GF is a forty-one-year-old woman who arrives for her first visit at the clinic. She reports that she has been feeling sad and depressed, with crying spells, trouble sleeping, increased appetite, impaired concentration, and fatigue. She has experienced depression in the past but was able to overcome the symptoms without medication. Upon physical exam, she appears to be poorly groomed and with minimal facial expression. She is slow to respond to questions. She admits to being very anxious and worried about “everything.” She denies any current suicidal ideation. However, she expresses concerns about the future and that it may not be an improvement. She has tried over-the-counter medications to help with sleep, but they have not been effective. Answer the following questions as header in your paper.
- What additional information would you like before making a decision about what to do with GF?
- What approach would you suggest for this patient? Which of her symptoms would concern you and require intervention?
- Does she need to be referred to another provider, or can she be managed in a primary care setting?
- Are there any nonpharmacological strategies that might be appropriate for her?
be sure to include medications, dosages and schedules. Include highlights of patient teaching and/or lifestyle alterations. Support your decisions with at least one reference to a published clinical guideline and one peer-reviewed publication.
Expert Solution Preview
Introduction:
The patient GF is a middle-aged woman who presents with symptoms of depression. As a medical professor, it is important to carefully examine GF’s case and determine the appropriate course of action. This paper will answer various questions regarding the patient’s condition, concerns and potential treatment options.
1. What additional information would you like before making a decision about what to do with GF?
Before deciding on GF’s treatment plan, it is important to know about her medical and psychiatric history. Knowing about her previous episodes of depression and how she was able to overcome them without medication will be critical information. Also, GF’s family history of mental illness, social support system, and job stressors will be beneficial in choosing the right treatment for her.
2. What approach would you suggest for this patient? Which of her symptoms would concern you and require intervention?
GF is presenting with classic symptoms of depression, including sad and depressed mood, insomnia, poor concentration, and appetite changes. The concerning symptom that warrants intervention is the patient’s increased risk of suicide, as she expresses concerns about the future. A proper approach would involve a comprehensive evaluation by a mental health professional, including psychiatric evaluation and psychological testing. Treatment for depression, such as psychotherapy or medication (antidepressants), may be recommended.
3. Does she need to be referred to another provider, or can she be managed in a primary care setting?
GF’s symptoms indicate that she requires specialized mental health evaluation and intervention. Therefore, she should be referred to a mental health specialist for proper management and treatment. A primary care provider may not have the necessary training to manage the complex and severe cases of depression.
4. Are there any nonpharmacological strategies that might be appropriate for her?
Several nonpharmacologic strategies can help manage depression. Cognitive-behavioral therapy, exercise, psychotherapy, and mindfulness meditation are some of the viable options that can be used alone or in combination with medication for GF. Light therapy is also known to be effective in treating seasonal affective disorder (SAD), a subtype of depression. Evidence-based recommendations regarding the treatment of depression suggest that using both psychotherapy and drug therapy in combination is often more effective than using either treatment alone.
Conclusion:
The treatment of depression requires a comprehensive approach. The physician must consider both pharmacologic and nonpharmacologic strategies, including lifestyle modifications, when devising a treatment plan. Factors, such as GF’s previous psychiatric history, the severity of her symptoms, and suicidal thoughts, should be considered while creating her treatment plan. It is crucial that GF is referred to a specialist mental healthcare professional to ensure she receives proper treatment to address her symptoms.
