The differential diagnoses for this patient will include major depressive disord

The differential diagnoses for this patient will include major depressive disord

The differential diagnoses for this patient will include major depressive disorder, hypothyroidism, chronic fatigue syndrome, and seasonal affective disorder. MDD is likely given a history of depression with symptoms of fatigue and weight gain and psychosocial stressors such as homelessness exacerbating the condition (NICE, 2022). Hypothyroidism needs to be considered since some symptoms are similar and it is a
fairly common problem among young women. Chronic fatigue syndrome is a possibility given persistent fatigue and disruption to lifestyle. Alternatively, this may be SAD, especially if the symptoms are seasonal. Each of these requires further diagnosis toestablish the etiology for treatment.
 
Diagnostics to Perform
 
Diagnostics are also important to determine the cause of the problem. Initial laboratory investigations should comprise complete blood count (CBC), thyroid profile (TSH, free T4), and metabolic profile (Na, K, urea, creatinine). Another tool for depression is the Patient Health Questionnaire-9 (PHQ-9) with which mental health status should be
evaluated. Other tests, including vitamin D level and cortisol level, might reveal nutrient deficiencies or adrenal disorders. Last, mental/physical health- social/psychological history will examine the effects that her homelessness has brought about on her.
 
Veteran Resources in the Community for Referral
 
Georgia Department of Veterans Service (GDVS) and the Atlanta VA Medical Center are resources available. The GDVS provides counseling, housing assistance, and employment resources for veterans. Among the services that the Atlanta VA Medical Center delivers are mental health services, therapy, and evaluations; it connects veterans with housing and financial aid. These resources ensure comprehensive care for veterans& challenges.
 
Treatment Plan and Resources Integration
The treatment plan consists of biological and psychosocial assessment and intervention. Diagnostics will rule out physical causes of hypothyroidism or anemia. An SSRI and referral to CBT may be commenced for MDD or SAD (Psychiatry Clinical Practice Guidelines, 2021). Housing instability will be taken care of using the GDVS and
the Atlanta VA housing assistance. The focus of teaching and counseling will be on medication compliance and stress management. Follow-up appointments will be made to determine the effectiveness of treatment and to refer her to other resources for support and counseling. Regular meetings with care coordinators will ensure her continued recovery and stability.
References
NICE. (2022, June 29). Overview | Depression in adults: treatment and management |
Guidance | NICE. www.nice.org.uk. https://www.nice.org.uk/guidance/ng222
Psychiatry Clinical Practice Guidelines. (2021, December 29). PsychDB.
https://www.psychdb.com/teaching/clinical-practice-guidelines-cpg