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Capella 4015 Assessment 3
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Capella University
NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care
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Date
Concept Map: The 3Ps and Mental Health Care
Understanding Major Depressive Disorder (MDD)
Major Depressive Disorder (MDD) is a complex and prevalent psychiatric condition that significantly impacts an individual’s emotional and physical well-being. It typically presents with persistent sadness, decreased interest in usual activities, constant fatigue, disrupted sleep cycles, and notable shifts in appetite and body weight. Often, this disorder is triggered by emotionally distressing life events such as trauma, grief, or personal loss, and it compromises cognitive, social, and occupational functioning (Bains & Abdijadid, 2023).
In Ivy Jackson’s scenario, her clinical presentation aligns with the diagnostic features of MDD. Her care plan focuses on fostering psychological healing and emotional regulation by addressing both biological vulnerabilities and psychosocial triggers.
Case Study Overview
Patient Background and Symptomatology
Ivy Jackson, a 63-year-old female, experienced emotional distress following the end of her 38-year marriage due to her spouse’s infidelity. Since the separation, she has demonstrated hallmark signs of depression, including extreme fatigue, sleep disruption, appetite loss, mood instability, and involuntary weight reduction. These symptoms have significantly impaired her daily functioning. Additionally, her family’s history of depression suggests a hereditary component that may be influencing her current mental health status.
Psychiatric Evaluation and Diagnostic Criteria
Based on the DSM-5-TR standards, Ivy fulfills the criteria for Major Depressive Disorder. She reports over five core symptoms—such as sustained low mood, anhedonia, and persistent tiredness—lasting for more than two weeks and affecting her everyday activities. Although Ivy has not indicated any suicidal intentions, her sense of hopelessness, social withdrawal, and emotional disconnection are concerning signs that suggest a risk of clinical deterioration without timely intervention.
Risk Factors and Potential for Recurrence
A combination of psychosocial and biological variables contributes to Ivy’s condition. The emotional trauma from her divorce is a significant psychological stressor. Moreover, her genetic predisposition to depression—highlighted by her family history—further increases her vulnerability. Other important considerations include her recent discontinuation of venlafaxine due to side effects and the psychological impact of the empty nest phase, both of which exacerbate her depressive symptoms. Medication withdrawal is a well-recognized factor that heightens the likelihood of depressive relapse.
Treatment Plan and Prognostic Outlook
Evidence-Based Interventions for Recovery
Unlike normal grief responses, MDD is associated with long-term disturbances in brain chemistry, particularly involving the serotonergic system and hypothalamic-pituitary-adrenal (HPA) axis dysregulation (Bains & Abdijadid, 2023). Ivy’s management plan should integrate both pharmacological and non-pharmacological strategies. SSRIs like escitalopram are generally recommended due to their favorable safety and efficacy profile. Psychotherapy, especially Cognitive Behavioral Therapy (CBT), is crucial for modifying negative thought processes and improving mood regulation. Complementary lifestyle changes—such as regular physical activity, scheduled routines, and social engagement—can enhance her emotional resilience and reduce the probability of recurrence.
Case Summary and Intervention Plan
Category | Details |
---|---|
Patient Information | Ivy Jackson, 63 years old; recently separated after a 38-year-long marriage. |
Presenting Symptoms | Fatigue, disturbed sleep, involuntary weight loss, emotional instability, low mood, anhedonia, anxiety. |
Diagnosis | Major Depressive Disorder (MDD), per DSM-5-TR; five or more symptoms for over two weeks with functional decline. |
Psychosocial Contributors | Divorce-related emotional distress, hereditary predisposition, empty nest adjustment, recent discontinuation of antidepressants. |
Treatment History | Previously prescribed venlafaxine, which was discontinued due to side effects. |
Recommended Interventions | Initiation of SSRIs (e.g., escitalopram), CBT sessions, lifestyle restructuring, physical exercise, and strengthened social support. |
Prognosis and Risks | Favorable with consistent therapy; elevated risk of relapse if left untreated due to MDD’s chronic and neurobiological components. |
References
Bains, N., & Abdijadid, S. (2023). Major depressive disorder. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559078/ https://www.ncbi.nlm.nih.gov/books/NBK493211/
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