A Response to Ryan
Ryan, you answer all six questions to the case in a comprehensive and detailed manner, which makes it easier to keep track of logic chains helping to find the right answers. Discussing the third question about the aspects to be clarified during further interviews, you focus on asking about common symptoms manifested in patients with BD such as visual or auditory hallucinations and suicidal thoughts. I agree that using these questions is pivotal to clarify a diagnosis. It is also important to note that some patients may want to suppress such facts to avoid problems with children’s services. Therefore, interviewing the patient’s husband or other relatives can also be necessary.
The plan of care that you provide includes a range of evidence-based interventions that are helpful in depressed patients. You mainly focus on medications to be taken and patient education, and I would like to add on possible psychotherapeutic treatments for clients with post-partum depression. Post-partum depression affects more than ten percent of young mothers, and such a method as Perinatal Dyadic Psychotherapy is widely used to reduce anxiety and improve mother-infant interaction (Goodman, Prager, Goldstein, & Freeman, 2015). The above method helps normalize the so-called “maternal self-esteem” by increasing the level of women’s responsiveness and reducing parenting stress, which could be important for the patient from the case. IPT methods are also regarded as helpful in the case of post-partum depression in adult women. According to modern reviews, the best results can be achieved if IPT sessions (group, individual, or partner-assisted) are implemented during the acute phases of post-partum depression (Miniati et al., 2014). This approach to psychotherapy could be used to improve the effects of drug treatment for post-partum depression.
A Response to Aimee
Aimee, I like how you manage to provide concise answers without missing essential details pertinent to the assigned case. In general, I agree with your conclusions concerning the client’s mental health issues and the plan of care. In this response, I would like to discuss such questions as the role of cannabis withdrawal in the case and things to be highlighted in patient education sessions.
First, discussing additional information to be collected, you mention the effects of cannabis withdrawal on physical and mental health and suppose that the client’s symptoms can be related to the pot-smoking stoppage. The hypothesis is worth noticing, and I believe that the client should also be asked if the process was medication-assisted or not because the side-effects of medications can also be important in the case. For instance, Sativex, a drug commonly used in replacement therapy, can cause a sensation of tiredness, physical weakness, and vertiginousness (Allsop, Lintzeris, Copeland, Dunlop, & McGregor, 2015).
The plan of care that you provide is constructed with special attention to patient education and family education. I also believe that it would be necessary in the case, and it seems that specific recommendations would need to be given to her spouse. Focusing on the normalization of the sleep-wake cycle is pivotal since prolonged sleep deprivation causes hallucinations and, therefore, increases the risks of traumas for both women and her dependent children.
Moreover, the patient’s husband should be recommended to help her more with the baby to avoid physical exhaustion. It is evident from the case that the woman loves her children, and the discussion of child development issues associated with postnatal depression should become an important part of patient education (Netsi et al., 2018). In particular, it is known that potential issues include greater risks of depression in children, problems with behavior, and low academic performance (Netsi et al., 2018).
References
Allsop, D. J., Lintzeris, N., Copeland, J., Dunlop, A., & McGregor, I. S. (2015). Cannabinoid replacement therapy (CRT): Nabiximols (Sativex) as a novel treatment for cannabis withdrawal. Clinical Pharmacology & Therapeutics, 97(6), 571-574.
Netsi, E., Pearson, R. M., Murray, L., Cooper, P., Craske, M. G., & Stein, A. (2018). Association of persistent and severe postnatal depression with child outcomes. JAMA Psychiatry, 75(3), 247-253.
Goodman, J. H., Prager, J., Goldstein, R., & Freeman, M. (2015). Perinatal dyadic psychotherapy for postpartum depression: A randomized controlled pilot trial. Archives of Women’s Mental Health, 18(3), 493-506.
Miniati, M., Callari, A., Calugi, S., Rucci, P., Savino, M., Mauri, M., & Dell’Osso, L. (2014). Interpersonal psychotherapy for postpartum depression: A systematic review. Archives of Women’s Mental Health, 17(4), 257-268.