Presented With The Complaints Of Depression Psychology Essay

Presented With The Complaints Of Depression Psychology EssayThe purpose of this case subscribe to is to describe the case of a patient known as Ellen Farber. Ms. Farber, an redress comp any executive, arrived at a psychiatric emergency room at a university hospital with many complaints in regard to her overall wellhead-being. It is likely that Ms. Farber has been touched by her symptoms to a large degree. This case study will discuss the complaints provided by Ms. Farber and will provide a detailed countersign of how her symptoms fit the criteria provided in the DSM-IV-TR for some(prenominal) disorders such as major Depressive sickness, item-by-item Episode Eating indisposition non otherwise undertake and Impulse-Control disease Not Otherwise qualify. This paper will likewise discuss derivative diagnoses as well as co-occurring disorders that may be show up. The final function of this paper will discuss a possible treatwork forcet excogitate as well as an indic ation of the patients prognosis base on known information ab come forward her diagnosis.Ellen Farber is a 35 year aging woman who presented with complaints of depression, the supposition of driving her car off of a cliff, and many other symptoms. Upon closer evaluation of Ms. Farbers symptoms it appears that she is suffering from a major Depressive Episode. The symptoms that she has exhibited that take on for this conclusion are a lack of energy for the past 6 months a lack of pleasure for the past six months increasingly heady depressed witticism for the past six months oversleeping in counts of 15-20 hours per day gorge to the extent that she has gained 20 pounds over the past few months and thoughts of suicide with a specific plan (Barlow Durand, 2012, p. 206). According to the Diagnostic and Statistical Manual of rational Disorders (4th ed., text rev. DSM-IV-TR Ameri washbowl Psychiatric Association, 2000), the presence of a single phrenetic depressive episode in t he absence of a nonher disorder, such as schizophrenia, indicates that Ms. Farber smoke be diagnosed with study Depressive Disorder, Single Episode. It is similarly realise that Ms. Farber has never get a lined a prior major Depressive Episode indicating even further that major Depressive Disorder, Single Episode is the proper diagnosis for her (DSM-IV-TR, 2000, p. 375). It is essential to prognosticate out that Ms. Farber is also a chamberpotdidate for other diagnoses because she has exactd in rip eating and impulsive spending. Ms. Farber has report that she has shackled in eating binges since she was an adolescent. During these binges she reports that she eat anything that she can find. Although she has engaged in intermittent binge eating since adolescence she has do so without using compensatory methods to rid her body of the excess calories. According to the DSM-IV-TR (2000), Ms. Farber should be diagnosed with Eating Disorder Not Otherwise Specified (Binge-Eating Disorder) because she does not engage in the compensatory behaviors that are typically characteristic of Bulimia Nervosa (p. 595). Finally, Ms. Farber has engaged in shopping sprees that she refers to as get binges. This excessive and impulsive spending has issuinged in a large amount of debt, rough $250,000, that has arisen from illegal practices such as unauthorized use of her employers credit cards and over drafting stick accounts to open new accounts, a process she calls check kiting. Since the money was use on impulsive purchases and cannot be accounted for by another disorder, such as substance dependence or a paraphilia, it appears likely that Ms. Farber is also a candidate for a diagnosis of Impulse-Control Disorder Not Otherwise Specified (DSM-IV-TR, 2000, p. 677).According to the DSM-IV-TR (2000), the following diagnoses are relevant for Ellen Farberaxis of rotation I major(ip) Depressive Disorder, Single EpisodeEating Disorder Not Otherwise Specified (Binge-Eating Di sorder)Impulse-Control Disorder Not Otherwise Specified bloc II border Personality Disorder bloc III Moderately Overweight axis vertebra IV Unemployed, financial difficultiesAxis V GAF = 35 (current)On Axis II, Ellen fulfilld a diagnosis of Borderline Personality Disorder for several reasons. First, she has reported that she has engenderd heartlong feelings of emptiness, chronic feelings of loneliness, chronic feelings of sadness, and chronic feelings of isolation. In order to satisfy her feelings of emptiness she has engaged in weekly buying binges which established her current level of debt. Ellen has also engaged in periodic episodes of binge eating without compensatory behaviors. She has also experienced chronic uncertainty with whom she wants to be friends and near what she wants to do in life. We also know that she has been in numerous brief and intense relationships with both men and women. In these relationships, Ellen exhibits a cursorily temper that has frequently l ed to arguments and physical fights. Based on a comparison of Ellens symptoms and the diagnostic criteria for Borderline Personality Disorder provided in the DSM-IV-TR it is clear that Ellen suffers from Borderline Personality Disorder (DSM-IV-TR, 2000, p. 710). Ellen has not presented with any other medical examination conditions other than the fact that she is moderately overweight. Since this is the only condition of concern it was listed on Axis III. Axis IV includes relevant information about psychosocial and environ noetic problems that may be affecting Ellen. Since Ellen is inactive and is experiencing a large amount of debt as a result of her spending binges this information is listed under Axis IV (DSM-IV-TR, 2000, p. 33). On Axis V I have include a GAF add of 35. After evaluating the information provided in the DSM-IV-TR it seemed apparent that Ellen throw a representation within the 40-31 range on the GAF scale. She fell into this range as a result of her suicidal tho ughts with a specific plan and because she is currently unemployed but unable to work as a result of her depression. in spite of appearance the scale it appeared that Ellens level of functioning was not severe enough to receive a GAF score of 31 but her functioning was not well enough to receive a GAF score of 40. Based on this scale, it seems that Ellen fits in the middle of the 40-31 scale so I assigned a GAF score of 35 (DSM-IV-TR, 2000, p. 34).According to the DSM-IV-TR (2000), there are several common derivative diagnoses present for Major Depressive Disorder, Single Episode. These disorders include Bipolar I Disorder Bipolar II Disorder Mood Disorder Due To a General Medical Condition Substance-Induced Mood Disorder Dysthymic Disorder and Schizoaffective Disorder (DSM-IV-TR, 2000, p. 373). In the process of diagnosing Ellen, I made a differential diagnosis between Dysthymic Disorder and Major Depressive Disorder, Single Episode. The primary way that this differential diagnos is was made was comparing the length of time that Ellen reported experiencing her symptoms and comparing them to the length provided in the DSM-IV-TR. For Dysthymic Disorder, a period of at to the lowest degree two years must be met for depressed mood (Barlow Durand, 2012, p. 209). Symptoms for Major Depressive Disorder, Single Episode are only required to be present for a period longer than two weeks (Barlow Durand, 2012, p. 206). From the information that is known about Ellen, it only appears that Ellens symptoms have differed from her normal level of functioning for six months. Since Ellen did not look the minimum two year requirement for depressed mood it seemed apparent that her symptoms only met the criteria for Major Depressive Disorder, Single Episode. Eating Disorder Not Otherwise Specified also presented with a differential diagnosis, Bulimia Nervosa. This was soft distinguished because Ellen did not engage in compensatory behaviors in order to break her caloric intak e, and a diagnosis of Bulimia Nervosa requires that a person engage in inappropriate compensatory methods to embarrass weight gain (DSM-IV-TR, 2000, p. 589).It is not special for other mental disorders to co-occur with Major Depressive Disorder, Single Episode. These common mental disorders include Substance-Related Disorders, Panic Disorder, Obsessive-Compulsive Disorder, Anorexia Nervosa, Bulimia Nervosa, and Borderline Personality Disorder. Axis II presents the personality disorders that Ellen has presented with and Borderline Personality Disorder is listed. Ellen has presented with chronic feelings of loneliness, emptiness, sadness, and isolation. She has also experienced chronic uncertainty about what she wants to do in life and with whom she wants to be friends. She has engaged in numerous intense relationships with both men and women that have often resulted in arguments and physical fights as a result of Ellens quick temper. In order to cope with her chronic symptoms she h as engaged in weekly buying binges and daily episodes of binge-eating. Based on this information, as express previously, Ellen meets the criteria for Borderline Personality Disorder (DSM-IV-TR, 2000, p. 710). There are no conditions listed in the DSM-IV-TR that co-occur with Eating Disorder Not Otherwise Specified (Binge-Eating Disorder) or Impulse-Control Disorder Not Otherwise Specified.The word of Ms. Farber is complicated by her thought of driving her car off a cliff. This indicates that she possesses suicidal desire, capability, and intent. As a result, she should be asked to agree to, or sign, a no-suicide contract. This contract is essentially a promise that she will not attempt suicide without contacting the mental health professional overseeing her case first. If she declines to agree to the terms, or if there is doubt about her sincerity, hospitalization may be required (Barlow Durand, 2012, p. 251). Considering that Ms. Farber has presented with several co-occurring c onditions, interference for her Major Depressive Disorder would be most effective if she undergoes combined handling. The first smell of her treatment should be a medication based treatment, particularly treatment with a selective-serotonin reuptake inhibitor (SSRI). This medication functions by blocking the presynaptic reuptake of serotonin causing a temporary summation in the levels of serotonin at the receptor site. All antidepressant therapies provide some form of make headway to about fifty percent of the patients who receive them (Barlow Durand, 2012, p. 236). In combination with the prescription medicine for SSRIs, I would also recommend cognitive-behavioral therapy. A cognitive-behavioral approach, such as Lynn Rehms moderation therapy, could assist Ellen in gaining control over her moods and daily activities while incorporating cognitive therapy to assist her in identifying and correcting errors of thought, shifting her thought pattern from a depressive intellection pattern to a more realistic thinking pattern (Barlow Durand, 2012, p. 240). Ms. Farber should also undergo treatment for her diagnosis of Eating Disorder Not Otherwise Specified (Binge-Eating Disorder). The most appropriate treatment for Ms. Farber would be a technique that involves therapist led treatment. It seems appropriate that she should undergo guided self-help therapy in which she would meet with a therapist periodically to review a self-help manual. This approach would be the most effective for her because she presented with several diagnoses (Barlow Durand, 2012, p. 375).The prognosis for Ms. Farber appears to be relatively arrogant in regards to the alleviation of her Major Depressive Episode however, there are some risks within the first two years following her diagnosis of Major Depressive Disorder, Single Episode that may alter her prognosis level to fair. more or less 67%, or two-thirds, of patients experiencing a Major Depressive Episode may experience complete remission of their symptoms. One-third, or 33% of individuals suffering from a Major Depressive Episode may only experience partial remission of their symptoms or may not experience any alleviation of their symptoms at all. At least 60% of individuals with Major Depressive Disorder, Single Episode will experience a second episode and 5%-10% will subsequently groom a manic episode, meeting the criteria for Bipolar I Disorder (DSM-IV-TR, 2000, p. 372). In the first year following an episode there is a 20% risk of reoccurrence. In the second year the risk of reoccurrence increases as heights as 40% which would qualify Ms. Farber for a diagnosis of Major Depressive Disorder, repeated (Barlow Durand, 2012, p. 208). By undergoing combined treatment for her depression her chances for remission may increase slightly over receiving medicinal treatment alone (Barlow Durand, 2012, p. 243). At this point it is impossible to determine the exact course of Ms. Farbers symptoms. At best we can expect a more collateral prognosis with treatment than without any treatment at all.Ellen Farber presented with several co-occurring conditions and psychosocial and environmental problems that have potentially affected the onset and severity of her symptoms. The purpose of this paper was to discuss Ms. Farbers symptoms, provide diagnoses based on the DSM-IV-TR, and discuss the appropriate means of treatment for her conditions. Ms. Farber has been affected immensely by her symptoms and requires appropriate treatment immediately in order to prevent her condition from worsening. In the end, her prognosis ranges between fair and relatively positive based on the available knowledge about her diagnosis. It appears that if Ms. Farber receives the appropriate treatment she is at a greater likelihood for remission of her symptoms and continuing treatment may reduce the risk of a reoccurrence of her symptoms. Only time can definitively show how Ms. Farber will be affected by the course of h er co-occurring disorders.