play a major role in the development as well as treatment of major depressive disorder and personal disorders. When an individual suffers from these disorders, the family members as well as friends get affected in the process (Levy, 1999, pp.78). In some cases friends and family members who love the individual suffering from the disorder starts to develop feelings of helpless, confusion, hopeless, angry, frustrated and resentful. In such cases it is always necessary that family members and friends give support to the patient since this creates some form of hope to the patient as well as it gives some a reason to view life in a different perspective. Moreover, it always evident that people suffering from personal disorder have feeling of being socially inept therefore they tend to avoid social interaction for fear of being ridiculed, humiliated, rejected or disliked. In Joan’s case she is unhappy with her current job, the people she works with, about her career, her life both at home and at work( Clark, 2003),pp.67). Family and friends who are close to Joan should give her support and understand her more by encouraging her to view life in a positive way. Joan mentions that she avoids most social situations that may cause her angst as a result she becomes despondent and angry. In addition, she feels that she needs to hide her feelings so that nobody would know how she is really feels. In such cases friends and families should take it a duty to encourage such people to visit social places as in many circumstances go with them and encourage them to interact and socialize with other people (Millon, 2004, pp.78). Steps to be taken in relation to Joan’s case Since Joan is suffering from a major mental health disorder hence her case needs immediate medical attention as well as treatment which include various therapeutic therapies. This will inturn ensure Joan’s personal safety once she undergoes some therapeutic therapies related to her case, as they will help her get over the depression disorder (Millon,2004,pp.78). As way of getting much insight into Joan’s case as well as ensuring continuity communication between us it will be necessary to apply interpersonal communication skills between me and Joan. Since someone suffering from major depression gets defensive quiet often it will be necessary it is always important not to use an accusatory tone as it not helpful(Millon,2004,pp.78), rather I will try to use a tone which conveys a sense of understanding this will help in getting more information as far as Joan’s case is concerned. Using an understanding tone I will offer help to Joan by asking her what I could do to help her in the current situation, this will help her realize how much I am interested in her case which will eventually make her open up as well as confide in me more(Millon,2004,pp.78). According to the Australian Mental Health Act the rights, privacy, dignity and self respect of people suffering from mental illness should be kept to the minimum necessary circumstances(Happell, 2009,pp.20-80). The Mental Health Act therefore establishes procedures as voluntary treatment for such disorders. I will refer Joan to the Australian Mental Health Act and encourage her to tell me more about her past since the information will be regarded as confidential hence it is only between me and her, no third party will access her information, as this will be a violation of the Australian Mental Health Act(Happell, 2009,pp.20-80).. As far as Joan’s therapeutic treatment is concerned I will recommend some therapies related to her case. Therapy is usually considered as the basis of treatment for most of major depressive disorder cases. The most common form of therapy which I will recommend for Joan is Cognitive behavior Therapy which is adopts two-pronged approach (Millon, 2004, pp.78). In the first approach, Joan will be taught on the methods she can use to address the depressive symptoms when they strike such as learning how to identify negative patterns of thought and transforming them into positive thoughts. The second approach of this therapy will help Joan to trace the roots of her depression such as childhood trauma, difficulties at home, at work and within her family relations. These therapies will help Joan to pinpoint out the causes of her depression and anxiety as well as how well to resolve them (Happell, 2009, pp.20-80). Since Joan has problems with the family, friends and fellow staff members at work, interpersonal therapy will be very important for her. This is because this therapy teaches relationship skills that can be used when it comes to interacting with family, friends and perfect strangers (Happell, 2009, pp.20-80). It will be also necessary to talk to Joan’s family members about her case since, receiving counseling with the entire family will help Joan’s family in answering questions related to her condition. Document Clinical Observations How Joan will be able to discuss her concerns with other people Mental health nursing is usually successful if it is based on therapeutic relationship and willingness of the patient to seek treatment. For Joan to be able to discuss her concerns with other people it will be necessary for her to develop a positive mind towards her situation (Taylor & Kermode, 2006, pp.20-45). This will primarily create a positive mind for Joan as well as it will initiate an inner reinforcement within her to assess her medical care and discuss her concerns with family members as well as friends (Happell, 2009,pp.20-80). Putting in place a Supportive environment will be essential for Joan as this will enable Joan to discuss her concerns more openly. With this in mind, it implies that establishing a conducive therapeutic environment for Joan will be the best way to go according to the stipulated regulation found in the Australian Mental Health Act. As stipulated in the Australian Mental Health Act, individuals suffering from mental disorders should be provided with supportive as well as a restrictive environment which does have any disturbances to the patients (Taylor & Kermode, 2006, pp.20-45). Signs of depression that Joan is showing In relation the case Joan currently is showing some signs of depression. The current Symptoms which Joan is presenting right now are earlier signs of Major depression disorder. From the case Joan is unhappy both with her current job as well as at home something which has triggered sadness in her life now. Sadness is usually perceived as a core symptom of major depression in an individual’s life and it usually leads to sad moods which never go away as in Joan’s case (Taylor & Kermode, 2006, pp.20-45). The other symptom is an overwhelming sense of despair which too is considered as a major symptom of depression which has been displayed with Joan current situation (John, Andrew, Donna 2009, pp.67-70). Joan’s state of unhappiness as well as past painful moments in her life has triggered a feeling of low self-worth, experience of low feelings, hopelessness which has lead to her loss of interest or pleasure in social activities and work promotion. Joan has been having recurring thoughts about committing suicide and infact she has even planned on how to commit it (Victoria, 2007, pp.56-70). Recurring thoughts of death or suicide, wishing to die as well as attempting suicide is usually perceived as an adverse symptom of major depression disorder which is evident in Joan’s case(Happell,2009,pp.20-80). Questions that I will ask Joan during the assessment How she handles anxiety What strange emotional thoughts does she think of when alone Why she always thought of committing suicide How her past life has been? How her family members treated her as well as friends? Her past life experiences How she handles life experiences as well as life related stress Her social life What kind of stress she was currently encountering Where she works, the kind of job she does, the details about her job and whether her job is more involving or not? What factors currently were affecting her in work place? Her social life and how she interacts with her friends in daily activities Signs of Anxiety that Joan is currently showing Joan currently is exhibiting signs of anxiety. The most common signs of anxiety comprises of social isolation, extreme levels of shyness, avoidance of interpersonal relationships, Feelings of inadequacy and feelings of loneliness (Happell, 2009, pp.20-80). In relation to the case, Joan blushes with no apparent reason as well as she is shy which is unusual for woman of her age. An extreme level of shyness is considered to be one of the key signs for a person suffering from anxiety as in the case of Joan. Joan mentions that she avoids most social situations that may cause her angst as a result she becomes despondent and angry. In addition, she feels that she needs to hide her feelings so that nobody would know how she is really feels which are clear signs of anxiety(Happell,2009,pp.20-80). Steps that could be taken in relation her safety Since Joan has anxiety disorder in which constantly has feelings of worry, distress and has difficulties in controlling these feelings putting in place safe environment is the first step in ensuring her safety(Herrman, Maj & Sartorius, 2009, pp.45-60). Quiet environment with little distraction as this helps in quick recovery. In addition, I will encourage Joan to seek medical attention by personally recommending to her therapeutic and medical treatments that can help her in dealing with her anxiety (Herrman, Maj & Sartorius, 2009, pp.45-60). Documentation (Mental Health Assessment) In relation to the case it is evident that Joan is suffering from both Major depression order as well as anxiety personal disorder. Joan was not happy with her current life both at home as well as at her work hence she saw it essential to seek medical attention in relation to her mood disorders(John, Andrew, Donna 2009, pp.67-70). From the case it is evident that Joan’s depression was caused primarily by her past life experiences as well as family issues When interacting with Joan,I will seek to maintain a positive therapeutic relationship with her. At first instance will try to use an understanding tone which primarily will provide a room for Joan to explain her case to me(John, Andrew, Donna 2009, pp.67-70). I will encourage Joan to seek medical attention immediately by telling and infact offering free help to see her treated as well as telling her that she was not alone, there other with people with even worse cases but it is not the end of life hence no need for her to think about committing suicide. I will explain to Joan reasons why she should seek medical attention as well as why she should live and enjoy life fully. By doing this it will actually empower Joan to draw more attention to her therapeutic treatment therapies as well as the courage to get well and move on with life(John, Andrew, Donna 2009, pp.67-70). Treatment of depression like any other mental disorder relies mostly on psychotherapy and medication for quick as well as strong effects. Since Joan has feelings of unworthy it I will use plenty of a reassurance tone as this will enable her to have positive attributes towards life (Herrman, Maj & Sartorius, 2009,pp.45-60). Given the fact, that most of the people suffering from major depression spend a lot of time ruminating on their own individual situations and feeling sorry for their own situations, it is always necessary that one try to sympathize with sufferer rather than pointing out the situation(John, Andrew, Donna 2009, pp.67-70). This will do a lot of good as far as Joan case is concerned since I will spend most of the time understanding her and supporting her all through the therapies. Since depression is usually treated through various therapies (Brunero & Stein-Parbury, 2008,pp.14-20). In order to ensure that my therapeutic approaches lead to Joan’s in successful plan in managing as well as assessing her medical care, I will first and foremost begin my therapy by establishing an intensive friendly as well as supportive therapeutic environment for Joan. Once this is in place, I will provide intensively educational program to Joan for three to four sessions about depression and how to deal with the situation. Since many individual approaches emphasize on the importance of a patient actively being involved in his or her recovery, this will do much better for Joan (Brunero & Stein-Parbury, 2008, pp.14-20). I will ensure that encourage Joan to participate fully in her own recovery by having a daily medical care assessment of her situation and noting any improvements as far the condition is concerned (Jinni, Robert, Klaus, 2008,pp.56). To ensure that Joan keeps the daily records for her own mental medical assessment, I will check personally the records to note any improvements or see if it is necessary recommend other therapeutic therapies for quick recovery if she does not show any improvements over time. Since Joan has problems as far as her social relations are concerned, it will be necessary for me to implement interpersonal therapy for her. The focus of this therapy primarily is usually to improve an individual’s family relations as well as social relationships (Byrne & Neville, 2010, pp.50-70). This therapy will help Joan to start having feeling of self worth since it will provide essential support to Joan’s overall wellbeing. Since Joan is unhappy both at home and with her own career, this therapy will seek to improve her relationship skills, communication skills, expression of emotions as well as it will create assertiveness within her. Once Joan is familiar with the therapies will recommend pharmacotherapy and here I will ensure that she uses the right drugs as well as she takes them correctly as required through constant monitoring(David ,2007,pp.67). Close monitoring will be done since major depression disorder is a recurring condition which requires that close and initial monitoring of symptoms be done frequently to eliminate them (David ,2007,pp.67).This primarily will enable me to ensure that Joan is doing well and strictly following the treatments with kin interest as way of avoiding a relapse or recurrence. I will advise Joan to use a validated patient measure outcome such as PHQ-9 to evaluate her response on weekly basis to assess her condition (Baker & Velleman, 2007,pp.12-20). 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