Subject: Psychology and Education
Topic: DEPRESSION
Language: English (U.S.)
Pages: 6
Instructions
1. Develop a fictional client for this case study providing a brief summary of the case, including: (Please read my summary below) a. Name, age, gender b. Family history c. School history d. Employment history e. Social history f. Current family dynamics 2. Outline specific symptoms the client is experiencing, including: a. duration b. frequency 3. Summarize the etiology for the disorder (genetic and environmental) 4. Provide appropriate treatment planning (therapy - individual/group/family) a. Discuss two types of theoretical approaches that have been used with this disorder. Include the key figures, specific methods used, and pros/cons of each approach. b. Choose one of these therapeutic approaches and describe techniques that have been shown to be effective with this disorder. 5. Discuss the recommended medication(s) a. Examine the biological changes in the brain that occur with the medication(s) and how this changes behavior 6. Suggest other treatments and include the rationale for each. 7. Determine the final prognosis and conclude the case study.

Depression

Personal Background

Personal Information

Name: Kevin Mackenzie Hughes

Gender: Male

Age: 17

Family History

Kevin’s mother had him when she was only 17 years old. Her parents chased her from their house and she had to live with her then boyfriend, Kevin’s father for a while. Unfortunately, Kevin’s father did not consider the situation ideal and he ran away when Kevin was only five years old. His mother has had to rely on welfare, work multiple jobs, as well as constantly borrow from friends and family in order to provide for her and her child. She is currently working as a Vocational Nurse at a local nursing facility where she usually picks up extra shifts to earn more money. 

Kevin has no recollection about his father. He relies on his mother’s accounts for information regarding his paternal side. Sadly, his mother only bad-mouths his father so much so that he has developed a deep hatred for his father. He does not have a proper male role model in his life as even his maternal grandfather and uncles rarely speak to him and his mother. 



School History

Kevin has been in and out of school for most of his adolescent years. He performs poorly in school where he receives “D’s” and “F’s” in almost all of the classes. He has been kicked out of several schools in the past due to his disruptive behavior, skipping classes, and his meth addiction. His mother has convinced him to enroll in a new school so that he can be able to complete his high school education. She believes that Kevin is a smart boy who would excel in school if only he applied himself more. Her belief in her son has led her to enroll him in after-school tutoring. 

Employment History


Kevin is unemployed. His drug abuse and low moods are to blame, as they do not allow him to hold down a job for a considerable amount of time. He almost ended up in jail once when he was working at the local grocery shop. His mother had made him look for a job so that he could help with some of the household bills. He had been working at the local grocery store for less than a week when he took money out of the cashier box when nobody was looking. He used the money to buy meth and other drugs. His mother had to reimburse the owner to deter him from pressing charges against Kevin.  

Social History


Kevin keeps to himself most of the time and does not seem to have any friends. He considers his band mates as mere acquaintances and they usually do not hang out after band practice. His band mates describe him as reclusive, and polite. He rarely talks to others during the practice sessions. However, they also say he is an amazing guitarist and his songs are indicative of an individual who is emotionally tortured. 


Current Family Dynamics

The patient has not spoken or seen his father since the latter disappeared twelve years ago. The mother constantly talks ill about the father, which has led Kevin to develop feelings of hatred towards his father. Kevin also has some resentment towards his mother for constantly bad-mouthing his father. 

Kevin’s mother is at her wits end when it comes to helping her son. She feels that her son has a lot of potential but is wasting it because of his substance abuse. She feels that his problems are because of the father abandoning the family when Kevin was only five. According to her, if Kevin had a strong relationship with his father then he might not have turned out so disruptive. 


She also does not believe that her son can kick his meth addiction alone. She says that he tried but it has been a year and he obviously needs help. She also wants him to become more responsible and help around the house more often. 

Symptoms

The patient is complaining of extremely low moods at every time of day. The low moods persist even when he is high on methamphetamines. He also has trouble concentrating in class or during house chores. He is unable to carry out his school assignments due to this lack of concentration. 

The patient also experiences extreme bouts of anxiety especially in social settings ever since he could remember. He says the drugs help him stop feeling anxious, perhaps the reason his drug addiction has persisted for several years. He also has difficulty initiating conversations with other people, a possible effect of his anxiety issues. The patient also suffers from insomnia and even when he manages to sleep; it is difficult to remain asleep throughout the night. Most alarmingly, Kevin often has suicidal thoughts, a problem that needs to be dealt with right away before the situation gets out of hand. According to the patient, he has been having recurrent suicidal thoughts for a year now. 

From the symptoms mentioned above, Kevin seems to be suffering from depression, a disease that has been aggravated due to his significant drug abuse as well as lack of a steady source of emotional support. 


Etiology of the Disorder

A variety of factors can be held responsible for the occurrence of depression in individuals. According to Hasler (2010), genetic factors play an essential role in the development of depression. The author asserts that depression is more common in individuals who have close relatives that suffered or continue to suffer from the disorder. The common belief is that several different distorted genes exert their influence to increase the risk of individual developing symptoms of depression. Kevin’s mother claims that her mother used to suffer from bouts of depression when she was younger. Similar symptoms in Kevin and his grandmother could point to a genetic predisposition to depression.

The environment also plays a significant role in triggering depression in individuals. Childhood trauma such as the loss of a parent, close relative, or a friend can significantly increase the risk of depression. Feelings of neglect or abandonment during childhood can also contribute to a person developing symptoms of depression (Saveanu & Nemeroff, 2012). 


Kevin’s depression could also be attributed to environmental factors. According to Burbach & Borduin (1986), tense or broken parent-child relations can be a potential trigger of depression in adolescents. His father left him and his mother when Kevin was only five years old. He has had to live out his life without a father figure and this must have elicited feelings of abandonment in the young boy leading to depression in his adolescent years. 


Seeing his mother struggle to raise him all on her own must have also been traumatic for the child further exacerbating the already precarious situation. In addition, the fact that his maternal grandparents and relatives hardly ever communicate with him could have resulted in feelings of abandonment. 


The patient’s dalliance with meth and other addictive substances could also be considered a trigger for his depression. Renner, Baxter, Suzuki, & Ciraulo (2011) believe that substance abuse is usually a trigger or a precursor for major depression episodes and symptoms. Kevin’s addiction to methamphetamines could be a way of self-medication as well as a factor that triggered his depressive symptoms. 

Treatment Plan

There are different psychological treatments for depression that are currently being used with varying degrees of success. Cognitive behavior therapy is perhaps the most well known therapeutic treatments of depression. The main remise underlying the treatment plan is that the way we behave and think affects how we feel. Thus, the psychologist aims to change some of the patient’s behavior and thought patterns that are contributing to his depression. The therapist identifies common behavioral problems and teaches the patient how to deal with anxiety, and common difficulties. 


Another therapy treatment plan is the mindfulness-based cognitive therapy, which is often delivered to groups of patients. The purpose of this therapeutic treatment is to help the patients focus on their present without constantly feeling guilty about their past or feeling anxious about their future. The patients are first taught to meditate and focus on their present physical activities such as breathing. Later on, the patients are taught how to use the technique when deciphering their feelings and thoughts. The treatment plan is highly effective as it helps stop the patient’s mind from wandering into the past or the future. It also helps in allaying negative feelings and thoughts. 

Recommended Medication

Taking into consideration the patient’s age, gender, and medical history, antidepressants such as SSRIs will be the best course of medication for the patient. The SSRI improve the moods of the patients. Suicidal tendencies usually dissipate with a marked improvement in moods. The drugs are also non-addictive, which would have been disastrous for the patient who has demonstrated traits of chronic substance addiction. 


Selective serotonin reuptake inhibitors work by blocking the reabsorption of serotonin in the brain. Certain receptors in the brain cells reabsorb the chemical to balance its levels. However, in the case of depression and other mood-associated disorders, the receptor reabsorbs higher levels of serotonin than is normal leading to a deficiency of the chemical in the brain. The deficiency leads to low moods and a lack of satisfaction with living and one’s life. Higher levels of serotonin in the brain elevate the patient’s moods, behavior, and outlook. Examples of SSRIs include Zoloft, Prozac, and Lexapro. 

Other Possible Treatments


According to Eby & Eby (2006), another possible treatment for depression is magnesium therapy. The researchers postulate that magnesium deficiency is one of the main causes of neuropathologies. The magnesium ions help to regulate the flow of calcium in the neuronal channels. A deficiency in magnesium can lead to neuronal damage, which ultimately manifests itself as depression. Their research revealed that depressed patients treated with magnesium demonstrate rapid recovery in less than seven days. 


Mukaino, Park, White, & Ernst (2005) investigated the effectiveness of acupuncture in treating depression. Their studies concluded that acupuncture might not yet be superior to antidepressant medications. However, there is slight evidence to suggest that acupuncture may enhance the effectiveness of the antidepressant medications.  


Final Prognosis and Conclusion

Kevin is suffering from clinical depression, which is exacerbated by his substance abuse. He is also thinking about suicide and has problems concentrating or sleeping throughout the night. Various factors such as childhood trauma and genetics have played a huge role in triggering the patient’s depression. It is advisable for Kevin to receive psychological treatment therapies such as cognitive behavior therapy, which has proven very effective in the treatment of depression. Antidepressant medication should also be included in his treatment plan to boost the chances of the therapy succeeding. 

References

Burbach, D. J., & Borduin, C. M. (1986). Parent-child relations and the etiology of depression: A review of methods and findings. Clinical Psychology Review, 6(2), 133-153.


Eby, G. A., & Eby, K. L. (2006). Rapid recovery from major depression using magnesium treatment. Medical hypotheses, 67(2), 362-370.


Hasler, G. (2010). Pathophysiology of depression: do we have any solid evidence of interest to clinicians? World Psychiatry, 9(3): 155-161. 


Mukaino, Y., Park, J., White, A., & Ernst, E. (2005). The effectiveness of acupuncture for depression–a systematic review of randomised controlled trials. Acupuncture in Medicine, 23(2), 70-76.


Renner, J. A., Baxter, J., Suzuki, J., & Ciraulo, D. A. (2011). Substance abuse and depression. In Pharmacotherapy of depression (pp. 239-274). Humana Press.


Saveanu, R.V., & Nemeroff, C.B. (2012). Etiology of depression: genetic and environmental factors. Psychiatry Clin North Am 5(1): 51-71.