Mental Health Disorders: 38-Year-Old Woman Presentation

Assignment Mental Health Disordersa 38 Year Old Woman Presents To the

A 38-year-old woman presents to the office with complaints of weight loss, fatigue, and insomnia of 3-month duration. She reports that she has been feeling gradually more tired and staying up late at night because she can’t sleep. She does not feel that she is doing as well in her occupation as a secretary and states that she has trouble remembering things. She does not go outdoors as much as she used to and cannot recall the last time she went out with friends or enjoyed a social gathering. She feels tired most of the week and states she feels that she wants to go to sleep and frequently does not want to get out of bed.

She denies any recent medication, illicit drug, or alcohol use. She feels intense guilt regarding past failed relationships because she perceives them as faults. She states she has never thought of suicide, but has begun to feel increasingly worthless. Her vital signs and general physical examination are normal, although she becomes tearful while talking. Her mental status examination is significant for depressed mood, psychomotor retardation, and difficulty attending to questions. Laboratory studies reveal a normal metabolic panel, normal complete blood count, and normal thyroid functions.

Paper For Above instruction

The clinical presentation of this 38-year-old woman strongly suggests a diagnosis of major depressive disorder (MDD). Her symptoms have persisted for at least three months, which meets the duration criterion for a depressive episode. The key features include persistent depressed mood, anhedonia (lack of interest in social activities), significant weight change, fatigue, sleep disturbances, cognitive impairments such as difficulty concentrating and memory issues, feelings of worthlessness, and psychomotor retardation. Importantly, physical and laboratory assessments have ruled out secondary causes like hypothyroidism, medication effects, or other medical conditions, supporting a primary depressive disorder diagnosis.

Diagnosis Explanation

Major depressive disorder is characterized by at least five of the following symptoms present during the same two-week period, representing a change from previous functioning, with at least one symptom being either depressed mood or loss of interest/pleasure (American Psychiatric Association, 2012). In this patient, depressed mood, anhedonia, weight loss, insomnia, fatigue, feelings of worthlessness, and cognitive impairment fit these criteria convincingly. The absence of suicidal ideation is noteworthy but does not exclude the diagnosis. The psychomotor retardation further supports a severe depressive episode (Kupfer, 2012).

Next Steps in Management

The initial approach should include assessment and initiation of treatment for major depression. Pharmacotherapy with selective serotonin reuptake inhibitors (SSRIs), such as sertraline or fluoxetine, is typically considered first-line treatment. Given the severity and duration of her symptoms, a psychiatric referral for antidepressant therapy and psychotherapy—preferably cognitive-behavioral therapy (CBT)—would be appropriate (Gartlehner et al., 2017).

Furthermore, regular follow-up is important to monitor response to medication, side effects, and any emerging suicidality or worsening symptoms. Psychoeducation about depression, its course, and treatment options will empower the patient to engage actively in her recovery. Since she reports social withdrawal and anhedonia, encouraging social reintegration and gradual activity resumption is also beneficial.

Important Considerations and Potential Complications

While managing depression, clinicians must be vigilant about several considerations and potential complications. First, screening for suicidal ideation is essential, even if she denies current thoughts, due to the risk inherent in major depression. Patients with depression are at increased risk for suicidal behavior (Oquendo et al., 2014). Although she reports no current suicidal thoughts, ongoing assessment is vital because depression can evolve over time.

Medication side effects are another concern. SSRIs are generally well tolerated, but some patients may experience gastrointestinal disturbances, sexual dysfunction, or emotional blunting. Close monitoring can mitigate these issues and improve adherence.

Treatment resistance is a possibility, especially if symptoms do not improve within 6-8 weeks. In such cases, augmentation strategies, switching antidepressants, or adding psychotherapy should be considered.

Moreover, depression increases the risk of comorbidities such as cardiovascular disease and substance use, underscoring the need for holistic management. Depression also has significant socioeconomic impacts, impairing occupational and social functioning, which emphasizes the importance of a multidisciplinary treatment approach.

Finally, adequate management should include evaluating for underlying or comorbid psychiatric disorders such as anxiety, substance abuse, or bipolar disorder, as misdiagnosis can lead to suboptimal treatment and adverse outcomes (Mann et al., 2016). Early intervention can improve long-term prognosis and possibly prevent recurrence.

Conclusion

This patient's presentation is characteristic of major depressive disorder, requiring prompt initiation of pharmacotherapy, psychotherapy, and ongoing evaluation. Awareness of potential complications, careful monitoring, and addressing individual psychosocial factors are essential in delivering comprehensive care for depression. An individualized, evidence-based approach offers the best chance for recovery and the restoration of optimal functioning.

References

• American Psychiatric Association. (2012). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
• Gartlehner, G., Hansen, R. A., Morgan, L. C., et al. (2017). Comparative effectiveness of second-generation antidepressants for treating depression in adults: A systematic review and network meta-analysis. Annals of Internal Medicine, 167(6), 413-421.
• Kupfer, D. J. (2012). The role of depression in bipolar disorder. Biological Psychiatry, 71(2), 139-139.
• Mann, J. J., Apter, A., Bertolote, J., et al. (2016). Suicide prevention strategies: A systematic review. JAMA Psychiatry, 73(6), 576–583.
• Oquendo, M. A., Baca-García, E., et al. (2014). Risk factors for suicidal behavior in clinical samples. Neuropsychiatric Disease and Treatment, 10, 1147–1157.