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Introduction
Identifying a disorder is the main challenge in giving assistance to mental health patients. A therapist must be able to identify the disorder their patients suffer from in order to give the most appropriate intervention. Many disorders have conflicting symptoms that make it challenging to identify a disorder. Although various diagnostic tools have been developed, care should be taken to ensure that the appropriate treatment is provided. Marla is having a bad experience in her life. She complains of restless night where she has difficulty in getting sleep. She also complains of poor concentration which is affecting her work as an accountant. The paper will try to determine a possible disorder that she may be suffering from, establish the causes of the disorder and propose appropriate treatment. Proper diagnosis and treatment can be helpful to Marla. With proper treatment, Marla will be able to overcome her problem and be able to go back to her normal life.
Diagnosis
Marla could be suffering from Major Depression Disorder. For an individual to be said to be having Major Depression Disorder certain symptoms are expected. DSM IV lists various symptoms that can be observed in a Major Depression Disorder. Loss in weight and appetite are some of the symptoms that a patient diagnosed with Major Depression Disorder could manifest.
The disorder may affect the cognitive ability of the patient making the patient not be able to concentrate in their work. The patient may also experience feeling of worthlessness and show restless behavior. In addition, the patient may also thoughts about death and may think of committing suicide (American Psychiatric Association, 2000, p. 36). For the person to be considered to be suffering from Major Depression Disorder, the symptom must be observed continuously for a period of more than two weeks. The symptoms affect the ability of an individual to carry out daily activities in the normal way. In addition, there should be no obvious cause such as traumatic event, mourning or another disorder (American Psychiatric Association, 2000, p. 37). An individual is diagnosed to be having a Single Major Depression the series of symptoms are observed for the first time.
Before diagnosis was made, a pre-diagnosis test was needed. The pre- diagnosis test is required in order to reveal the lifestyle of the patient. Interview on Marla provided important information that helped to identify her problem. Marla was requested to explain the period she had been experiencing the symptoms. She was asked to give details about medical history and the response that her physician had given over her problem. To establish whether the symptoms resulted from other causes, her relationship and family information were explored. More specific information about the symptoms was also explored. Marla was asked to specify how her experience was affecting her daily activities. She was asked whether she had experienced other episodes of sleep problems in her life and whether she had problems in preparing for sleep. Finally, Marla was asked whether she has any history with depression episode. The pre-diagnosis questions helped to rule out other causes of the symptoms and provide guidelines to further diagnostic tests.
Marlas history reveals three symptoms of Major Depression. She had difficulty in sleep, agitated behavior and loss of cognitive abilities. However, a pre-diagnosis interview revealed other symptoms of Major Depression. From the interview, it was revealed that Marla had experienced loss of interest is some activities that she enjoyed before. She had also lost her appetite over the period of the symptoms and experienced unexplainable change in weight. From the interview, Marla reported that she has experienced the symptoms for a period of about one month. She claimed that she had not experienced the symptoms before, that this the first time that she has had feeling. She admitted that her experience was interfering with her daily activities. She said that her experience was affecting her work. She claimed that her work as an accountant needed concentration and that she was not effective in her duties because of lack of concentration. She state also affected her daily practice such getting out of bed and eating. Asked how her Hispanic culture affected her life, Marla said that her religion and culture did not permit taking ones life. She said that she could not contemplate committing suicide. The interview did not reveal any other possible causes of the symptoms. Marla did not have any moaning or traumatic episode in a period of twelve months ruling such episodes as the cause of her symptoms. Marla has high desire to get better and optimistic that she will be able to recover. From the details provided, it is evident that Marla is experiencing a Single Major Depressive episode.
Causes of Major Depression Disorder
Mood changes are a normal experience with everybody. Changes in mood are important in life. It helps and individual adjust his or her life. Mood disorder occurs when the episodes of mood changes are more frequent and intense than normal (Comer, 2009, p. 57). Mood disorder is also characterized by an inability of an individual to manage the mood changes. Mood changes are wrongly referred to as depression although they do not qualify as clinical depression. Instead, the mood changes are a normal way to respond to daily experiences, internal thought process, fatigues, stress or extraordinary experiences.
Mood changes are different to persons suffering clinical depression such as Marla. Such individuals experience frequent and more intense mood changes. The day of individuals with clinical depression starts and ends low. Depression can result from bad experience such as relationship problems, loss of a job or loss of a loved one. However, some depression may not have an obvious cause. Major depression is occurrence of more intense depression. This depression does not only affect the mood but also affects other aspects of an individuals life. Major depression also affects an individuals thought and may lead to bodily pain (American Psychiatric Association, 2000, p. 44). Depressed persons have difficulties in making decision and remembering some things. Depressed individuals experience dark and negative thoughts, low motivation, frequent mood changes and abnormal behavior changes. Depression may affect an individuals sleeping habits, eating, relationships and emotions. Depression also causes an individual to lose interest in a relationship and a depressed individual may withdraw from friend and family. In some cased depressed individuals may experience psychomotor agitation where the individual fidgets and have difficulty in remaining calm. To a majority of the individuals, episodes of depression take only a short time. Nonetheless, there are those in whom the symptoms may last longer. There are varied explanations to the causes of depression, but the causes are not well understood. Depression is thought to have more than one cause. Depression is thought to have hereditary elements. Research studies have shown that Major Depression was related to low level of sensitivity to serotonin and neurotransmitters (American Psychiatric Association, 2000, p. 37). Research has also shown differences in brain functioning on individual who experience major depression and those who do not. However, it is not clear whether the difference in brain activity that causes major depression of Major Depression leads to the difference. Most Major Depressions are related to psychological factors. Research has shown that personality, major life events, cognitive styles and culture are strongly correlated with major depression.
Treatment
Major Depression can be treated using various therapies, but the success of a method depends on the individual patient (American Psychiatric Association, 2000, p. 87). For Marla, a Social cultural model of therapies is highly recommended. Marla is a Mexican, which is a minority group. Research shows that individuals from minority groups tend to discontinue therapies than individuals from non-minority groups. Discontinuity from a therapy is named as one of the major causes of failure in corrective therapies. In the United States, there is high rate of therapy drop-out among Africa Americans, Native Americans, Asian Americans and Hispanic Americans. It is believed that most members of minority groups discontinue from therapies because of differences in their race and ethnicity. It is also believed that lack of sensitivity in the therapies motivates them to drop. Social-cultural therapies have been found to be effective in minority groups. Social cultural models increase sensitivity to moral issues, cultural issues and the model of treatment making them more successful with minority groups. The culture-sensitive approach is able to address the particular problem experienced by minority group. Gender-sensitive therapy can be helpful in Marlas case by being able to address the specific issues faced by women.
Group therapy is one the best way to address Marlas case. Many therapists agree that therapies that are based on social settings are more successful in treating psychological disorders. Group therapy allows individuals having similar experiences to come together, share their experiences and be helped as a group. Marla will benefit a lot from a group where she shares with other individuals with similar experience and cultural background. The group therapy should be focused on increasing self-esteem and self-worth, sharing experiences, developing better social skills, and enabling an individual to develop support networks. Group therapy has better results than individual therapy in minority groups and helps to increase compliance (Comer, 2009, p. 68).
Family therapy can also be beneficial to Marla. Family therapies consider family as a social setting aiming at improving family dynamics. Family has dynamics such as communication, organization, role-playing, alliances and rules that can be used to transform an individual life. Family therapy helps to identify problems, unhealthy relationships and interactions with the aim of using the family unit in the healing process. A support group can also be very helpful to Marla. A support group consisting of fellow Mexican women can help her address her problems.
Conclusion
Identifying a psychological disorder is the first step to treatment. From diagnosis, Marla is identified to be having Major Depression Disorder. The disorder is responsible for the restless nights, poor concentration and agitated behavior. Although the causes of the disorder are not clear, various therapies can be given as treatment. Social-cultural models of therapies are the best for Marlas case. Group therapy with individuals with similar cultural backgrounds will be helpful. Family therapy and support groups will also be useful.
Reference List
American Psychiatric Association. (2000). Practice guideline for the treatment of patients with major depressive disorder. Am J Psychiatry, 157: 145.
Comer, R. (2009). Abnormal Psychology. New York: Worth Publishers.
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