The following are the three questions that would be appropriate for the client:
What do vital factors you believe are contributing to your depression?
What makes you believe that you have no option?
What are some of the previous medication you have taken as part of your treatment for depression?
The primary person that I would seek to get feedback from is his wife, as she would have a better understanding of the treatment process for the man concerning his case of depression. Stahl (2013) points out that getting feedback from close relatives is essential when dealing with instances of depression, as it helps in highlighting how an individual has been able to deal with depression focusing on the treatment options. One fundamental question that I would ask her focusing on the depression case of her husband is: What some of the previous treatment options that your husband has taken as part of his treatment for depression? The question seeks to understand some of the medication that the patient has taken previously, as well as, gaining a clear understanding of whether they have had the expected levels of effectiveness.
Taking into account that this is a mental health issue, the diagnostic test that would be most appropriate for this patient is DSM-V to help in calibrating his symptoms based on the signs indicated in this diagnostic tool. DSM-V offers a diverse platform from which to examine a patient depending on the symptoms that he or she may present with the focus being towards determining the likelihood of a specific mental condition (Stahl, 2014). In this case, the diagnostic test will play a critical role in the analysis of the patient depending on the possibility that he or she may suffer from severe depression.
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The first differential diagnosis, in this case, depression, is adjustment disorder with depressed moods, which presents somewhat similar symptoms when compared to depression taking into account that a patient shows signs of distress. The second differential diagnosis is bipolar disorder in which patients may show severe signs of hypomanic, manic, or a mixture of two presenting themselves through some form of depression (Yasuda, Zhang, & Huang, 2008). The third differential diagnosis to consider is anxiety disorders, as a patient may show signs of anxiety attacks, which are also common when dealing with patients suffering from depression. In all the differential diagnoses, patients tend to exhibit significant cognitive changes depending on the severity of the condition. Usage of the DSM-V diagnostic tool may help in meeting set expectations as part of promoting differential diagnosis for the patient.
The first pharmacologic agent that would be appropriate for this patient is selective serotonin reuptake inhibitor (SSRI). SSRIs play a critical role towards easing on uneven or inability to manage emotions effectively to help in ensuring that patients are well positioned towards dealing with the symptoms of depression (Howland, 2008). The second pharmacologic agent to consider is tricyclic antidepressants (TCA), which act as antidepressants with the focus being towards ensuring that patients are well positioned towards dealing with symptoms associated with depression.
When using the drugs that have been indicated as part of drug therapy, it is essential to take note of some of the contraindications that would affect the patients. Some of the contraindications to consider include weight gain, insomnia, fatigue, and sexual problems. The contraindications arise due to a situation where patients tend to experience a significant change in their hormonal balance depending on the drugs that they take as part of drug therapy.
References
Howland, R. H. (2008a). Sequenced treatment alternatives to relieve depression (STAR*D). Part 1: Study design. Journal of Psychosocial Nursing and Mental Health Services, 46 (9), 21–24.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press
Yasuda, S.U., Zhang, L. & Huang, S.-M. (2008). The role of ethnicity in variability in response to drugs: Focus on clinical pharmacology studies. Clinical Pharmacology & Therapeutics, 84 (3), 417–423.
