Notably, several biological factors lead to the development of depression in an individual. These factors include neurological, genetic, neuroendocrinological, and immunological factors (Clark et al., 2017). Observations from the case mentioned above study do not show any history of Depression among Phil’s relatives, and thus, his condition cannot be genetically inherited. However, the case study shows Phil experiences mood swings of sadness and anger interchangeably. In addition, Phil also reports having difficulties sleeping at night. The symptoms mentioned above indicate effects of depression contributed by hormonal and brain chemical imbalance.
Psychological Problems of Depression
Psychological factors contributing to depression are characterized mainly by loss, negative thinking, and sense of failure, and experiencing a series of stressful events in life. The details in Phil’s case study are that he was fine before the separation of his parents. Phil’s hope of ever having his father and mother living together died, causing him to start experiencing sadness and anger. Therefore, the leading cause of Phil’s condition is his father’s loss, which resulted in a psychological disorder. As a result of this loss, Phil has developed negative thinking, which makes him not care about what he valued in life before, such as driving (Clark et al., 2017). Phil’s mother adds that he used to score grade B in school in the past, but now he scores Cs and Ds, which signals how psychological stress affects his academic life.
Social Problems of Depression
The major social problem exhibited by people suffering from depression is connecting with other friendly people. Phil’s case study provides several instances depicting social issues of depression. For example, his mother reports that Phil had a good relationship before the separation and his father’s remarrying. However, since his father remarried, Phil began arguing with his mother and siblings frequently. In addition, Phil confesses to having difficulties interacting with his friends and engaging in sports (Clark et al., 2017). Phil’s mother acknowledges receiving numerous calls from school due to his violent behavior, including fighting since his father remarried.
Spiritual Problems of Depression
Results from research studies agree that increased spiritual faith and believing in God contribute to reducing depression. Spirituality can provide an individual with hope, peace, and purpose in life and thus reduce their depression symptoms (Clark et al., 2017). This case study shows that Phil and his family are members of a local church. Phil’s mother reports having gained great church support in going through her divorce issues. In addition, Phil confirmed that he loved attending church and that he has several friends. He added that people in the church were kind to him.
Assessment of the Case
Performing a proper assessment on an individual with depression symptoms is essential in providing counselors and clinicians with evidence-based results concerning the severity of their condition. The self-report obtained from both Phil and his mother show that Phil has been experiencing sadness and anger interchangeably for four months (Maurer et al., 2018). In addition, Phil has reported feeling hopeless and loss of interest in life on multiple occasions concerning his parents ever re-uniting. Ever since his father remarried, Phil has experienced difficulties in sleeping and interacting with friends. His mother also reports that Phil’s academic performance has dropped significantly, and thus, Phil undergoes a depression diagnosis to establish whether his condition is moderate or severe.
Episodes of depression that an individual can experience can fall into either mild, moderate, or severe depending on the rating results given to various measurement parameters on the ICD-10 and DSM-5 (Clark et al., 2017). The two diagnostic instruments provide ratings on the level of depression in an individual by assigning scores to various symptoms based on their severity and the level of functional impairment. The table below shows results from a two-week diagnosis of multiple symptoms of depression in Phil their episodic severity using ICD-10 and DSM-5 systems (see Table 1).
Table 1. Symptoms of Depression
|Mood switch from sadness to anger||10||Severe||Self-report or by others about mood changes||10||Severe|
|Feeling down and hopeless||7||Severe||Loss of hope, confidence and self-esteem||7||Severe|
|Loss of interest in several aspects of life||5||Moderate||Loss of interest and happiness in life||6||Moderate|
|Feeling tired and worn-out||1||Loss of energy and experiencing fatigue||5||Mild|
|Difficulties in sleeping or excessive sleeping||6||Moderate||Hypersomnia or insomnia||6||moderate|
|Loss of appetite or overeating||1||Mild||Appetite loss or excess appetite||5||Mild|
|Poor interpersonal relations and socialization(others)||7||Severe||Difficulties in making and maintaining friends other||7||Severe|
|Psychomotor activity changes with retardation or agitation||5||Moderate||Psychomotor retardation or agitation||6||Moderate|
|Reduced thinking and concentration abilities (others)||5||Moderate||Reduced ability to think and concentrate||6||Moderate|
|Experiencing bad feelings about yourself and guilt||4||Mild||Feelings of worthlessness and guilt.||5||Mild|
Other Conditions Present in Phil’s Case Considered in the Above DSM-5 Include:
- The ability to make friends and socialize, and
- The ability to think and concentrate.
Theories and Factors Explaining the Development of Depression
Psychological and biological theories provide an adequate explanation of the origin of depression. Most biological theories attribute the source of depression to factors such as reduced noradrenalin. This reduction cause disorders such as insomnia or hypersomnia. In addition, this hormonal imbalance can alter the brain’s structure (Clark et al., 2017). Psychological theories use several models, such as behavioral models and psychoanalysis, to explain the origin and development of depression. Psychological theories attribute depression to life events that result in the loss of something valuable or environmental stress.
Multicultural or Social Justice Considerations
In the diagnosis of depression clinicians or psychiatrists must consider whether multicultural issues such as discrimination, and social justice problems like imprisonment are the contributing factors of the condition. After establishing, whether the above factors contribute to depression clinicians can determine the appropriate treatment to administer (Maurer et al., 2018). Phil’s case study does not mention any multicultural or social injustice issues which could have a stake in his depression.
Treatment Recommendations: Recommendations for Biological Problems
The biological factors leading to depression in Phil can be due to several causes. As a result, clinicians should establish the specific cause of mood swings by performing physical testing on Phil. To include or eliminate genetic factors, the doctor should interview Phil to establish any history of depression along his family lines. A psychiatrist should engage Phil in further interviews to establish the severity of his symptoms. Depending on Phil’s response to the interview questions, the doctor can treat his condition by prescription antidepressant drugs such as Bupropion, duloxetine, or citalopram. Alternatively, the doctor can prescribe mood-stabilizing medications such as valproic acid to Phil (Bernaras et al., 2019). Better still, the clinician can perform psychotherapy or brain stimulation therapy to help to balance Phil’s brain chemicals.
Psychological Treatment Recommendations
In the treatment and management of psychological issues causing Phil’s depression, the doctors and his family have a significant role to play. First, Phil’s family should understand and treat him kindly. The family should also support him through his treatment therapies to help him heal quickly (Bernaras et al., 2019). Phil should also be willing to cooperate with the doctors throughout his treatment process at a personal level. Doctors should engage Phil in several therapy sessions such as behavioral, cognitive, and psychodynamic therapies on the medical side.
Social Problems Treatment Recommendations
The social issues contributing to depression in Phil can be reduced by encouraging him to attend interpersonal therapies. These therapy sessions would help Phil reduce the depressive feelings caused by losing his desired family set-up. In addition, interpersonal therapy can help Phil reduce cases of social conflicts (Bernaras et al., 2019). This therapy uses behavioral approaches to suppress the depressive social issues affecting an individual. It takes 12 to 16 sessions for an individual to recover.
Recommendations for Individual Counselling
Schools and colleges should initiate and implement guidance and counseling to help in reducing cases of depression among students. Phil’s school needs to start peer counseling programs to help Phil express themselves freely among his peers. Phil should also consider seeking help from religious leaders, teachers, and other counseling professionals. This way, Phil can efficiently access support whenever he experiences depressive feelings at any location.
Specific Consideration Affecting Diagnostic Impression
One specific consideration which affected the diagnostic impression is Phil’s contemplation of suicide. Noteworthy, Phil does not mention any suicidal thoughts or attempts to kill himself throughout the case study. This consideration informed me that he still has some hope that things will get better in the future. As a result, one cannot consider him completely hopeless while awarding the score for his feelings of hopelessness.
Bernaras, E., Jaureguizar, J., & Garaigordobil, M. (2019). Child and adolescent depression: A review of theories, evaluation instruments, prevention programs, and treatments. Frontiers in Psychology, 10.
Clark, L., Cuthbert, B., Lewis-Fernández, R., Narrow, W., & Reed, G. (2017). Three approaches to understanding and classifying mental disorder: ICD-11, DSM-5, and the national institute of mental health’s research domain criteria (RDoC). Psychological Science in the Public Interest, 18(2), 72-145.
Maurer, D. M., Raymond, T. J., & Davis, B. N. (2018). Depression: Screening and diagnosis. American Family Physician 8(8), 508-515.