In this specific instance, Marco has a significant depressive condition. Several essential characteristics must be present in the patient in order to identify major depression disorder. According to the American Psychiatric Association’s DSM-5 (2017), there must be numerous distinct changes in mental state for diagnosis of major depressive disorder. These changes include feelings of depression or easy agitation and abnormalities in sleep, appetite, or sexual desires.
The DSM-5 lists several additional diagnostic criteria for major depressive disorder. Suicidal thoughts diminished cognitive, and motor abilities, and a lack of enjoyment at work or with friends are other symptoms of major depressive illness (American Psychiatric Association, 2017). These symptoms are important for determining a diagnosis of major depressive illness. These signs and modifications in mood and behavior can endure for at least two weeks, and classmates, family, and coworkers frequently notice them (American Psychiatric Association, 2017). Because of many factors in his case study, this may be the ideal diagnosis to offer Marco.
There is a strong indication of a serious depressive illness in Marco’s case study. Some of the signs of the condition can be seen in Marco’s thoughts, feelings, and actions. Marco has experienced experiencing depression for more than seven months, a protracted period of boredom, and feeling uninterested in a variety of things he once enjoyed. Additionally, Marco has mood swings that are purposefully designed to make him angry at even the tiniest things, including loud noises and bright lights.
Marco acknowledged that he frequently has unfavorable ideas about himself, including feelings of not being clever enough, not deserving his salary, and being an impostor inside the organization. Marco claims that he frequently feels exhausted and lacks the drive to do the same chores that he used to complete daily as a result of many of these thoughts and sensations. In addition, he complains about feeling “like a loser” for enjoying video games, which he does to divert his attention from his critical inner dialogue.
One of Marco’s symptoms that can influence not only his mental health but also his physical health is his loss of appetite. Marco reports that his appetite is normal. However, he also reports that his clothes do not fit due to losing 10lbs over the past month. All of these thoughts and behaviors that Marco reports can point to a multitude of disorders within the DSM-5. However, when considering all of these symptoms at once, many reported symptoms go along with the diagnosis of major depressive disorder.
The diagnosis of a depressive illness involves some biopsychosocial and sociocultural factors. Knowing a person’s genetic background can assist in identifying a depressive condition because depression is frequently a hereditary marker inside their DNA (Gonda et al., 2019). Marco has disclosed a familial history of mental illness in his case. According to him, two of his aunts were said to have psychiatric issues. They have a long history of bipolar disorder, namely.
The suicide of one of his aunts could imply that Marco is genetically predisposed to psychiatric illnesses, especially depressed episodes like major depressive disorder. Numerous theories explain why someone could experience depression on a biological level and a person’s family history of the condition. According to the monoamine hypothesis, serotonin, dopamine, and norepinephrine, among other monoamine neurotransmitters, may be lacking or out of balance, resulting in a depressive condition (Gonda et al.,2019).
In this case, there have been several attempts to assist the monoamine neurotransmitters in carrying out their role. Several treatments may be administered when attempting to improve a patient’s ability to produce monoamine neurotransmitters. To improve monoamine function, several early antidepressants, such as tricyclics and monoamine oxidase inhibitors, have been employed (Gonda et al., 2019). Recent innovations have made it possible to support the operation of these transmitters, nevertheless. Selective serotonin reuptake inhibitors (SSRIs) are now being researched as potential antidepressants (Gonda et al., 2019). With increasing information on how antidepressants act on a chemical and biological level, their effectiveness has increased.
Analyzing the case study aids in defining Marco’s social position while attempting to comprehend the sociocultural repercussions of his illness. In order to comprehend depression, several social aspects must be considered. The lack of enjoyment at work or with friends is one of the primary symptoms of major depressive disorder, according to the DSM-5 (American Psychiatric Association, 2017). Throughout Marco’s case study, this is evident. Numerous stresses that Marco experiences might affect his thoughts and actions at work. As was already established, Marco claimed he did not feel deserving of his salary and frequently experienced reoccurring fears that his employer would soon see the error of his ways and dismiss him.
This has a significant impact on his social position at work. His culture is not explicitly defined in the case study. Nevertheless, his culture can also have an impact on how he lives. Many cultures tend to reject the concept of mental diseases or individuals affected by them. If this is a factor in Marco’s life, it may also significantly impact his attitudes and actions, which would worsen his symptoms.
There are three basic therapy options for people dealing with a depressive condition. The three primary treatment modalities are medication, psychotherapy, and supportive measures (Bschor et al., 2008). The patient’s comfort, availability, and preferences are taken into account in every aspect of a treatment plan. A strong therapeutic bond between the doctor and the patient should be the cornerstone of the fundamental course of therapy (Bschor et al., 2008). A doctor should be sympathetic and understanding of the patient’s situation while also comprehending the patient’s condition. A strong working connection between the patient and their doctor, psychiatrist, or therapist lays a solid basis for developing a treatment plan in the future.
Pharmacotherapy would be Marco’s first line of treatment. This course of treatment is known as the “medication option,” in which he can take particular medications to influence his brain and lessen his symptoms. Antidepressants would be the first kind of medication that Marco may take. This one is one of the most popular drugs for treating major depressive illnesses. Serotonin synaptic concentration is increased in the central nervous system by antidepressants (Bschor et al., 2008). Benzodiazepines are another class of medicine that might be prescribed to Marco. This drug has an immediate sedative and anxiolytic effect, even though it is not often advised (Bschor et al., 2008). As a result, it is applied to the short-term therapy of extremely depressed and suicidal individuals.
Active solutions are offered as the patient is supported mentally and emotionally through problem-coping (Bschor et al., 2008). This will enable Marco to develop a sympathetic relationship with his psychologist and attempt to discover answers to many of his concerns. Lastly, motivational clarification focuses on identifying problematic beliefs and actions (Bschor et al., 2008). This will assist Marco in identifying the behaviors, ideas, and actions that contradict his regular existence. To help Marco, a psychologist could even advise several forms of therapy, including cognitive behavioral therapy, deep psychology-based therapy, or psychoanalytic psychotherapy (Bschor et al., 2008). These therapy-based treatment approaches will benefit Marco, particularly if he adheres to the above indicated fundamental techniques.
Supportive measures are the final and maybe most important type of therapy. This means that the patient needs a support network that is ready to lend a hand if they want to feel capable and in charge of their lives. The significance of including the patient’s family has been emphasized several times (Bschor et al., 2008). This makes patients feel loved and supported while also holding them accountable for adhering to their objectives. Some individuals experience extreme loneliness and feel singled out while receiving therapy. Due to this, the individual’s success and recovery depend on the support of family and peers. Marco’s family is not mentioned in the case exactly, but it does state that friends urge him to go out with them.
Marco needs to know that his friends still value his company despite his difficult circumstances. While several studies have been conducted on various therapies for major depressive illness, it has been demonstrated that none of them are superior to the others and that all have a very high non-responder rate (Bschor et al., 2008). This should not come as a surprise because every person is different and reacts to therapies in a different way. The process of selecting the best treatment option largely relies on the patient.
In Marco’s instance, he would have to discuss that with his therapist. It could be necessary to go through a process of trial & error since Marco might respond favorably to certain sorts of treatment but not others. Marco must ultimately decide what he thinks would work best for him. If Marco were forced to get a certain type of treatment, he may refuse to do so or choose not to, which would make the treatment ineffective. Marco should choose the most suitable approach among suggested therapy options.
References
American Psychiatric Association. (2017). Diagnostic and statistical manual of mental disorders: DSM-5.
Bschor, T., & Adli, M. (2008). Treatment of depressive disorders. Deutsches Ärzteblatt International, 105(45), 782. doi: 10.3238/arztebl.2008.0782
Gonda, X., Petschner, P., Eszlari, N., Baksa, D., Edes, A., Antal, P., Juhasz, G., & Bagdy, G. (2019). Genetic variants in major depressive disorder: From pathophysiology to therapy. Pharmacology & Therapeutics, 194, 22–43.