Mr Jones agreed to admit himself to hospital as he saw no other way out.
Hospital Treatment
Once admitted to the wards Mr Jones was briefed by a consultant on the treatment that was going to commence within the next couple of days;
- To check that there is no physical illnesses present that maybe contributing to his depression. This will include blood pressure and pulse, listening to the heart and lungs and examinations of your abdomen, nervous system, eyes, reflexes and blood count. A urine sample will be needed; this will be tested to see if there are any traces of glucose, protein or blood.
- A review on Mr Jones medical history to see if he has ever experienced depression before. Detail of family history in case there has been history of psychiatric disorders.
- He will be assigned a ‘key worker’ who will either be a nurse or a social worker. They will program a timetable of daily activities these will include group and one to one therapies, relaxation classes, occupational therapies. Drug treatment is likely, as Mr Jones can be monitored closely on the ward.
A care plan was made for Mr Jones; a care plan will involve all of Mr Jones vital statistics such as pulse, blood pressure and weight. Mr Jones will be weighed a lot throughout his recovery period because a lot of people with depression loose weight through loss of appetite. A gain in weight after admission is a sure sign of progress.
The care plan was discussed with Mr Jones because it involves him it is his care plan which gives him the opportunity to ask any questions. The care plan will return home with Mr Jones when he is ready so that professionals that continue to assist Mr Jones in his recovery can document his progress.
Mr Jones voiced his concerns of being able to see his family whilst he is in hospital.
He was reassured that his family could visit him at any time on the wards but was advised not to leave the grounds because his new medication could have side affects or the out side could be unsettling to start with until he has started his therapy and dealt with the underlying problems.
The basic test was scheduled the next morning.
Mr Jones had not slept well, but then again he was used to not getting much sleep lately. He was nervous but hoped that they would find an illness that was contributing to his depression, at least then he would not feel like he was going insane.
A couple of hours after the tests he was requested to have a one to one counselling session with the psychotherapist. The distinction between a councillor and a psychotherapist is very fine a psychotherapist has had longer and more formal training.
Mr Jones entered the bright office and sat on a settee that was placed under a large barred window. The desk was light oak and well used. The man sitting behind the desk introduced himself to Mr Jones as Dr Reeds. Dr Reeds asked Mr Jones to think of possibilities of solutions and changes that he thought would best help him.
After Mr Jones had thought about the question he started to explain the things that had occurred within his life and how they had made him feel no matter how small it had been it had had a dramatic affect on his moods. Dr Reeds used his active ‘listening skills’ nodding in the right places making Mr Jones think about the last sentence / comment he had just made, by the end of the hour session Mr Jones had not only given Dr. Reeds a clearer picture of what was going on in his mind but himself too. By hearing himself explaining and telling someone else his problems it had turned and really he had explained it to himself.
Dr Reeds asked Mr Jones what he had intended to do about his new found problems and how he could turn his life around. A psychotherapist will not tell the patient what to do but enables the patient to set their own goals over their lives. Nobody can tell an individual what to do; with determination the mind is a very powerful tool. Paul Gilbert (2000)
On returning to his ward with determination to turn his life around Mr Jones was met by the consultant. Mr Jones was told that his test results had been completed and that they had found a problem that was the cause of his depression. Continuing the consultant explained to Mr Jones that he had what they call bipolar affective disorder known as manic depressive this has been past down in his genes, his father had suffered from the same genetic influences and had taken his own life when Mr Jones was a baby. After speaking with Mr Jones mother they had found that he was not informed of this as the families did not want the children to think that their father was mentally ill and disown any acknowledgement of him. Mr Jones was told that his form of depression would require a totally different set of treatments as to those that are prescribed to somebody who becomes only or (solely) depressed. The medication would be a mood stabilising drug this includes lithium and carbamazepine, these help to prevent these episodes.
Self help
As well as taking the medication which will be prescribe continuously because it has been diagnosed as a genetic disorder, Mr Jones was informed on how he could help himself and keep the depressive vulnerabilities to a minimum;
- Write a diary – by writing the problem down can help Mr Jones to stop dwelling on the situation.
- find a hobby – occupy the mind by doing this it can leave little time to think negative thoughts
- Relaxation periods – long baths, funny films, singing to records these will ease away any tensions, its surprising just how relaxing they are!
- Exercise – even if it’s just walking or dancing, feeling better about yourself helps.
- Diet – eat little and often, don’t eat junk foods but allow yourself a treat. Try to avoid alcohol as this alters the effectiveness of the anti depressants.
- Getting professional help – attend a local drop in centre. Keep your meeting regular and routine. Routine can help stabilise your thoughts.
At Night
People with bipolar disorders are vulnerable to sleep deprivation.
- Don’t wind yourself up by watching T.V too late, turn computers off as the light from the screen can alert you and may interfere with your sleep.
- Have a bedtime drink – hot chocolate warm milk, avoid caffeine based drinks.
- Have a bath – a hot bath will relax the body inducing fatigue. After the bath lay in a quiet, dark, warm room. Sometimes soft music in the background can help. People with bipolar disorders are vulnerable to sleep deprivation.
After just one week the medical team were willing to send Mr Jones home for a probationary period to see how he coped with living with stresses of everyday life. Mr Jones has no money worries, nor any marital stresses, but will be closely monitored within his home surroundings
Mrs Jones was consulted about the return home of her husband and was asked how she felt about it. Mrs Jones was overjoyed at the thought having her husband home again as the children had missed him terribly, but also voiced her concerns of whether she would find him again how she had found him before.
The team of professionals informed Mrs Jones that Mr Jones had made considerable progress, his weight had gained, his medication even though it was early days seemed to suit Mr Jones because the depression was not as sever as it was on his admission. Mr Jones had participated in regular exercise and had plans to join his local gym on returning home. Mrs Jones was put at ease when they informed her that for the first month or so Mr Jones would be seen daily by his social worker.
Care At Home
The Professionals that will assist Mr Jones with getting used to his surrounding and rehabilitation are:
A community psychiatric nurse – this person will monitor Mr Jones depressive state and advise Mr Jones on his medication and other treatments that may help
An Appointed social worker (ASW)/ community health worker – this person will work along side Mr Jones on his recovery keeping him positive helping also with emotions life experiences and physical condition.
Mind – a self help organisation that have drop in centres and 24hr call services that help people with mental health problems.
Councillor – this would be a professional body, somebody for Mr Jones to off load his thoughts and feelings onto, relieving himself of any stresses.
G.P – Your local G.P will still need regular visits to keep his records up to date plus assess your progress for himself.
Mr Jones was advised that if he should ever feel any of the following to seek help from any of the above. The earlier they can catch the depression the better it will be for both him and his family.
- sleep disturbance
- lack of sleep
- loss in appetite
- loss of appetite
- lethargy, or restlessness and agitation
Mr Jones was making remarkable recovery and seemed back to normal, his wife commented to the ASW that he seemed better than normal. Mr Jones was more energetic keeping himself busy and involving all the family, which the children enjoyed. Mr Jones’s care plan had shown his progress to be steady but positive. The family have been informed that because his illness is hereditary that there was a 20% chance that one of his children might inherit it. Dr Stefan Cembrowicz and Dr Dorcas Kingham (2002)
Mrs Jones was taken to one side and advised on what procedures to take if she felt that her husband’s treatment started failing. Sometimes people who suffer from depression do not always realise early enough.
- Request a re- assessment
- Contact your G.P – the medication may need looking at
- Are you or your children safe / is your husband safe?
Toni Battison (2004)
Mrs Jones was given leaflets on how to care for somebody with depression at home. Within these leaflets were phone numbers and internet addresses that Mrs Jones could access to retrieve any information required or to talk to others within the same situation as hers.
Conclusion.
Depression whether it be mild or severe is quite common. Depression often ends in suicide because suicide is often a last cry for help. Depression can have a serious effect on not only the patient but their spouses and children. Councillors are experienced in working with depressive clients therefore help them to express their needs and experiences, depressed people need to be understood. It will seem hard to express ones emotions and needs to start with as a depressed person often does not know why they are depressed. Their negativity needs to be challenged and turned into a positive this requires a lot of will power but can only be achieved by the sufferer.
References
Drugs (2006) ‘Medication used for depression’ Version 15.02. [Online] available from:
NHS Direct (2007) ‘Depression’ [online] available from:
Dr Stefan Cembrowicz and Dr Dorcas Kingham (2002) Beating Depression,
Class Publishing Ltd, London
National service Framework for mental health (1999), ‘Modern standards and service models’. [Online] Available from:
Paul Gilbert (2000) ‘Counselling for Depression’ second edition, Sage Publications, London
Toni Battison (2004) ‘Caring for someone with depression’ Published by Age Concern England, London.
Bibliography
Dr Stefan Cembrowicz and Dr Dorcas Kingham (2002) Beating Depression,
Class Publishing Ltd, London
Drugs (2006) ‘Medication used for depression’ Version 15.02. [Online] available from:
National service Framework for mental health (1999), ‘Modern standards and service models’. [Online] Available from:
NHS Direct (2007) ‘Depression’ [online] available from:
Paul Gilbert (2000) ‘Counselling for Depression’ second edition, Sage Publications, London
Toni Battison (2004) ‘Caring for someone with depression’ Published by Age Concern England, London.