Question

In two to three pages, complete the case study below by answering the questions. Maria Lopez is a single Hispanic female living in a large Mississippi city. She is 35 years old and has been diagnosed with major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). She recently lost her job and health insurance, so she does not take any medication for her illnesses. Maria has had physical health issues as well, including hypertension, type 2 diabetes, and obesity. Maria's closest family lives in Florida, but she rarely sees them, as both parents are alcoholics.

Speculate on Maria's mental illness onset, its course, and its possible outcome.

Explain the close association between Maria's mental illnesses and her physical comorbidity.

Describe how Maria would answer quantitative questions regarding four dimensions of health: life satisfaction, hopelessness, anxiety, and depression.

PLEASE ADD IN THE REFERENCES AS WELL AS IN TEXT CITATION IF QUOTING SOMEONE

Answer 1

Maria's mental illnesses and her physical comorbidity:

Maria Lopez is a 35-year-old female who has recently been diagnoses with major depressive disorder and post-traumatic stress disorder. Maria is currently not taking any medications to assist with her illnesses as she recently lost her job and health insurance. She is a single Hispanic woman, living in a large city within Mississippi. Her closest family live in Florida, and both her parents are alcoholics, so she commonly does not see them. She has a history of physical health issues, including type two diabetes, obesity and hypertension. Approximately half of the individuals whom are diagnosed with post-traumatic stress disorder (PTSD) are also diagnosed with major depressive disorder (Flory, et. al., 2015). Onset of PTSD and MDD may arise at any age during the patient’s life. Therefore, it is likely these conditions arose at any point during Maria’s life. Many symptoms in both PTST and MDD commonly overlap, such as restlessness, irritability, and decreases in past interests and activities. Generally, resulting in extensive symptom occurrences. Individuals with PTSD are typically diagnosed when they are exposed to a rigorously distressing event or disorder, such as a life-threatening illness, tragic life altering event, violence, or military experience. Other symptoms of post-traumatic stress disorder include intense fear, physical reactions to reminders of the event, trouble maintaining relationships, panic attacks, and difficulty concentrating (Bisson, 2007). Major depressive disorder symptoms include weight gain and weight loss, suicidal thoughts, exhaustion, withdraws from socializing, anger, agitation and negative thinking. MDD typically progresses from the symptoms of continuous sadness and hopelessness (Belmaker, et. al., 2008). This shows that Maria most likely developed MDD due to her symptoms of PTSD. Maria’s outcome for both illnesses can improve and potentially be treated and cured. Both illnesses, MDD and PTSD can improve through counseling and therapy. If Maria is devoted to treatment psychotherapy and medication can help to improve her symptoms and provide treatment. Psychotherapy also known as therapy talk helps to improve emotional difficulties and help with numerous mental illnesses, including MDD and PTSD, as it helps to eliminate symptoms causing more trouble and develop a sense of healing and control (Flory, et. al., 2015).

                As well as Maria mental illnesses, she is faced with physical health issues, such as hypertension and type two diabetes. Approximately 40-90% of adolescents whom were diagnosed with major depressive disorder also develop at least one other illness (Belmaker, et. al., 2015). This shows that majority of those diagnosed with major depressive disorder develop two or more comorbid diagnosis. As well, in patients over the age of sixty it is common these patients have two or more diseases and is considered an exception when they have less than two illnesses (Sartorious, 2013). Patients like Maria, suffer from mental disorders such as PTSD and MDD are more likely to have suffered from a prior physician illness, such as an injury of chronic illness (Sartorious, 2013). A patient may have been diagnosed with an illness and must endure treatments. This can cause feelings of sadness and fear, becoming more upset and feelings of grief, resulting in the diagnosis of a mental disorder such as MDD and PTSD. Maria prior had been diagnoses with type two diabetes which could have resulted in the generation of her mental disorders. As well a patient who has been diagnosed with PTSP and MDD has common feelings of hopelessness and sadness, and in result commonly may stop caring adequately for their body, resulting in the rising on a physical illness. Depression commonly causes the frequent rise of blood pressure, which results in hypertension (Saratorious, 2013).

Maria four dimensions of health: life satisfaction, hopelessness, anxiety, and depression:

          Maria’s illnesses and circumstances cause a major impact on the four dimentions of health; life satisfaction, hopelessness, anxiety and depression. Currently Maria is unemployed and without health insurance, she is alone and does not communicate with her family, showing her sadness and lonesome, in result her current life status is unsatisfactory. She is currently at more risk to further deplete her health without health insurance. There is potential she was diagnosed with PTSD and MDD because of her parents being alcoholics, and not associating with them may potentially help as it will not pose a trigger to the traumatic circumstances. However, being alone commonly results in loneliness and feelings of sadness causing depression and resulting in unsatisfactory life. In her current circumstances it is highly likely Maria feels a large sense of hopelessness as she currently lost her job and no longer has health insurance to properly help with treatment and medication for her mental disorders. Anxiety is a common factor resulting from PTSD and MDD, the fact that Maria is alone without any close friends or family, and little meaningful relationships during the hard times she is encountering is more likely to increase anxiety. These circumstances also can increase depression for Maria, as she feels alone, at loss and has nobody to comfort her, causing feelings of loneliness and thoughts of failure as if she has no purpose to her life, resulting in depression.

References:

Belmaker, R., & Agam, G. (2008). Major Depressive Disorder. The New England Journal of Medicine, 358, 55-68. doi:10.1056/NEJMra073096

Bisson, J. (2007, Sept). Post-Traumatic Stress Disorder. Occupational Medicine. Retrieved May 23, 2018 from https://academic.oup.com/occmed/article/57/6/399/1376325

Flory, J., & Yehuda, R. (2015, June). Comorbidity between post-traumatic stress disorder and major depressive disorder: alternative explanations and treatment considerations.

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4518698/

Sartorious, N. (2013, April 25). Comorbidity of mental and physical diseases: a main challenge of medicine of the 21st century. Shanghai Archives of Psychiatry. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4054544/