NURS FPX 4015 Assessment 3

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Capella university

NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care

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Date

The 3Ps and Mental Health Care: A Conceptual Framework for Managing Major Depressive Disorder (MDD)

Major Depressive Disorder (MDD) is a prevalent and debilitating mental health condition that ranks as the third leading cause of disease burden globally (Bains & Abdijadid, 2023). The management of MDD often involves an integrated approach that addresses three primary factors: psychological, physiological, and pharmacological, collectively referred to as the 3Ps. These three dimensions provide a comprehensive framework for understanding the complex nature of MDD and guiding treatment strategies. A concept map, which visually organizes these components, plays a crucial role in enhancing clinical understanding and supporting evidence-based mental health care practices.

Case Overview: Understanding Ivy Jackson’s Struggles with MDD

Ivy Jackson, a 61-year-old woman, is presenting with classic symptoms of Major Depressive Disorder after experiencing a significant life stressor—her recent divorce. Symptoms such as persistent sadness, weight loss, sleep disturbances, and overall emotional distress align with the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). These signs suggest a need for a holistic approach to care, which involves assessing her risk factors, diagnosing her condition, selecting the appropriate medication regimen, identifying potential complications, and implementing suitable nursing interventions.

Mental Health Diagnosis: Exploring Ivy’s Symptoms and Background

Ivy’s case is consistent with the DSM-5 definition of MDD, which is characterized by a prolonged low mood, a loss of interest in daily activities, cognitive disturbances, disrupted sleep patterns, and a noticeable decline in functional ability (Bains & Abdijadid, 2023). Ivy experiences chronic sadness, frequent crying episodes, and pervasive feelings of hopelessness following the abrupt end of her 38-year marriage. She also reports anhedonia, meaning she no longer enjoys activities that once brought her pleasure, including walking and socializing with her family. Furthermore, Ivy has lost 10 pounds due to a reduced appetite and is suffering from insomnia, fatigue, and difficulty concentrating.

Though Ivy denies any suicidal thoughts, her social isolation and emotional distress heighten her risk for further complications. This necessitates close monitoring and intervention.

Ivy’s depressive symptoms are influenced by multiple factors. The significant psychosocial stressor—her divorce—is a key trigger for her depressive episode. Her family history of depression, including her mother and brother, also suggests a genetic predisposition to the condition. Additionally, Ivy has a medical history of hypertension and has experienced depressive episodes in the past, especially during significant life transitions, such as when her youngest child left for college.

Her non-adherence to medication is another critical risk factor. Ivy had been prescribed venlafaxine, a Serotonin-Norepinephrine Reuptake Inhibitor (SNRI), in the past but discontinued the medication due to withdrawal symptoms. This discontinuation is likely contributing to her current depressive relapse. Non-adherence to antidepressant treatment has been shown to be a significant factor in the recurrence of depression (Naudín et al., 2022).

While Ivy’s condition is triggered by a clear stressor (her divorce), the persistence of her symptoms beyond the stressful event suggests MDD rather than situational depression. Situational depression tends to be short-lived and directly linked to external stressors, while MDD is associated with underlying biological factors, such as neurotransmitter imbalances and dysfunctions in the Hypothalamic-Pituitary-Adrenal (HPA) axis (Remes, 2021). Given Ivy’s extended symptoms, history of depression, and the severity of her emotional distress, an MDD diagnosis is well-supported.

Concept Map: Breaking Down Ivy Jackson’s MDD Care

To better understand Ivy’s condition, a concept map provides a visual representation of the key factors involved in her MDD diagnosis and management. This map organizes the psychological, physiological, and pharmacological factors into a structured framework to guide care planning.

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: Comprehensive Care for Ivy Jackson

The case of Ivy Jackson underscores the critical importance of a structured and multidisciplinary approach to diagnosing and managing Major Depressive Disorder. By using a concept map, healthcare providers can clearly identify and address the key factors involved in MDD, from psychological stressors to physiological and pharmacological concerns. A comprehensive care plan that integrates evidence-based strategies—such as psychological therapy, pharmacological treatment, and lifestyle modifications—will be essential to improving Ivy’s mental health, treatment adherence, and overall 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