Psychiatric Evaluation

Psychiatric Evaluation

Student’s Name

Institutional Affiliation

Write down your assessment of D. R. and signs of depression he is exhibiting:

D.R exhibits signs of depression and a negative attitude towards life. D.R also exhibits signs of sadness, feeling discouraged about his future, problems in completing tasks, and guilt. From my assessment it is evident that D.R is disgusted with himself for failing to achieve his goals and not living up to his expectation. The frustrations have created a mental image to which D.R sees himself as a failure in the society. D.R has a number of distorted beliefs and cognitions. D.R highlights some of his life’s events and the statement of his family members being successful reminds him that he is a failure in life. B.D spends most of his time highlighting his failures and nothing positive in his life indicating that he has no future plan of getting himself out of his conundrum.

Write 8 questions you would ask D. R. (not necessarily all at once) to conduct further assessment (things you would like to know about him, how he feels, what his goals are, etc.):

Of the following treatments the doctor is offering, list pros and cons of each treatment and indicate which one you would recommend for D. R. at this stage:

  1. Have you ever felt like your life is meaningless?
  2. You are not feeling sad? Are you?
  3. Has harming yourself ever crossed your mind?
  4. What is your outlook towards life?
  5. Have you ever thought about your future?
  6. Do you value people’s opinion on you?
  7. Do you believe in success?
  8. Have you ever pictured yourself as a successful person? How did it feel?

Adding more antidepressants can help in managing D.R ‘s anxiety. Also, the use of more antidepressants may prevent any panic from occurring as it is the case of D.R. A research carried out shows that the mind continues to mature until a person reaches 25 years (Somerville, 2016). D.R is still 24 which offers him a limited widow of time for his brain to fully mature. Adding more antidepressants challenges his brain to stop maturing. Adding more antidepressants also increases chances of dependence to the medication which may also cause withdrawal symptoms should D.R decide to stop using the medication. Further, the use of antidepressants also increases the potential for onset of dementia.

  1. Continue adding/changing antidepressants
  2. The shorter duration of treatment and the use of anticonvulsants as mood stabilizers have no effect. Researchers point out that lithium inhibits glycogen synthase kinase 3, which is involved in the pathogenesis of dementia (Ries, Hermanns, Poeck, & Strauss, 2017). The second study shows that lithium reduces cases of suicidal sensation, especially at the beginning of treatment. A 180-day interruption of lithium, however, is associated with an increased risk of mortality. According to the researchers, this highlights the need to support the continuation of lithium levels and closely monitor patients.

    1. Add Lithium to medication regime
    2. The use of TMS in treating depression has been known to be very effective. One of the pros of using this method of treatment is that it has been found to be non-invasive, and can be tolerated easily with patients. The treatment method does not use any form of anesthesia which is convenient for patients. Patients can also resume their duties after the end of the therapy session. The treatment method is also efficient especially for patients who struggle to use their medication. The treatment method does not interfere with the patient’s memory making it a safe alternative.

      1. TMS
      2. The downside to using this form of treatment is that patients may experience anxiety before treatment. Patients may also experience headaches and facial twitching during the treatment process. The treat men regimen is also time consuming as it requires 30 treatments spanning a period of six weeks. Each session lasts one hour.

        The use of ECT in treatment of mental disorders offers few side effects as patients are usually sedated during the procedure. Since the procedure uses a muscle relaxer for the process, there may be muscle soreness after the process. The treatment procedure has possible side effects such as jaw pain, memory loss, headaches, and nausea.

        1. ECT
        2. On a positive note, holistic psychotherapy can be self-sustaining, economical, and does not require prescription drugs with harmful side effects. Holistic treatments also focus on the balance between body and mind.

          1. Holistic options
          2. Holistic therapy encourages positive thinking as a way to balance body and mind. Counseling and psychotherapy are usually part of a holistic therapy for depression. These modes emphasize the acquisition of treatment skills rather than the use of prescription drugs.

            On the downside, holistic therapies are generally not supported by doctors and many people question their effectiveness. However, when he says the effectiveness of prescription drugs is questionable, he admits that treating mental illness is quite complex.

            Recommendation

            In my opinion, the best form of treatment is the use of TMS, as it has less downsides and can be easily incorporated into the existing medication without harming the patient. The treatment also does not interfere with the patient’s life which makes it a better alternative.

            List 10 small steps you would recommend for D. R. (again, not necessarily attempted all at the same time):

            List areas of cognitive behavior therapy you would address if you were seeing D. R. on a regular basis:

            1. Take time to assess yourself.
            2. Find your areas of weakness.
            3. Talk to a friend or family about your doubts and fears.
            4. Take medication strictly.
            5. Perform more routine activities to prevent stress buildup.
            6. Take on a hobby to avoid negative thoughts.
            7. Maintain a healthy social life.
            8. Get plenty of rest.
              • Perform physical activities and exercises.
              • Monitor your diet and avoid any recreational drugs.
            9. For D.R, addressing key aspects in his life such as social life, family and his personal beliefs of what life is will be my primary concern. D.R has shown to have a negative aspect towards life and changing his belief system will place him on the right track eventually.

              References

              Ries, A. S., Hermanns, T., Poeck, B., & Strauss, R. (2017). Serotonin modulates a depression-like state in Drosophila responsive to lithium treatment. Nature communications, 8, 15738.

              Somerville, L. H. (2016). Searching for signatures of brain maturity: what are we searching for?. Neuron, 92(6), 1164-1167.