Additiona Case Studies

This week’s discussion question is about GF, a 41-year old woman who arrives for her first visit at the clinic. She reports that she has been feeling sad and depressed, with crying spells, trouble sleeping, increased appetite, impaired concentration, and fatigue. She has experienced depression in the past but was able to overcome the symptoms without medication. On physical examination, she appears to be poorly groomed and with minimal facial expressions. She is slow to respond to questions. She admits to being very anxious and worried about “everything”. She denies any current suicidal ideation. However, she expresses concerns about the future and that it may not be an improvement. She has tried over-the-counter medications to help with sleep, but they have not been effective. …show more content…
A past medical history and a brief review of systems will be done in order to rule out medical disorders that can mimic depression. Since she is 41 years old I would inquire about her menstrual cycle history since there is a connection between hormone changes and depression. A review of her medications and substance use may also provide information on her depressive symptoms. I would use 9-question Patient Health Questionnaire which will assist in determining the severity of depression and can be used at follow up visits to evaluate the effectiveness of the treatment (Mitchell et al., 2013). I would also like to have a CBC, BMP, thyroid level, and a pregnancy test done before proceeding with any antidepressant therapy. If the depression is caused by a medical issue such as hypothyroidism then correction of this condition will need to be