Depression Case Study S: Middle-aged female patient presents with feeling “fed u

Depression Case Study
S: Middle-aged female patient presents with feeling “fed up”, exhausted, overwhelmed, and sad. She is divorced (4 yrs.) and a mother to two children ages 9 & 11. She describes herself as “useless” several times, especially regarding caring for her children and her work. She does not go out with friends, stating, “What’s the point.” She describes her relationship with her partner/Dave as deteriorating both in their social life and in their sex life.
O: The patient is tearful and somewhat withdrawn during the interview. Affect is blunted. The interview reveals difficulty falling asleep (for 2 hrs.) and waking early. She has decreased appetite and weight loss, poor self-care, forgetfulness, and poor concentration. Symptoms have lasted for a couple of months. In addition to the information provided, I would ask for the patient’s current medications, health history, and family history.
History of suicide attempt x 1, 4 years ago, by taking #12 acetaminophen with a few glasses of wine, hoping to “fall asleep and not wake up.” The provider assesses that she was glad to be alive and “felt like a twit” when she woke up. This attempt was impulsive and unplanned. Further assessment leads to the patient’s disclosure that she has no current suicidal plan and no homicidal ideation. She is able to list supports (sister, friends, and boyfriend/Dave). She verbally contracts to a safety plan in which she would be able to ask for help if suicidal thoughts recurred.
Based on the case study, answer the following questions.
• Identify the target symptoms/problems.
• What additional subjective and objective information would you gather?
• Which psychiatric symptoms are a treatment priority for this case?
Medication Choice:
• List one medication that would be appropriate for this case. Include the name and starting dose.
• What is your rationale for choosing this medication? What is the mechanism of action for your medication choice?
• What laboratory testing/monitoring is needed for safely prescribing this medication?
• Are there any contraindications or safety issues associated with this medication?
Safety Risk Assessment:
• What are the safety concerns, if any, associated with this case? How will you address safety?
• When would you follow up with this patient?
References:
• List at least two references.