Clinical Case: Depression and Alcohol Abuse

Problem Description: The patient transferred to the halfway house in June 2005 and has been through alcohol abuse ever since. He volunteered to enroll in the clinical program asking help to relieve him of his problems. He expressed that he drank alcohol because he wanted to be relieved of his extreme sadness and feeling of worthlessness. Despite his drunkenness, his feelings worsened. Further interview with the patient revealed that his problems were triggered by pressures with family and his inability to cope the pressures.  The patient’s problems were acquired but the problem has been recurring for the past 5 years.

Diagnosis: The patient experienced more than five lapses and attacks of depression that at one time resulted to suicide attempt. This occurrence qualified the case to be diagnosed as Severe Clinical Depression and Alcohol abuse. The patient was enrolled in a special medical program for treatment and was scheduled for regular sessions with the resident Psychiatrist.

Treatment Received

Medications: The patient was prescribed Zoloft (Sertraline), a selective serotonin reuptake inhibitor (SSRI), a medication that increases the amount of neurochemical serotonin in the brain. This was given for the first two (2) weeks from diagnosis (October 12-26, 2006) but was replaced by Nardil (Phenelzine), a monoamine oxidase inhibitor (MAOI) since the previous medication did not provide relief. Though Nardil showed satisfactory effect to the patient, caution is needed the food intake of the patient. MAOIs when interacted with tyramine containing foods like aged cheese, wines, most nuts, chocolates including over-the-counter cold and cough medications, can cause high blood pressure. (Panzarino 2007) The patient will have to have a special food diet and will be closely monitored for all other medications prescribed. Nardil medication will be maintained for at least five (10) weeks or until there are no more traces of depressive attacks.

Psychotherapies: The patient went through scheduled sessions with the resident Psychiatrist, who held regular talking and cognitive/behavioral therapies to resolve his internal psychological conflicts, to change his negative thinking and behaving that are associated with depression. The patient was also made aware that he would need to help himself to solve his problem, where he was advised not to set to difficult goals or expect too much of himself, to find diversion or outlets like art, painting or athletics.

Recommendations

The one year rehabilitation program for the patient was monitored to be successful. The medication Nardil maintained by the patient lasted for 20 weeks. He has not touched alcohol since the first complication with Nardil where he experienced high blood pressure. He willingly stopped since he was experiencing relief of his problem from the medication. He did not experience lapses of depression since February 2007. The patient also joined the baseball team and performed regular physical exercises. He also expressed relief with the medicine and showed happier disposition during the latest talking sessions with the doctor. The doctor recommended release from the program last October 9, 2007.

Michael is recommended for probation for five (5) years. He will need to make regular visits to the halfway house resident Psychiatrist to monitor traces of recurrence of his depression. Close monitoring should be made since he will be exposed to uncontrolled environment outside the facility. With confidence though, I consider Michael’s clinical problem solved and that he is completely cured from severe clinical depression.

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