Week 12 Journal 2023
There was a pregnant patient 2 months to term with depression whom on her first visit to the clinic was prescribed Zoloft 50mg every day which is a relatively safe antidepressant for while pregnant. While the team was optimistic of a positive outcome, the depression worsened especially with the advent of the motherâ€™s concern over miscarrying like her previous three unborn children. These thoughts exacerbated her depressive state and from a psychosomatic outlook may have contributed to the non-effectiveness of the drugs administered.
While many patients have in the past relapsed, there is always hope for helping a mother carry to term. PMHNPs have to establish a strong therapeutic rapport with patients which encompasses providing critical information, psychotherapy, and availing appropriates treatments and drugs that will allow aid in resolving psychological issues (Kumar et al., 2020). In the case at hand, this relationship was developed gradually toward aiding in keeping both her and the baby healthy through various medical interventions. The outcomes of these efforts is more spread out thus less relapses which indicates a significant improvement in her mental health.
Primarily, for this patient, mitigating the relapses was key with Gotter (2017) emphasizing that doing so encompasses recognizing triggers, adjusting oneâ€™s lifestyle, and effectively handling strain. For this patient, dealing with strain is especially important since it is directly linked to her triggers of past trauma losing three babies. With the progress made of carrying this child to the third trimester unlike previous ones, it is important to maintain treatment, engaged in meditation, and try to remain positive throughout.
Secondly, it is crucial that we get the patient to a point of self-confidence and optimism pre-and post- natal so she can better function even as a new mom. Occasionally, medication and therapy bring patients relief sooner but take longer for others (Battle et al., 2016). In this case, there is a chance it could take longer due to the complexities of the case both now and after birth. Therefore, we will continue with treatment and check on her to ensure she is able to return to her normal life and thrive.
Battle, C. L., Uebelacker, L. A., Friedman, M., Cardemil, E. V., Beevers, C. G., & Miller, I. W. (2010). Treatment Goals of Depressed Outpatients: A Qualitative Investigation of Goals Identified by Participants in a Depression Treatment Trial. Journal of Psychiatric Practice, 16(6), 425â€“430. https://doi.org/10.1097/01.pra.0000390763.57946.93
Gotter, A. (2017, August 3). 15 Ways to Avoid Depression. Healthline. Retrieved March 25, 2023, from https://www.healthline.com/health/how-to-avoid-depression#5.-Reduce-stress-
Kumar, A., Kearney, A. R., Hoskins, K., & Iyengar, A. (2020). The role of psychiatric mental health nurse practitioners in improving mental and behavioral health care delivery for children and adolescents in multiple settings. Archives of Psychiatric Nursing, 34(5), 275â€“280. https://doi.org/10.1016/j.apnu.2020.07.022