Handling a patient with depression from illness.

Antidepressant medications and psychotherapies can help many if not most depressed individuals, but millions of primary care patients do not receive effective treatment. Effective management of depression in the primary care setting requires a systematic, population-based approach which entails systematic case finding and diagnosis, patient engagement and education, use of evidence-based treatments including medications and / or psychotherapy, close follow-up to make sure patients are improving and a commitment to keep adjusting treatments or consult with mental health specialists until depression is significantly improved. Programs in which primary care providers and mental health specialists collaborate effectively using principles of measurement-based stepped care and treatment to target can substantially improve patients’ health and functioning while reducing overall health care costs.

Handling a patient with depression from illness.

Introduction

Depression is one of the most common and disabling chronic health problems encountered in the primary care setting. In this article, opportunities and strategies to improve care for depression in primary care practice are reviewed and collaborative care, an evidence-based approach to chronic disease management for depression is introduced. In this approach, primary care providers (PCPs) and care managers look after a caseload of depressed patients with systematic support from mental health experts.

Handling a patient with depression from illness.

Handling A Patient With Depression From Illness

Depression is a mental health disorder characterized by extreme sadness and loss of interest and pleasure. It is caused by major life events such as chronic illness, sudden loss of a job, and loss of a beloved relative (Gold, et al, 2020). Depression presents with sleep disturbance, loss of interest, fatigue, impaired concentration, and suicidal ideation.

Handling a patient with depression from illness.

My Encounter With A Patient With Depression

G.M is a 32-year old female who presented at the outpatient department with complaints of generalized body malaise, sleep disturbance, and impaired concentration. Recently, she was diagnosed with coronary heart disease and diabetes mellitus type 1. She is currently on insulin, metformin, atorvastatin, digoxin, and enalapril. She reports of being overwhelmed by taking medicine daily. G.M is a teacher in a local school. She is married and has two children. When doing the mental assessment, I observed that she is neat, oriented to time place, and person, and restless. She seems to be sad, have a low volume and a weak tone. Her thought process is hopeless and she says she might die and leave her family.

Handling a patient with depression from illness.

How I Advocated In The Patient’s Situation

As the primary care provider, I re-assured the patient of the diseases; diabetes and coronary heart disease are chronic long-term diseases whose symptoms are controlled through lifestyle modification and drug compliance. I sent the patient to the clinical psychologist to start psychotherapy sessions. I also initiated antidepressants; citalopram 10mg once daily. According to Zhang, et al, (2019) depression is managed by both pharmacotherapy and psychotherapy. Citalopram is a serotonin selective inhibitor that works at the serotonin and dopamine receptors hence relieving the depressive mood.

Handling a patient with depression from illness.

Legal/Ethical Complications When Handling The Patient

Ethics are the moral principles that guide nursing practice. They are beneficence, non-maleficence, autonomy, and informed consent (Smith, & Sisti, 2020). Before initiating treatment, I assured the patient that the information provided is private and confidential, I ensured got fully informed consent from the patient, and I prioritized the patient’s needs and preferences hence observing the principle of autonomy.

Handling a patient with depression from illness.

Depression – treatment and management

People with depression can find it difficult to take the first step in seeking support. They may need to get help with the support of family members, friends or a health professional.

There is no one proven way that people recover from depression. The good news is that there is a range of treatments, health professionals and services available to help with depression. There are also many things that people with depression can do to help themselves.

Handling a patient with depres

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