Depression and Anxiety Management. Kathleen Roose, RN. Goal. The goal of this presentation is to provide National Guard medical case managers with information about the symptoms, implications, and management of depression and anxiety. Objectives.
Depression and Anxiety Management
Kathleen Roose, RN
The goal of this presentation is to provide National Guard medical case managers with information about the symptoms, implications, and management of depression and anxiety.
"What you thought before has led to every choice you have made, and this adds up to you at this moment. If you want to change who you are physically, mentally, and spiritually, you will have to change what you think."
- Dr. Patrick Gentempo
“Suicide is a permanent solution to a temporary problem.”
Suicide risk assessment and prevention is essential to the care of all people with depression and anxiety.
SGT Lara Daniels, a 34-year-old female, is seen by her primary care provider today. SGT Daniels has been working as a physical therapy assistant until six months ago, when she went on medical leave before the birth of her third child. “I really need to get back to work,” she states during visit. “We can’t afford all this time off.” She is married, and has been in the National Guard for the last eight years.
SGT Daniels is in good general health, but complains today of insomnia and back pain, stating that an old work injury had been aggravated by the delivery of her last child. She states she has been experiencing pain every day, and requests medication for this as well as for something to help her sleep. After further questioning, SGT Daniels admits that she has been feeling more sad and irritable than usual. “I’m just under a lot of stress,” she says. “Things are hard between my husband and me right now.”
After a thorough evaluation, SGT Daniels’ primary care provider believes she is likely suffering from a depressive disorder. He carefully assesses her suicide risk today; SGT Daniels denies thoughts or plans of self-harm. Her provider refers her to a psychiatrist and orthopedic specialist for further evaluation, and prescribes her a sleep aid and PRN pain medication for her to take in the meantime.
SGT Daniels follows up with the psychiatrist, who diagnoses her with major depression. After trying several medications, she is prescribed Zoloft and begins weekly psychotherapy with good results. After several months, SGT Daniels reports she is feeling better. She has also started physical therapy for her back pain, and states her pain is now better controlled. While she still reports financial stress, she now states, “I feel like I can handle it better. I’m much happier now.”
Centers for Disease Control and Prevention. (2012, April 20). An Estimated 1 in 10 U.S. Adults Report Depression. http://www.cdc.gov/Features/dsDepression/
HealthDay. (2011, October 20). Suicide Rates Vary by Region: CDC. U.S. News. Retrieved from http://health.usnews.com/health-news/family-health/brain-and-behavior/articles/2011/10/20/suicide-rates-vary-by-region-cdc
Keyes, C. (2011, January 19). Suicide rate doubles for Army National Guard. Retrieved from http://articles.cnn.com/2011-01-19/us/army.suicide.rate_1_army-suicides-suicides-among-active-duty-soldiers-suicide-rate?_s=PM:US
Mayo Clinic Staff. (2012, February 10). Depression (major depression). Retrieved from http://www.mayoclinic.com/health/depression/DS00175
National Institute of Mental Health. (2011, November 15). Mental Health Medications. Retrieved from http://www.nimh.nih.gov/health/publications/mental-health-medications/what-medications-are-used-to-treat-anxiety-disorders.shtml
U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration. (2009). Suicide Assessment Five-step Evaluation and Triage. Retrieved from http://www.vahealth.org/Injury/preventsuicideva/documents/2011/pdf/SAFE-T%20Pocket%20Card.pdf
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University of Maryland Medical Center (2011). Depression. Retrieved from http://www.umm.edu/patiented/articles/depression_000008.htm