Problem: You are spending time with Mr. Plotsky, who has been admitted to an inpatient psychiatric unit for evaluation of depression. He hardly makes eye contact, slouches in his seat, and wears a blank but sad expression. Mr. Plotsky has had numerous bouts of major depression in the past and says to you, "This will be my last depression. I will never go through this again."
A. Because safety is the first concern, what are the appropriate questions to ask Mr. Plotsky at this time?
B. In terms of behaviors, thought processes, activities of daily living, and ability to function at work and home, give examples of the kinds of signs and symptoms you might find when assessing a patient with depression.
C. Mr. Plotsky tells you that he has been on every medication there is, but none have worked. He asks you about the herb St. John's wort. What should you tell him about its effectiveness for severe depression, interactions with other antidepressants, and regulatory status?
D. What might be some somatic options for a person who is resistant to anti-depressant medication? (Hint: "somatic" means treatment involving the body such as ECT)
D. Mr. Plotsky asks what causes depression. In simple terms, how might you respond to his query?
E. Mr. Plotsky tells you that he has never tried therapy because he thinks it is for weaklings. What information could you give him about various therapeutic modalities that have proven effective for other patients with depression?