Domestic violence has been documented to be linked to depression. Women who have experienced domestic violence from their partners are likely to suffer from depression and other mental conditions (Bhattacharya, Shen and Sambamoorthi, 2014). Working in the ED, I encountered a female patient who had suffered from domestic violence from her husband while she had her three children. Because of the ordeal, the woman exhibited signs of depression also including difficulty in sleeping and insomnia, anxiety, difficulty in concentration, headaches, loss of appetite and weight, back pains and gastrointestinal problems. These symptoms are typical for depression. According to Bhattacharya, Shen and Sambamoorthi, (2014), chronic physical conditions are linked to depression. In my patient’s case, the presented physical condition resulted from the domestic assault from her husband. Presenting with multiple physical conditions is indicative of the presence of a mood disorder hence patients with limited physical symptoms are less likely to have psychological complications.
In managing my patient’s situation, I encouraged adherence to the prescribed antidepressants. This is because in as much as antidepressants have been documented as highly effectual in treating depression, non adherence affects effectiveness. In order to enhance better recovery, I could also have identified other family members to offer guidance and support to the patient. Bhattacharya, Shen and Sambamoorthi, (2014), suggests this as a working solution Having good communication skills, working with a multidisciplinary team and understanding different forms of depression is also essential before offering the right intervention. By applying some of these strategies in the care of my patient, tremendous progress was realized. As part of the advocacy efforts for her care however, I spoke to the husband and encouraged the need for understanding her situation as he helps her to fully recover.
A major ethical and legal problem when providing care for patients with illnesses from depression lies in the uptake of the antidepressants. Before prescribing antidepressants, medical practitioners have an ethical mandate to consider alternative therapy including psychotherapy especially cognitive behavior therapy (CBT). By considering this option, the physician duties of care to patients suffering from depression moves from the need to merely prescribe antidepressants to improve patient outcomes. In the ED, my patient demanded to leave upon receiving her antidepressants. However, with some counseling, she considered CBT and managed to recover fully following her husband’s assault. Antidepressants and other medication are thus effectual in treating depression in patients but alternative options for addressing the presenting physical conditions due to depression must also be considered.
Reference
Bhattacharya, R., Shen, C., & Sambamoorthi, U. (2014). Excess risk of chronic physical conditions associated with depression and anxiety. BMC psychiatry, 14(1), 10.
