Clark (2011) argues that an evidence-based plan could be used to diagnose B’s health condition and determine the possible treatment plan. B’s treatment goal should be presented in a summarised form. Care should be taken to ensure that the correct diagnosis is made to avoid using the wrong treatment plan which could results in the wrong medication (Kroenke et al. 2010). First, the right procedure is to pay a visit to the doctor who could establish the medical history and recommend the best possible tests. This is a complex process that entails making an accurate diagnosis to avoid administering the wrong treatment.
The intervention program should start with noting down the clues on what went wrong and precipitating the events that triggered the symptoms. According to Haase et al. (2010), the doctor should progress further by listing the symptoms associated with depression and comparing them with those symptoms exhibited by the patient. The results are then evaluated to see if the patient meets the listed criteria, which provides a clear and accurate description of the patient’s symptoms and possible diagnosis. An involuntary clustering of the patient’s experience provides a description of the chronological development of the illness. According to Novak and Tabrizi (2010), the theoretical basis of clustering of the patient’s signs and how they have developed over time shows the interrelationship among the events leading to the patient’s condition. Each step should clearly demonstrate how the symptoms interfere with the patient’s normal functioning. The patients’ appearance, attitude, and consciousness should be noted. Other elements to consider include speech, mood, orientation, psychomotor activity, thought content, perception, insight, thought process, and judgment.
It is evident that the recent history of the patients is symptomatic of a variety of ailments such as attention deficit hyperactivity disorder (ADHD), which leads to a significant decrease in hyperactivity. Kroenke et al. (2010) note that anxiety should be identified by loss of concentration, lack of motivation, sleepless nights, and an irritable mood that manifested themselves in the sudden loss of concentration and interest in the patient. B evidently showed a significant loss of interest and dedication in her job. Besides, there is evidence of the inability to maintain personal relationships with other workers and family members (Lin, Huang & Su 2010). There is also loss of appetite, and the ability to carry out the daily chores, which made the patients more vulnerable to a life-threatening and severe condition.
Risk of the disorder
People at risk of the disorder include those who have experienced a traumatic episode. Besides, those who have a history of mental problems and dissociative symptoms can be classified under a similar category.
The patient would be diagnosed with a variety of symptoms. Some of them show evidence of dissociation, depressed mood or sadness, insomnia, and a significant loss of interest in most activities (Cleland et al. 2011). Impaired concentration, agitation, loss of pleasure in her work, and hypersomnia were evident for nearly two weeks. Those were additional symptoms of depression. If the patient becomes emotionally irresponsive, unrealistic, and depersonalized, then it is an indicator of the likeliness of being depressed. Showing signs of pessimism, sadness, emptiness, anxiety, hopelessness, irritability, restless, and sleep disturbance add to the list of depressed patients.
Theory shows that depression and anxiety disorder often occur together. However, both diseases have the same symptoms, making it difficult to tell the two conditions apart. Both can cause a lack of concentration, feelings of anxiety, agitation, and insomnia. A valid diagnostic criterion involving the patient depends on implicit experience and the application of the clinician’s tacit knowledge (Cleland et al. 2011). The entire diagnostics proceeds from the mere clinical signs and symptoms of the patient to the doctor’s medical knowledge. It is possible to narrow down the diagnosis to those symptoms of a patient suffering from depression. The type of personality disorder is of schizotypal personality disorder. Among the symptoms are that the patient becomes suddenly uncomfortable when in the company of colleagues and the family members including her husband. In addition, the patient would be diagnosed for cluster B disorders of the borderline personality disorder.
Pharmacotherapy and psychotherapy are interventional options that the clinician and family physician can use to address B’s problem and improve her health (Cleland et al. 2011). This could help to reduce suicidal tendencies associated with depression if diagnosed in the patient. Besides, a behavioural assessment enables the clinician to determine the behavioural deficits or excesses and be able to evaluate interpersonal issues that may be contributing to the depression. A cognitive assessment could lead the clinician to evaluate and determine the automatic thoughts that occur due to distortions, disruptions, targeted schemas, and maladaptive assumptions (Clark 2011). Cognitive therapy may be done using the traditional cognition techniques, antirumination approaches, metacognitive therapy; mindfulness based cognitive therapy, and hopeless models therapy. Here, the emphasis is on the role of thought and not the technique used for the therapeutic purposes.
Antidepressant medication is a viable alternative treatment, but different patients have different tolerance levels. However, the full history of previous medical trials, dosages, and the length of treatment of the patient could serve as the basis for prescriptions. B’s medical history enables the clinician to avoid contradictions, side effects, and worries on family members (Clark 2011). The medication is likely to enhance motivation for treatment, concentration, energy, appetite, and the ability to develop positive thoughts. Besides, the clinician should regularly review the cost of treatment and the response of the patient to the medicine to determine the efficiency and the possibility of recommending for alternative treatment.
This method would allow the clinician to train B on how to differentiate between feelings and automatic thoughts (Kroenke et al. 2010). However, it is also important educate and guide the patient to establish non-suicide contracts before the therapy is rolled out.
The potential implication of using cognitive, behavioral approaches and medication is to develop a link between B’s therapeutic goals and symptoms. Such a situation could allow the doctor to schedule the patient’s treatment plan through earlier intervention before the conditions deteriorates further. However, the potential risks include making the wrong diagnosis and being perceived to make intrusive intervention.
If diagnosis goes wrong
An inaccurate diagnosis of the patient’s condition would lead to an approval of lower sessions and questions when the sessions are repeated. That could results in a wrong diagnosis for which the patient does not qualify and that is likely to be seen as unethical and possibly trigger insurance fraud claims.
Clark, D M 2011, ‘Implementing NICE guidelines for the psychological treatment of depression and anxiety disorders: the IAPT experience’, International Review of Psychiatry, vol. 4, no. 23, pp. 318-327.
Cleland, J G, McDonagh, T, Rigby, A S, Yassin, A, Whittaker, T & Dargie, H J 2011,’The national heart failure audit for England and Wales 2008–2009’, Heart, vol. 11, no. 97, pp. 876-886.
Haase, A M, Taylor, A H, Fox, K R., Thorp, H & Lewis, G 2010, ‘Rationale and development of the physical activity counselling intervention for a pragmatic TRial of Exercise and Depression in the UK (TREAD-UK)’, Mental Health and Physical Activity, vol. 2, no. 3, pp. 85-91.
Kroenke, K, Spitzer, R L, Williams, J B & Löwe, B 2010, ‘The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review’, General hospital psychiatry, vol. 4, no. 32, pp. 345-359.
Lin, P Y, Huang, S Y, & Su, K P 2010, ‘A meta-analytic review of polyunsaturated fatty acid compositions in patients with depression’, Biological psychiatry, vol 2, no. 68, pp. 140-147.
Novak, M J & Tabrizi, S.J 2010, ‘Huntington’s disease’, Bmj, vol. 1, no. 1, pp. 340.