“Captain of the Ship” Project – Depressive Disorder Sample Essay
“Captain of the Ship” Project – Depressive Disorder Sample Essay
“Captain of the Ship” Project – Depressive Disorder
According to the World Health Organization (WHO), over 264 million people suffer from depression worldwide. It is also a very common mental disorder in the United States affecting approximately 17.3 million adults as of 2017 (Sadock, Sadock & Ruiz, 2014). The disorder has the ability to cause severe impairments that affect the normal undertaking of daily activities. Major depressive disorder is characterized by sadness, feelings of worthlessness, suicidal thoughts, loss of interest in activities, sleep and fatigue problems, hopelessness, anxiety and weight changes as well as uncontrollable emotions among other symptoms persisting for at least two weeks (American Psychiatric Association, 2013). This paper seeks to address depressive disorder through a case study of a male patient who lost his wife 4 years ago to cancer and feels responsible for her death “Captain of the Ship” Project – Depressive Disorder Sample Essay.
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HPI and Clinical impression
The patient is a 63 year old male brought to the clinic by his daughter who complains of his father’s crying habits, “He cries for no reason and is always feeling sad. He also does not go out of the house.” The patient claims that he does not leave the house because that is where his wives memories are contained. He has lost interest in all other activities and feels guilty of his wife’s death which he feels that he could have prevented if he had listened to her earlier. He also contemplates suicide as he perceives death as the only way to meet his wife and apologize. He also sees no reason for continuing to live as he describes the last 4 years after the death of his wife to have rendered him miserable. He has insomnia and has lost weight due to poor feeling habits linked to lost appetite. He also experiences anxiety most of the time “Captain of the Ship” Project – Depressive Disorder Sample Essay. The client is currently not under any medication.
Psychopharmacologic treatments and specific therapeutic endpoints
The treatment of major depressive disorders is focused on the alleviation of symptoms and improvement of the quality of life of the patient (Gabbard, 2014). Antidepressants are the most effective medications for the treatment of depression. These drugs include selective serotonin reuptake inhibitors (SSRIs) such as sertraline, paroxetine and escitalopram among others (Stahl, 2014). These drugs limit the reabsorption of serotonin neurotransmitter in the presynaptic cell thus heightening its extracellular level. This results in the binding of postsynaptic receptor by the elevated serotonin in the synaptic cleft. Others SSRIs have selective impacts on the dopamine, norepinephrine and monoamine transporters “Captain of the Ship” Project – Depressive Disorder Sample Essay. Tricyclic antidepressants (TCAs) such as clomipramine, amitriptyline and doxepin among others represent other antidepressants used to manage bipolar disorders, depression and other chronic illnesses. These are usually administered in the events that patients fail to tolerate SSRIs.
As such, the patient will receive a prescription of paroxetine 20 mg per day as the initial dose. This might be increased by 10 mg per day but not to exceed 50mg of the dose daily (Stahl, 2014). However, close monitoring will be done to prevent sedation of the client. Paroxetine changes will be done at intervals of two weeks in order to obtain the optimal dosage. This drug was prescribed because of its minima side effects and high effectiveness in treating major depressive disorder. During the course of treatment, it is expected that the patient will restore his normal functionality like sleeping patterns, interests, alleviation of suicidal ideation. He will also stop feeling sad and crying as well as be able to get out of the house. In addition, his anxiety will be reduced with continued adherence to the treatment “Captain of the Ship” Project – Depressive Disorder Sample Essay.
Psychological treatments and specific therapeutic endpoints
Psychological approaches are considered to be very effective in the management of moderate and severe depression. Interpersonal psychotherapy (IPT), cognitive behavioral therapy and behavioral activation facilitate behavioral, emotional and thought modification (Gabbard, 2014). Interpersonal psychotherapy focuses on resolving the symptoms and interpersonal problems while cognitive behavioral therapy modifies the behaviors, thoughts and feelings of the patient thus replacing negative thoughts with positive thoughts that enhance recovery (Ahern & Semkovska, 2017) “Captain of the Ship” Project – Depressive Disorder Sample Essay. Notably, behavioral activation is a short-term coping strategy that improves behaviors and feelings thus influencing an individual’s moods.
In this case, the patient will be engaged in individual, group and family therapy. During the individual therapy, he will be taught about depression, prevention and management as well as coping efficacies. He will also be able to accept his condition as the initial step to recovery and adherence to treatment. In the group therapies, he will open up and share his experiences with others as well as engage in multiple activities that will help manage anxiety. These include relaxation skills and social skills (Ahern & Semkovska, 2017). “Captain of the Ship” Project – Depressive Disorder Sample Essay On the other hand, family therapy will be essential in teaching the family members on how to provide social support to their patient and also ensure that he copes effectively. The family members will also be involved in ensuring that he adheres to both the pharmacological and psychological plans recommended.
IPT will be conducted in 12 weeks and will involve training the patient on how to resolve his personal issues such as forgiving himself and understanding that it wasn’t his fault that his wife died. The therapeutically endpoints for this interventions include the elimination of anxiety and restoration of the social aspect of the client. Consequently, the patient will develop positive thoughts and eliminate suicidal thoughts and feelings of sadness and worthlessness. He will also be able to engage in more positive activities and resolve his interpersonal conflicts. Additionally, he will be able to sleep well and maintain his recovery “Captain of the Ship” Project – Depressive Disorder Sample Essay.
Medical management needs
Patient centered medical management approaches are essential in optimizing the recovery of depressed patients. This is because; the medications could take up to six weeks to be effective which necessitates social and medical support. The collaboration between the primary care providers and the psychiatrist will help monitor the progress of the patient for any positive progress or adverse reactions caused by the drugs.
Community support resources
The community provides social support resources to patients with depression. For instance, they have built rehabilitation and home care centers for patients with mental disorders where necessary services are concentrated. Moreover, they organize fundraising events to support the treatment of depressed community members and cater for their housing and upkeep “Captain of the Ship” Project – Depressive Disorder Sample Essay. Moreover, they create awareness, condemn stigmatization and provide show love and compassion to the patients. Therefore, the client will definitely benefit from these community resources. Multiple websites on mental health from the community will also provide the patient with essential information and resources that he can benefit from the community.
Due to the sedative nature of paroxetine, the patient will be required to visit the clinic on weekly basis for monitoring. In the event of positive progress, the appointments will be extended to after two weeks and eventually on monthly basis. “Captain of the Ship” Project – Depressive Disorder Sample Essay.
Ahern, E., & Semkovska, M. (2017). Cognitive functioning in the first-episode of major depressive disorder: A systematic review and meta-analysis. Neuropsychology, 31(1), 52–72. doi:10.1037/neu0000319
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications. “Captain of the Ship” Project – Depressive Disorder Sample Essay
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press. “Captain of the Ship” Project – Depressive Disorder Sample Essay.
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Assignment 1: “Captain of the Ship” Project – Depressive Disorder
As nurse practitioners strive to achieve full-autonomous practice across the country, it should be noted that many states grant this ability to practice independently to psychiatric mental health nurse practitioners. To that end, you will be engaging in projects this semester that assume that you are practicing in a state that allows full-practice authority for NPs, meaning that the PMHNP may be the “captain of the ship” concerning caring for a patient population. The “captain of the ship” is the one who makes referrals to specialists, coordinates care for their patients/clients, and is responsible and accountable for patient/client outcomes overall. This is a decided change from a few decades ago when physicians were the “captain of the ship” and NPs played a peripheral role.
In this “Captain of the Ship” Project – Depressive Disorder Sample Essay Assignment, you will become the “captain of the ship” as you provide treatment recommendations and identify medical management, community support resources, and follow-up plans for a client with a depression disorder.
• Recommend psychopharmacologic treatments based on therapeutic endpoints for clients with depression disorders
• Recommend psychotherapy based on therapeutic endpoints for clients with depression disorders
• Identify medical management needs for clients with depression disorders
• Identify community support resources for clients with depression disorders
• Recommend follow-up plans for clients with depression disorders
To prepare for this Assignment:
• Select an adult or older adult client with a depressive disorder you have seen in your practicum.
In 3–4 pages, write a treatment plan for your client in which you do the following:
• Describe the HPI and clinical impression for the client. “Captain of the Ship” Project – Depressive Disorder Sample Essay
• Recommend psychopharmacologic treatments and describe specific and therapeutic endpoints for your psychopharmacologic agent. (This should relate to HPI and clinical impression.)
• Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices. “Captain of the Ship” Project – Depressive Disorder Sample Essay
• Identify medical management needs, including primary care needs, specific to this client.
• Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.
• Recommend a plan for follow-up intensity and frequency and collaboration with other providers. “Captain of the Ship” Project – Depressive Disorder Sample Essay
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