THE ROLE OF MENTAL HEALTH PROFESSIONALS IN THE INITIAL STAGES OF PSYCHOPHARMACOLOGICAL INTERVENTION
In the initial stages of psychopharmacological intervention, mental health professionals must be aware that complications or concerns can arise. Clients may experience negative side effects of the medication. They might forget or avoid taking the medication. The disorder may have been misdiagnosed and cause other issues. The client may have preexisting conditions that other medical professionals had not known when the diagnosis was made. The client could have had a comorbid condition that they did not disclose. In short, a number of very serious issues might manifest in the early stages of treatment requiring action on the part of the mental health professional.
Discussion 1
Post a brief description of the antidepressant medication that you selected and explain its benefits and limitations (including neurobiological considerations). Next, explain how you would support the psychiatrist’s recommendation to use the medication to a hesitant client despite its limitations. Use the Learning Resources and current literature to support your response.
Required Readings
• Lichtblau, L. (2011). Psychopharmacology demystified. Clifton Park, NY: Delmar, Cengage Learning.
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o Chapter 2, “Pharmacotherapy of Depression” (pp. 21–34)
• Preston, J. D., O’Neal, J. H., Talaga, M. C., & Moore, B. A. (2021). Handbook of clinical psychopharmacology for therapists (9th ed.). New Harbinger.
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o Chapter 7, “Depressive Disorders” (pp. 36-43)
o Chapter 17, “Antidepressant Medications” (pp. 74-82)
o Appendix C, “Psychotropic Drug Interactions (pp. 111-112)
• American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.Links to an external site.Arlington, VA, American Psychiatric Association, 2013.
Use the DSM-5 to guide you through your understanding of the diagnostic criteria for mental disorders.
• National Institute of Mental Health. (2016). Antidepressant medications for children and adolescents: Information for parents and caregivers.Links to an external site. Retrieved from https://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml
As you review this website, consider the variety of medications used for mental health treatment.
• Spiegel, A. (2012, January 23). When it comes to depression, serotonin isn't the whole story.Links to an external site. [Blog post]. Retrieved from http://www.npr.org/blogs/health/2012/01/23/145525853/when-it-comes-to-depression-serotonin-isnt-the-whole-story
As you review this blog, consider the information provided and how depression was treated in the past and how it is currently treated.
• Document: Depression Case Studies Download Depression Case Studies(PDF)
Select a case study from this document to complete this week’s Discussion 2
Discussion 2
Depression Case Studies
Marcus
Marcus is a 31-year-old Caucasian law student. He feels “worn out, burned out, and
busted.” He has no girlfriend or boyfriend, yet he has dated in the past. Although
Marcus’s studies keep him occupied, he finds himself wondering if all of his efforts are
worth the coming payoff. He will be taking the bar exam soon—he is fairly sure he will
pass it.
Lately, Marcus has been “slipping back into some old patterns of thinking and acting.” In
the past, he has battled major depressive disorder and believes that he may be
becoming depressed again. Marcus quickly counts off his symptoms: sleep loss, weight
loss, a sense that everything is devoid of joy or excitement, and so forth. His choice to
come to counseling was precipitated by an increase in the frequency of using club drugs
like ecstasy and cocaine “to have at least a little fun.” Marcus uses these now about
once every 2 weeks. He notes that his last “bout” of depression happened around a
time when he was using these substances frequently.
Sample Solution
Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant medication used to treat depression and other mental health disorders. Common SSRIs include sertraline, fluoxetine, paroxetine, and escitalopram (Lichtblau, 2011). These medications work by increasing the amount of serotonin available in the brain. This can help alleviate symptoms such as low moods or difficulty concentrating. However, SSRIs may also have some side effects including nausea, headache, insomnia and sexual dysfunction (Preston et al., 2021). Neurobiologically speaking, SSRIs increase the availability of serotonin through blocking its uptake into neurons which boosts its activity throughout the nervous system (Lichtblau 2011).
When presented with an option of taking an SSRI medication such as sertraline to treat depression or another mental health disorder I would explain to my client that while it is not a cure-all solution there is evidence supporting its effectiveness in treating different types of depression. I could emphasize that this drug has fewer side effects than other antidepressants like tricyclic drugs and has fewer interactions with other drugs than MAOI's (Preston et al., 2021; Lichtblau 2011). Additionally, I would make sure to discuss any potential neurobiological implications for my client before recommending this treatment so they are aware of how their body will be affected by this drug. Furthermore, I would ensure that my client knows what to do if they experience any negative side effects from the drug and remind them to alert their doctor or psychiatrist immediately should any serious symptoms arise such as suicidal thoughts or feelings.
stating, “I don’t want to be a writer. It’s stupid. It’s a stupid waste of time.” Chris responds, “That’s your dad talking.” Chris notes that Gordie is repressing his American dream because his father does not want him to be a writer. He then states that he wishes he was Gordie’s father because if he were, Gordie would not be considering taking shop courses instead of his college courses. Chris acts as a father figure to Gordie, who finds comfort and solace in his friends following his brother’s death. He resents the idea of taking college courses because he knows that it will isolate him from his friends, leaving him completely alone. When the boys finally make camp for the night and go to bed, Gordie is awoken by a nightmare of his father telling him “it should’ve been you” referring to Denny’s death.
Chris’ American dream is to prove wrong the people that believe he will ultimately end up bad because of his family. When Gordie mentions that Chris could take college courses too, he states that no one would let him because they all think of him as “one of those lowlife Chamber kids.” He then explains how upset he was at being suspended from school. Chris was suspended because he stole the school’s milk money, not because he wanted to, but because he was expected to. When he became guilty and tried returning the money, his teacher used it to buy herself a new suit. He explains to Gordie that even if he tried to tell someone that story, they wouldn’t believe him because he’s nothing more than a kid brother to Eyeball Chambers. Deep down, Chris is a good kid whose dream is to succeed in life. His American dream is to make the adults in his life see him not as a punk, but as the intelligent, caring, boy that he is.
One of the most important scenes in the film occurs when the four boys reach a bridge. They must decide whether to cross the bridge or walk an extra five miles to go around the bridge. This entire film represents the journey of childhood into adulthood, thus making the train tracks a symbol of the journey from one stage of life to another. The bridge, as well as the tracks in general, demonstrate that the path towards adulthood can be adventurous, dangerous, and downright scary. When the boys are about halfway across the tracks, a train comes along, forcing them to run. In this instance, the train symbolizes the trauma that the boys have experienced that have ultimately forced them to grow up quicker than average boys their age.
When the boys get close to finding the body, they again are forced to make a decision regarding the direction they take. They can either walk the train tracks or cross a field into a forest and ultimately decide to walk through the field. By choosing this path rather than the tracks, this shows that the boys desire to make their own destinies rather than follow the path that has already been paved for them by their family members, community members, and society itself. When the boys finally find the dead body, Gordie decides that they will not take credit for finding it, as that is not the way to prove themselves to their community. They report the body anonymously and return back home. Gordie and Chris say goodbye to the other boys a