Description of the Patient, Pertinent History, and Medical Information
The patient was an older adult aged 60. He had a wife and five children who were all in tertiary level of learning. He was a retired teacher; thus, he received monthly pension benefits. However, he was the core breadwinner of the family. In this case, the funds he obtained were insufficient. Products from his farm supplemented this income. The patient has been exhibiting depression symptoms for the past year.
The patient was an alcoholic in the past, a situation which caused him much friction with his wife and children. He was also unable to effectively manage the little income he generated from his teaching profession. For some time, his family was forced to flee from him since he was also violent, especially under the influence of alcohol. Early this year, he attempted suicide by taking rat poison. Besides, he complained of headache and back pains. He went through psychotherapy and got better.
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Diagnosis
From the observation, the patient is suffering from a major depressive disorder. Due to alcohol, the patient did not invest or develop anything with the income he obtained while working. He attempted committing suicide and experienced unexplained physical pains. Suicidal thoughts and these particular pains are primary symptoms of a major depressive disorder (Wang et al., 2017). Furthermore, these symptoms are occurring for the first time in his life. This is a significant symptom of a major depressive disorder. He has been healthy all through his life from childhood.
Ethical Implications
Questions about his past, economic activities, and family may offend the patient as they may trigger feelings of regret. In this case, the patient may perceive this as being disrespectful. At his age, he may not understand how his past can link to his present situation.
Second Patient
Description of the Patient, Pertinent History, and Medical Information
The patient, in this case, was a young adult aged 38. He is not married and is also unemployed. However, he finished his masters' level of education two years ago and was yet to land any job. He always acquired food from the family farm and lived in a rented apartment. The father of this patient suffered depression due to his inability to meet the needs of his family effectively. Down the line, his grandfather also had depression at some point in his life. While in school, the patient was always isolated and was very secretive. He always preferred being alone, even when troubled.
Diagnosis
The patient is suffering dysthymia (persistent depressive disorder). The patient has always shown symptoms of depression from the past. Staying in isolation and low-self-esteem are key symptoms of depression (Huang et al., 2017). Persistent depressive disorder can affect one for many years (Nuckols, n.d). The patient has exhibited its symptoms for an extended period. He is now out of school but still suffering from the disease. Dysthymia typically comes and goes after sometime over the years. Similarly, the condition varies in intensity from one moment to another. For instance, it may take some month or years and go away for some time before recurring again. From my observations, the patient has been experiencing depression that varies in severity from one moment to another but does not entirely go away.
Ethical Issue with Counseling this Patient
While it was evident that the patient has dysthymia, he thought he is excellent and even argued that he has been like that for an extended period. Therefore, counseling him would be against his consent since he is not ready to undergo any form of the psychological therapeutic procedure. Forcing the process would be a breach of his rights as a patient.
References
Huang, Y. J., Lane, H. Y., & Lin, C. H. (2017). New Treatment Strategies of Depression: Based on Mechanisms Related to Neuroplasticity. Neural plasticity, 2017, 4605971. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5405587/pdf/NP2017-4605971.pdf
Nuckols. C. C. (n.d). Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition. Retrieved from https://dhss.delaware.gov/dsamh/files/si2013_dsm5foraddictionsmhandcriminaljustice.pdf
Wang, J., Wu, X., Lai, W., Long, E., Zhang, X., Li, W., … Lin, H. (2017). Prevalence of depression and depressive symptoms among outpatients: a systematic review and meta-analysis. BMJ Open, 7(8), e017173. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5640125/pdf/bmjopen-2017-017173.pdf
