Mental Health Paper (Case Study Sample)

Mental Health Paper Student’s Name Institutional Affiliation Course Code and Course Name Professor Date Mental Health Paper Introduction Mental health nursing is a critical specialization in the health care delivery system because of the specialized focus on clients with psychiatric disorders. In this field, one has to have sufficient knowledge about mental health disorders, interpersonal skills, and the quality of approaching people with care. The paper aims to describe the case of a 35-year-old female patient diagnosed with depression, anxiety, and PTSD. She has a history of harming herself and has traumatic experiences such as physical and sexual abuse. The patient is currently taking numerous medications and follows a Course of therapy in an attempt to minimize and control the symptoms that hinder her daily living. This paper will consider the psychiatric and medical profile of the patient, the therapy schedule and goal, and the understanding of holistic nursing care in the mental health discipline. Mental Illness/Disorder Pathophysiology & DSM-5-TR Diagnostic Criteria The patient has been diagnosed with three primary mental health disorders: depression, anxiety, and PTSD, and they are essential to understand since they are some of the most prevalent mental illnesses in the United States. Standard features of depression include feelings of hopelessness, despair, and a general lack of interest in activities that were previously enjoyable (Bains & Abdijadid, 2023). This type of depression mainly originates from neurotransmitter instability ensuing from serotonin, norepinephrine, and dopamine dysregulation that plays a part in mood modulation. These changes can manifest in various ways, including genetic predispositions, stress, and changes in the brain. To diagnose major depressive disorder according to the DSM-5-TR criteria, the patient must report the presence of at least five of the following symptoms in the same two-week duration: depressed mood, anhedonia, weight changes, sleep disturbances or increased psychomotor activity, fatigue, feelings of guilt or worthlessness, diminished ability to concentrate, and recurrent thoughts of death or suicide. Anxiety disorders can be defined more specifically as a category of related disorders in which the primary symptom is fear and anxiety. The patient’s anxiety can be described as increased general worrying, inability to sit still, and inability to focus. Regarding the underlying processes, anxiety is marked by heightened activity of the amygdala – the brain structure associated with the processing of fear – and reduced prefrontal cortex activity, which is responsible for rational thinking and decision-making (Chand & Marwaha, 2023). Moreover, excess and deficiencies of neurotransmitters like gamma-aminobutyric acid (GABA) and serotonin increase anxiety levels. The DSM-5-TR criteria for generalized anxiety disorder include excessive anxiety and worry occurring more days than not for at least six months, difficulty controlling the worry, and the presence of three or more symptoms: anxiety, agitation, difficulty sleeping, fatigue, increased heart rate, lack of focus, sleep disorders, and increased sensitivity to stimuli (Substance Abuse and Mental Health Services Administration, 2016). These symptoms must be associated with clinically significant impairment in social, occupational, or other essential domains of functioning. PTSD is a psychological disorder that occurs in a person who has undergone a life-threatening event and will experience several symptoms. This study focuses on PTSD in the patient, for which she experiences intrusive thoughts of past trauma, nightmares, and severe anxiety. Some of the pathophysiological findings linked to PTSD include heightened activity of the amygdala, decreased activity of the prefrontal cortex, and HPA axis hypofunctionality, which is responsible for the regulation of the stress response. According to DSM-5-TR, the criteria for PTSD are exposure to actual or threatened death, serious injury or sexual violence, re-experiencing symptoms (such as memories or nightmares), avoiding trauma-related stimuli, negative alterations in mood and thought, and increased arousal (American Psychiatric Association, 2022). These symptoms must be present for one month or more, resulting in clinically significant distress or impairment. It is crucial to know the nature of these disorders, symptoms, and diagnostic tests that might help create a proper treatment plan that would fit the patient. Depression Disorders Pathophysiology & DSM-5-TR Diagnostic Criteria Depression is a prevalent mental illness characterized by persistent feelings of sadness, hopelessness, and a lack of interest in activities. The successive etiologic pathophysiology of depression is relayed to neurotransmitter inconsistency, serotonin, norepinephrine, and dopamine, which influence mood control. These biochemical changes are caused by genetic dispositions, environmental stress, and studying effects on the brain and how it functions. According to DSM-5-TR criteria, major depressive disorder (MDD) is diagnosed when a patient exhibits at least five of the following symptoms for two weeks (American Psychiatric Association, 2022). The major depressive disorder symptoms are as follows: depressed mood, anhedonia, weight loss or weight gain of at least 5% of the original weight, insomnia, hypersomnia, psychomotor agitation, slowing down, fatigue or feeling of lack of energy, feelings of worthlessness, and guilt, diminished ability to concentrate, and suicidal thoughts. Patient Presentation and Current Treatment Symptoms diagnosing the central depressive disorder include the patient’s depressed mood, reduced pleasure in activities previously considered enjoyable, weight loss or gain, disturbances in sleeping, fatigue, low self-esteem, and thoughts about death or suicide. These symptoms have been present in the past few years, evidencing interpersonal interaction, marked social impairment, and occupational performance. Specific instructions regarding the prescription are Trazodone, 150 mg per day; Lexapro, which is an antidepressant that is taken in thirty milligrams per day; and supportive therapy. Trazodone needs to be watched for side effects such as severe allergic reactions and increased drowsiness, while Lexapro should be watched for risks of hyponatremia and serotonin syndrome. Further, the patient is on Gabapentin 800mg three times daily for nerve pain, Metformin 1000mg per day for diabetes, and Lantus 22 units once daily. Monitoring patients’ blood glucose often and assessing gastrointestinal adverse effects is crucial. Treatment Options and Patient-Specific Considerations The management of depression entails the use of drugs, counseling sessions, and alterations of behavior patterns. Thus, antidepressants such as Lexapro, which is an SSRI, and others known as SNRIs can effectively help in treating depressive symptoms (Strawn et al., 2019). Available therapies include cognitive behavioral therapy as a way of modifying negative ways of thinking and dialectical behavior therapy as a way of improving the emotional regulation skills among the persons diagnosed with the disorder (Nakao et al., 2021). Concerning socio-economic status, the patient has issues with access to healthcare and affordability of medications, which require solutions that can be introduced based on financial assistance, lower service rates, or social services programs. The family members' education is essential regarding the medications, recommended changes in diet, and ways of dealing with symptoms to avoid noncompliance with the treatment. Some of the challenges affecting clients’ adherence to the treatment regimens are cost, side effects of antipsychotics, and the culture surrounding mental illnesses, which should require an accepting atmosphere. Table 1: DSM-5-TR Diagnostic Criteria for Depression Disorders Criterion Description A Depressed mood most of the day, nearly every day. B Markedly diminished interest or pleasure in all, or almost all, activities most of the day. C Significant weight loss when not dieting or weight gain. D Insomnia or hypersomnia nearly every day. E Psychomotor agitation or retardation nearly every day. F Fatigue or loss of energy nearly every day. G Feelings of worthlessness or excessive guilt. H Diminished ability to think or concentrate, or indecisiveness. I Recurrent thoughts of death, recurrent suicidal ideation, or a suicide attempt. Anxiety Disorders Pathophysiology & DSM-5-TR Diagnostic Criteria Anxiety disorders encompass a range of conditions characterized by excessive fear and anxiety. The pathophysiology of anxiety involves heightened activity in the amygdala, responsible for processing fear, and reduced activity in the prefrontal cortex, which governs rational thought and decision-making. Imbalances in neurotransmitters such as GABA and serotonin also contribute to anxiety. The DSM-5-TR criteria for generalized anxiety disorder (GAD) include excessive anxiety and worry occurring more days than not for at least six months, difficulty controlling the worry, and the presence of three or more symptoms: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances (American Psychiatric Association, 2022). These symptoms must cause significant distress or impairment in social, occupational, or other essential areas of functioning. Patient Presentation and Current Treatment The patient has more than an anxious mood, excessive worry, an inability to control it, physical restlessness, and insomnia that has been present for over six months. These symptoms adversely affect her ability to live her everyday life and her social relationships. She requires observation for elevated liver enzyme levels a...