Psychological_Disorder_Analysis

Marla is a 42-year-old Hispanic female who came into the mental health clinic with a variety of symptoms. These symptoms seem to be causing her acute physical and mental suffering, which impairs her level of functioning on daily. During Marla’s initial visit she complained of vague symptoms that included trouble sleeping, feeling anxious all the time, and not being able to concentrate (Axia College, 2007). Marla believes that these symptoms are the cause for her decreased performance at work. A concern about losing her job because of these symptoms is what has led her to this office today. After talking with Marla, this clinician believes that the symptoms presented require further analysis to reach a diagnosis. Although these symptoms do meet the same criteria as multiple diagnoses such as major depression, panic disorder with agoraphobia, and post traumatic stress disorder. All these must be ruled out. With the information that Marla has given me thus far I would suspect that she was suffering from either Dysthymic Disorder or Major Depression. After a full assessment is completed I will be more able to diagnose her condition. After I make my final diagnosis and decide on the best treatment, I will explain all the results to Marla and her family. I will then discuss an effective treatment plan that will help Marla to return to her everyday life with little or no symptoms. Clinical Interview Questions: 1.) What brings you here today' 2.) What can you tell me about your current medical condition' Are you presently taking any medications' 3.) When is the last time you remember being happy' Do you remember anything that may have happened to cause you to feel this way' 4.) Are married or in a relationship' Any problems' Do you have children' 5.) Do you work' What kind of work do you do' How about your husband/partner' 6.) What kinds of things do you like to do for fun and relaxation' 7.) How was life growing up' Did you have any siblings' 8.) Are there any other family members that have been diagnosed with any type of mental illness' Is there anyone who has or had any alcohol or chemical dependencies' 9.) Have you ever had thoughts about hurting yourself' 10.) What are your expectations’ in regard to therapy' The responses that I received from Marla during the initial interview have made it easier to put my main focus on several issues that have been presented at this time. Most important, the length of time that these symptoms have been present in Marla’s life leads this clinician to focus mainly on Dysthymic Disorder. Even though Marla has expressed feelings of depression and that there is a family history of mental depression, her symptoms do not meet the criteria for a diagnosis of major depression. In addition, the fact that Marla has not experienced any kind of traumatic event rules out the presences of a traumatic stress disorder. After a complete and comprehensive evaluation this clinician can with confidence diagnose Marla with 300.4 Dysthymic Disorder as according to the DSM-IV. A complete result of DSM-IV Multi-axial Evaluation for Marla is as follows: Axis I 300.4 Dysthymic Disorder, Late Onset, Prior Major Depressive Episode (Full Remission) Axis II V71.09 No diagnosis Axis III none Axis IV Occupational Problems, Inadequate Social Support Network Axis V GAF= 60 (current Dysthymia is a mood disorder characterized by chronic mildly depressed or irritable mood often accompanied by other symptoms such as eating and sleeping disturbances, fatigue, and poor self-esteem. This disorder can last for several years ("Dictionary.com," 2010). Although major depression and Dysthymic disorder do share similar symptoms, the symptoms of Dysthymia are less exaggerated and are persistent for at least two years. Also, there have been no major depressive or manic episodes exhibited within this time frame. A person who has been diagnosed with Dysthymic disorder will report that the symptoms do not subside for any long period of time, and he or she is frequently be in a depressed mood (Axia College, 2007). A person with Dysthymic disorder will have two or more general symptoms that may include problems sleeping, fatigue, and a change in appetite. Other symptoms may include decreased self-esteem, difficulty concentrating, and poor decision-making (Axia College, 2007). Most people diagnosed with Dysthymic disorder do meet the criteria for other mental illnesses, so Marla will be monitored closely for possible signs of an anxiety disorder. This is because she is showing some symptoms of anxiety at this time, and it is possible for people with Dysthymic disorder also to develop double depression. As a result people may develop Major Depression disorder along with Dysthymic disorder. In the event that this may happen he or she will experience chronic depression symptoms that may intensify symptoms related to major depression (Axia College, 2007). Dysthymic disorder affects about three to five percent of the population, and it is more frequently found in woman than in men. A person who has been diagnosed with Dysthymic disorder may experience short periods of remission, and it may last a few months but will return (Axia College, 2007). Generally this disorder only allows a person to be symptom free for one or two days. Other mental illnesses that are known to accompany Dysthymic disorder include anxiety and eating disorders, personality disorders, and substance abuse (Axia College, 2007). A multiple theoretical approaches in the development of unipolar depression can explain the cause of Marla’s disorder. The fact that there is a family history of depressive illness can explain the biological approach to depression. Research has proven that there is a possible predisposition for the development of unipolar depression in people who have a known family history of the illness. In addition, the biological view would add that there is a genetic component based on hormonal levels and the dysfunctioning of neurotransmitters in the brain (Comer, 2005). In Marla’s case, a combination of biological and multiple sociocultural factors contribute excessively to her diagnosis of Dysthymic disorder. The chance of developing a depressive illness increases among those of Hispanic ethnicity and among woman in general. These factors may have also played a big part in Marla’s disorder (Comer, 2005). To reduce the symptoms of depression Marla can be prescribe one of two antidepressant medications; a tricylic such as Prozac or Tofranil. Both have proven to be effective in treating unipolar depression but Prozac may be tolerated better and is less likely to have any undesirable side effects (Comer, 2005). The antidepressant medication may also work to reduce her feelings of anxiety. This will not only relieve Marla’s anxiety but also increase her cognitive abilities as well. Marla will benefit greatly from individual psychotherapy with a cognitive-behavioral approach. The main focus will be to increase her levels of optimism and enhance her self-esteem during regular sessions. The therapist will also help Marla to gain and maintain effective coping skills. Marla will be closely monitored for negative thoughts and reduce any maladaptive attitudes (Comer, 2005). Group therapy will be included in Marla’s plan of treatment, so that she can see that there are others who also suffer from Dysthymic disorder. This therapy will give Marla the opportunity to develop a social support network while at the same time allowing her to interact with people who have similar personalities. As others offer Marla encouragement she will achieve a higher level of functioning, and learn how she can cope with her illness in her everyday life. Marla will receive regular evaluations to ensure that she is gaining the most out of her treatment plan. In conclusion, though similar in many ways to Major Depression, Dysthymic disorder is often overlooked and left untreated. This disorder can go on for years without being diagnosed because it is presumed that the behaviors and attitudes that the person is experiencing is nothing more than negative personality traits (Axia College, 2007). The person who is living with Dysthymic disorder will have a lifetime of battles with his or her illness. However, when this disorder is properly diagnosed and treated the person will have an increased chance of recovery. The careful assessment and diagnosis of Dysthymic Disorder will ensure a more positive outcome and increased quality of life, and this is what Marla hopes to gain from her plan of treatment. References Comer, R. J. (2005). Fundamentals of abnormal psychology (4th ed.). New York: Worth. McGraw Hill Higher Education Web site, http://www.mhhe.com/socscience/psychology/faces/# Dictionary.com. (2010). Retrieved from http://dictionary.reference.com