You are a nurse at an outpatient clinic and are presented with a 68-year-old female client. She is experiencing the following symptoms: decreased appetite, disturbed sleep pattern, fatigue, difficulty concentrating, disordered thought process, anhedonia, guilt, and low self-esteem. The doctor diagnoses the client with major depressive disorder. Answer the following questions: Please use and provide the scholarly article used to answer the questions
Major depressive disorder (MDD) is a common mental illness characterized by persistent feelings of sadness, lack of interest or pleasure, and a range of physical and cognitive symptoms. It affects people of all ages, but is more prevalent in older adults. In the case of the 68-year-old female client, her symptoms of decreased appetite, disturbed sleep pattern, fatigue, difficulty concentrating, disordered thought process, anhedonia, guilt, and low self-esteem align with the diagnostic criteria for MDD.
To better understand MDD and its treatment options, the article “Treatment for Depression in Older Adults: An Overview of Evidence-Based Pharmacotherapy and Psychotherapy” by Alexopoulos, et al. (2015) provides valuable insights. This scholarly article reviews various treatment options for depression in older adults, including both pharmacotherapy and psychotherapy approaches.
Pharmacotherapy, or the use of medications, is a common treatment approach for MDD. The article highlights that selective serotonin reuptake inhibitors (SSRIs) are the first-line choice due to their safety profile, efficacy, and tolerability in older adults. SSRIs work by increasing the levels of serotonin in the brain, improving mood and reducing depressive symptoms. They have been shown to be effective in older adults with MDD. In addition to SSRIs, newer antidepressants, such as serotonin-norepinephrine reuptake inhibitors (SNRIs) and atypical antidepressants, may also be considered.
The article also mentions that psychotherapy, specifically cognitive behavioral therapy (CBT) and interpersonal therapy (IPT), are recommended as effective treatments for MDD in older adults. CBT focuses on identifying and changing negative thought patterns and behaviors, while IPT aims to improve interpersonal relationships and communication skills. Both types of psychotherapy have shown positive results in reducing depressive symptoms and improving overall well-being in older adults.
In the case of the 68-year-old female client, a combination of pharmacotherapy and psychotherapy may be considered. The healthcare team may prescribe an SSRI or another appropriate antidepressant, based on the client’s medical history, comorbidities, and potential drug interactions. Regular monitoring and adjustment of the medication may be necessary to achieve optimal therapeutic outcomes.
Additionally, psychotherapy, particularly CBT or IPT, can complement pharmacotherapy by addressing the psychological and social factors contributing to the client’s depressive symptoms. CBT can help her challenge negative thoughts, develop coping strategies, and promote behavioral activation. IPT can provide support in improving her relationships and communication skills, which may help alleviate feelings of guilt and low self-esteem.
Moreover, it is important to consider the client’s individual circumstances and preferences when developing a treatment plan. The article recommends a person-centered approach, taking into account factors such as the client’s social support network, cultural background, and personal goals. Collaborative decision-making between the healthcare team and the client can significantly improve treatment adherence and outcomes.
In conclusion, the diagnosis of major depressive disorder in the 68-year-old female client warrants a comprehensive treatment plan that combines pharmacotherapy and psychotherapy. The article “Treatment for Depression in Older Adults: An Overview of Evidence-Based Pharmacotherapy and Psychotherapy” by Alexopoulos, et al. (2015) provides valuable information on the treatment options available for older adults with depression. It emphasizes the use of SSRIs as the first-line pharmacotherapy choice and highlights the effectiveness of psychotherapy, particularly CBT and IPT, in improving depressive symptoms. Developing a personalized treatment plan that considers the client’s individual circumstances and preferences is crucial for optimal outcomes.