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Depression

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Psychological Disorder Analysis
Nicole Jones
PSY/270
Christopher Van Ness
May 18, 2014

Psychological Disorder Analysis
Patient: Marla a 42- year old Hispanic female who comes to the mental health clinic complaining of having trouble sleeping, feeling” jumpy all the time,” and experiencing an inability to concentrate. These symptoms are causing problems for her at work, where she is an accountant.
Interview with Marla
Marla: Good morning!
Me: Tell me what bring you in today?
Marla: I have been unable to sleep for about 2 months, and I jump all the time, which causes me to not be able to concentrate.
Me: I will need to ask you about 10 questions or more so I can get to know you better, and find out a little about your life, is that fine with you?
Marla: Yes!
Me: Tell me about yourself?
Marla: I am a single mother with 2 boys, who are teenagers. I do secretarial work. I enjoy spending time with my family.
Me: Tell me about your childhood?
Marla: I had a hard childhood my father left when I was 8 years old, and it seem like my life changed because I missed him all the time, and my mother had a nervous breakdown because he left her for another woman.
Me: So your mother did experience a psychological disorder?
Marla: Yes it started out with her being depressed all the time, and then she started drinking, which seemed to make it worst. I had to take care of myself and my younger siblings. My mother would drink every day, and all night, then she would fall asleep. The school called authorities because we never went to school, which resulted in protection services taking us out the home, and we were separated. I have no idea where my siblings are. I was told that my mother was admitted into a mental institution, when I got older I asked about my biological mother but no one could give me any information on how to locate her.
Me: Sorry to hear that, the abuse you went through caused traumatic family interactions that contributed to your anxiety. This explains why you keep very few friends around you. It is possible you don’t want to be hurt, and lose their relationship. Marla: Yes!
Me: Do you remember when these changes started?
Marla: The jumpiness started after I lost my husband, and continued.
Me: Do you feel nervous, and afraid even when you are not alone?
Marla: Yes, and it is very hard to concentrate at work.
Me: Have you tried to get up and go outside or in the bathroom and take deep breaths, drink some water? If not we will go over these techniques before you leave today.
Marla: I worry all the time and I’m tired of not getting any rest.
Me: I can see why you are having trouble sleeping with upsurge intensities of anxiety the next day, bring about you to feel jumpy. Nervousness overflows the mind with overpoweringly continuous undesirable evaluations in the direction of yourself, and all around you. When this happens it strongly effect your mind, and you find yourself being worried with tiresome thoughts, leading to greater jitteriness, and trouble thinking on repetitive everyday responsibilities.
Me: Do you have friends and how do you act around them?
Marla: I have two but one close.
Me: Do the one close friend know what’s going on with you, while the other one don’t?
Marla: Wow I’m surprised you knew only one was told.
Me: So far I’m gathering that when you start feeling jumpy and unable to concentrate, that a panic attack is occurring. Countless quantity of people remain uninformed of how quickly the succeeding one will take place, as a result they commonly figure out there close supports, and lend on that person and not all their associates with their deep, and personal problems. Marla: It makes sense to me why one friend is closer than the other one now.
Me: Tell me about your past or present relationships?
Marla: A man have to approach me I am shy, and get very nervous when they do. I did not have many friends or boyfriends in my past. I fell in love with one man and that was my children father before he died in a car accident.
Me: You have experience a tragedy in your life, and the separation of your parents was a lost as well. This could definitely be why you are experiencing the jumpiness. Usually a person have been experiencing changes with themselves, but many ignore them, and then when they look for help the problem has overtaken them and get out of control.
Marla: I wonder if this is why I lost my last job.
Me: Difficulty concentrating can definitely affect your performance.
Marla: I just want a normal life, this issue with me is affecting my whole life, and the people around me.
Me: Do you have any goals?
Marla: I have not thought about my future, I just take one day at a time.
Me: Do you avoid being around a lot of people.
Marla: Yes, because I am afraid of having a panic attack.
Me: Do you have self-motivation?
Marla: No, I don’t know how.
Me: You just recognize you don’t know how to motivate yourself which is the first step towards your healing is admitting it. We can also work on this issue as well when we begin therapy.
Marla: I understand, thank you.
Me: Had you been experiencing irritation, tension and unhappiness before the jumpiness took place?
Marla: Yes I can’t recall the last time I was happy, or not always worrying about something.
Me: You just expressed your feelings, and we will work on you learning how to cope with life challenges.
Marla: I want to be happy and not stress out about things, so I can be a better mother to my children.

Me: Marla, together we are going to see if we can decrease the regularity, and sternness of your indications so you can break loose, and be free. Marla: Thank you, I feel confident that you can help me.
Me: Call me next week to make an appointment or sooner, and we can go further.
Marla: I will see you soon!
Dysthymia, panic disorder, remains a minor but long-term (chronic) form of depression. Symptoms typically last for at minimum two years, and frequently considerably longer than that. Dysthymia symptoms frequently come, and leave over an age of years, and their strength can adjust over time. On the other hand normally symptoms don't vanish for more than two months at a time. The individual may find it hard to be happy even on joyful occasions. People might say the individual have a depressed personality. (Mayo, (n.d.).
Dysthymia symptoms in adults possibly will include: * Loss of concentration in day-to-day activities * Unhappiness or mood down * Uselessness * Sleepiness, and shortage of energy * Low-slung confidence, self-depreciation or feeling incompetent * Distress focusing, and anxiety making choices * Bad temper or too much anger * Reduced activity, efficiency, and productivity * Averting of social happenings * Frame of mind of blame and doubts over the former years * Reduced appetite or overindulging * Sleep difficulties
(Mayo, (n.d).
Treatments and Drugs:
The two main treatments for dysthymia are medications and talk therapy (psychotherapy). Medications seem to be further in effect at treating dysthymia than psychotherapy once either is used alone. Using a mixture of medications, and psychotherapy might be to some extent more effective (Mayo, (n.d).

Which treatment method your physician indorses depends on aspects such as? * Severity of your dysthymia symptoms * Your wish to address sensitive or situational concerns disturbing your life * Your individual preferences * Earlier treatment approaches * Your capability to put up with medications * Additional emotional difficulties you may possibly have
Psychotherapy for dysthymia
Psychotherapy can aid you studying about your disorder, and your frame of mind, moods, point of view, and behavior. By means of the understandings, and information you achieve in psychotherapy, you can absorb healthy surviving skills, and stress control. Psychotherapy can likewise help you: * Learn to make judgments * Decrease self-defeating conduct patterns, for example unhelpfulness, impossibility, and an absence of assertiveness * Progress your ability to function in social environments, and work conditions
Medications for dysthymia
Kinds of antidepressants furthermost generally used to treat dysthymia contain: * Discerning serotonin reuptake inhibitors (SSRIs) * Serotonin and norepinephrine reuptake inhibitors (SNRIs)
Tricyclic antidepressants (TCAs) (Mayo, (n.d.).
The individual can discuss with their therapist the type of treatment that is best for them, and their goals, and try to reach them.

Reference
http://www.mayoclinic.org/diseases-conditions/dysthymia/basics/symptoms/con-20033879

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