Psych Note 6 depresion

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University of Notre Dame *

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5111

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Psychology

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Nov 24, 2024

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1 Psych Note: Depression Students Name Institutional Affiliation Course Professor's Name Date

2 Demographics : Mr G. is a forty nine years old Caucasian man from North Dakota. Chief complaint: Mr. G presents to the health care facility complaining of Insomnia, fatigue, and hopelessness. History of Present Illness : Mr. G is a forty nine years old divorced gentleman who self-refers to the health care facility. He is at present staying in a cheap local motel and is really upset about his present predicament. He claims that approximately five months ago, his sister and mother "conspired" for the purpose of getting him expelled from his flat. "My life is collapsing. I am afraid I've reached the end of my rope. I need assistance sleeping and a suitable place to call home." He was laid off around a year ago and is currently embroiled in a difficult workers' compensation lawsuit. He is presently on a food stamp program and lives solely on his money. Mr. G. notes a spike in mental and physical weariness since quitting his work. I had a really bad mental state, lost ten kilograms, and have trouble sleeping. The client claims he barely sleeps for two hours every night and is "tired." Though he dismisses thoughts of suicide, he has experienced instances of thoughts of dying and recalls taking "a bottle of Tylenol" as a youngster but "nothing transpired." he Reveals an extremely gloomy view and claims that shortly after things appear to be improving, he is "pushed off" once more. Past psychiatric History : Mr. G claims to have suffered from depression for ten years. He claims he cannot recall one day in the past ten years that he was not depressed. He claims that his depressive disorder has a seasonal aspect. There are certain signs that point to manic episodes (feeling euphoric, unable to sleep), but nothing conclusive. He has no hospitalization history for mental reasons, but instead got outpatient care in a variety of locations. He is extremely dissatisfied with the therapy he was given in the mental health system and. He was recently

3 given a range of drugs, the most of which are antidepressants, with no obvious improvement. He is not taking drugs for any health or emotional problem at the moment. Developmental History: Mr. G has one sibling. His parents stayed married till their dad died almost twenty years back. He recalls a positive relationship with his dad and a tumultuous one with his mom and sibling. He claims that his mom was emotionally as well as physically abusive. Mr. G deems himself to be intelligent, but acknowledges that he endured hardships in school. He enlisted in the Armed Forces just after completing high school. He served for a decade before being honorably discharged. At this period, he was married for roughly twelve months. He does not have any children. Mental Status Examination: Appearance and behaviour : The client seems cachectic, distressed and anxious Motor activity : The client appears restless Speech : The client's speaks somewhat rapidly, but WNL Mood: the client is upset Thought content: Thoughts are organized Thought processes: logical Affect : dysphoric and constricted Perceptual Disturbances : no perceptual disturbance noted Cognition : some deficit in concentration

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4 Abstract Reasoning : Logical. Concentration : client struggles to concentrate on tasks. Impulsivity: impulsive Insight: She feels extremely stressed Judgment: The patient displayed sound judgment by seeking treatment. Motivation: lost motivation Suicidal thoughts : no suicidal thoughts currently but have history of suicidal ideation Case Formulation: The client has a past psychiatric history. His symptoms are, also consistent with mild major depressive disorder. Diagnosis: major depressive disorder F33. 0 Treatment Plan: Pharmacology:  vilazodone (Viibryd)  sertraline (Zoloft)  paroxetine (Paxil, Pexeva), Diagnostic/Lab Work:  Complete Blood Count (C.B.C.)  Creatinine and Blood Urea Nitrogen (BUN)  Thyroid Function Panel

5 Patient Education:  Coping strategies including eating a healthy diet, Face his fears, being more active. Evidence-Based Non-Pharmacological Interventions:  Cognitive behavioural therapy (C.B.T.) (Davis et al., 2020).  Repetitive transcranial magnetic stimulation (rTMS) (Nguyen et al., 2021) Referrals:  Self-care practices websites  Anxiety and Depression Association of America (ADAA)

6 References Davis, S. P., Bolin, L. P., Crane, P. B., & Crandell, J. (2020). Non-pharmacological Interventions for Anxiety and Depression in Adults With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis. Frontiers in Psychology, 11, 538741. https://doi.org/10.3389/fpsyg.2020.538741 Nguyen, T. D., Hieronymus, F., Lorentzen, R., McGirr, A., & Østergaard, S. D. (2021). The efficacy of repetitive transcranial magnetic stimulation (rTMS) for bipolar depression: A systematic review and meta-analysis. Journal of affective disorders, 279, 250–255. https://doi.org/10.1016/j.jad.2020.10.013

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