Student Name
Capella University
NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care
Prof. Name
Date
Concept Map: The 3Ps and Mental Health Care
Major Depressive Disorder (MDD) represents a critical mental health challenge, standing as the third leading cause of global disease burden (Bains & Abdijadid, 2023). It is influenced by three primary factors—psychological, physiological, and pharmacological components—commonly known as the 3Ps. These factors play a crucial role in both the understanding and treatment of MDD, forming the basis for evidence-based mental health care. This concept map illustrates these elements to assist healthcare providers in clinical decision-making and enhancing patient care strategies.
Case Study of Ivy Jackson: A Comprehensive Overview of MDD
Ivy Jackson, a 61-year-old woman, presents with symptoms indicative of Major Depressive Disorder (MDD) following a significant life event. She reports feeling persistently sad, experiencing weight loss, sleep disturbances, and emotional distress. These symptoms are consistent with the criteria set forth by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Ivy’s case requires a holistic approach, encompassing a comprehensive risk factor evaluation, diagnostic assessment, pharmacological treatment, and personalized nursing interventions tailored to her unique condition.
Mental Health Diagnosis: Understanding Ivy’s MDD
Ivy’s clinical presentation aligns with Major Depressive Disorder, which is characterized by prolonged sadness, loss of interest in daily activities, cognitive impairment, sleep disruptions, and functional decline (Bains & Abdijadid, 2023). These depressive symptoms followed the abrupt dissolution of her 38-year marriage, resulting in feelings of hopelessness, frequent crying episodes, and anhedonia. Ivy also reported a 10-pound weight loss due to reduced appetite, alongside insomnia, fatigue, and difficulty concentrating. Despite denying suicidal ideation, her emotional distress and social isolation suggest a heightened risk, requiring close monitoring and intervention.
A range of risk factors contributes to Ivy’s depressive episode. These include psychosocial stressors, such as her divorce and family history of depression, which increase her vulnerability. A genetic predisposition is evident, as both her mother and brother have a history of depression. Additionally, Ivy has hypertension and has experienced previous depressive episodes, particularly during significant life transitions. She was prescribed venlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI), but discontinued it due to withdrawal symptoms, which likely contributed to her current relapse. Non-adherence to antidepressant medications is a well-documented risk factor for the recurrence of depressive symptoms (Naudín et al., 2022).
Although Ivy’s symptoms were triggered by her divorce, they are more indicative of MDD rather than situational depression. Situational depression typically resolves once the triggering stressor is removed, whereas MDD persists and is associated with biological dysregulation, including neurotransmitter imbalances and Hypothalamic-Pituitary-Adrenal (HPA) axis dysfunction (Remes, 2021). Given the chronic nature of her symptoms and her history of depression, a comprehensive treatment plan—comprising pharmacological therapy, psychotherapy, and lifestyle modifications—is essential to improve her emotional well-being, treatment adherence, and overall quality of life.
Concept Map for Ivy Jackson: The 3Ps of MDD
| Factors | Psychological | Physiological | Pharmacological |
|---|---|---|---|
| Risk Factors | Divorce, family history of depression, social isolation | Hypertension, past depressive episodes | Discontinuation of venlafaxine, non-adherence to medications |
| Signs & Symptoms | Persistent sadness, crying, hopelessness, anhedonia | Fatigue, weight loss, sleep disturbances, poor appetite | Side effects of antidepressants, withdrawal symptoms |
| Diagnostics | DSM-5 criteria for MDD | Thyroid function tests, CBC, Vitamin D screening | Past medication responses, adherence patterns |
| Complications | Chronic depression, social detachment, impaired decision-making | Unregulated hypertension, nutritional deficiencies | Relapse, medication non-adherence |
| Nursing Interventions | Cognitive Behavioral Therapy (CBT), Interpersonal Therapy (IPT), social support | Sleep hygiene, dietary counseling, physical activity | Medication adherence support, side effect management |
Conclusion: A Holistic Approach to MDD Management
Ivy Jackson’s case underscores the complexity of Major Depressive Disorder (MDD) and highlights the need for an integrated approach in its treatment. The concept map above provides a comprehensive breakdown of Ivy’s risk factors, symptoms, diagnostic methods, pharmacological treatments, complications, and nursing interventions. By utilizing clinical expertise and a patient-centered care approach, healthcare providers can develop a treatment plan that promotes better treatment adherence, enhances Ivy’s mental health, and improves her quality of life.
References
Bains, N., & Abdijadid, S. (2023, April 10). Major depressive disorder. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559078/
Chand, S., & Arif, H. (2023). Depression. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430847/
Lieshout, R. J. V., Layton, H., Savoy, C. D., Haber, E., Feller, A., Biscaro, A., Bieling, P. J., & Ferro, M. A. (2022). Public health nurse-delivered group cognitive behavioural therapy for postpartum depression: A randomized controlled trial. The Canadian Journal of Psychiatry, 67(6), 432–440. https://doi.org/10.1177/07067437221074426
NURS FPX 4015 Assessment 3
Naudín, M. A.-P., Abejón, E.-G., Gómez, F.-H., Lázaro, D.-F., & Álvarez, F. J. (2022). Non-adherence to antidepressant treatment and related factors in a region of Spain: A population-based registry study. Pharmaceutics, 14(12), 2696. https://doi.org/10.3390/pharmaceutics14122696
Remes, O. (2021). Biological, psychological, and social determinants of depression: A review of recent literature. Brain Sciences, 11(12), 1–33. https://doi.org/10.3390/brainsci11121633