Essay NU670-8D Unit 3 Assignment – Case Study: Mood Disorders Herzing

Essay NU670-8D Unit 3 Assignment – Case Study: Mood Disorders Herzing

NU670-8D Unit 3 Assignment – Case Study: Mood Disorders Herzing

Instructions

Patient Intake and History 

The patient is a 26-year-old college graduate who is currently euthymic but who has a history of major depressive episodes  

He has experienced major depressive episodes, mostly untreated, of varying lengths and severities since he was a teenager  

His symptoms have included insomnia, despondent thoughts, depressed mood, low interest in activities, poor energy, and impaired cognition  

He says his self-esteem drops and he feels rejection-sensitive and guilt-ridden for no apparent reason  

He has never had suicidal thoughts  

Some of the depressive episodes have been incapacitating and have interfered with school and work  

He appears to have good inter-episode recovery and is able to return to class and work 

The patient also has symptoms of social anxiety 

He is often nervous around new people and acquaintances  

He experiences anticipatory anxiety and will avoid certain social events  

These symptoms are present regardless of his affective state 

He has asked for a consultation because he has legal issues regarding drinking and driving that he thinks were likely fueled by his psychiatric symptoms  

At the time of the infraction (several months ago, just before graduating college), he had been started on a selective serotonin reuptake inhibitor (SSRI) for the depression and SAD symptoms  

Within days of starting he experienced elevated mood in a sustained fashion over several days  

He lost all anxiety, fear, and avoidance  

He was unusually talkative; had racing thoughts; was distractible, hyperactive, and impulsive; and had decreased need for sleep  

He exhibited grandiosity, in which he felt invincible and that the law did not apply to him; this led him to purposefully antagonize a man in a bar, drive while drinking, and challenge authority when police were called 

The mood elevation is complicated by the fact that the patient admits to heavy alcohol use on weekends throughout college  

The mood elevation abated with cessation of the SSRI treatment  

He has now completed college; he has few friends in the immediate area but his family is very supportive  

He wants to be a news reporter and is planning on applying to graduate school  

The patient has no family history of bipolar disorder; his mother has generalized anxiety disorder (GAD)  

He is not currently taking any medications 

 Vitals: 

• 98.8 
• 160/80 
• 76 
• 18 
• 5’10” 
• 190 lbs. 

 Please use the case study template to complete the case and answer the questions listed below:  

1. Does the patient’s history support a diagnosis of bipolar disorder even though his symptoms appear to have been triggered by a selective serotonin reuptake inhibitor? 
2. What would be the expected future course of illness for this patient? 
3. If the patient develops another depressive episode, how would you treat it? 
4. What medication would you choose (there could be many correct answers). What is the MOA of this medication? (Be specific i.3. What receptor does it work on, etc.) 
5. Provide and reference a recent research article (Published over the last 3 years) on the  medication treatment of Mood Disorders