NURS FPX 4015 Assessment 3

Student Name

Capella University

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

Prof. Name

Date

The 3Ps and Mental Health Care: Concept Map

Major Depressive Disorder (MDD) is a significant mental health condition and the third leading cause of disease burden globally (Bains & Abdijadid, 2023). The three essential factors—psychological, physiological, and pharmacological, commonly known as the 3Ps—play a crucial role in influencing the development and management of MDD. This concept map visually organizes these factors to enhance understanding and support evidence-based mental health care practices.

Case Scenario

Ivy Jackson, a 61-year-old woman, presents with symptoms characteristic of Major Depressive Disorder (MDD) following a distressing life event. Her persistent sadness, weight loss, sleep disturbances, and emotional distress align with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for MDD. These symptoms necessitate a comprehensive care approach, including evaluating her risk factors, diagnostic procedures, medication regimen, potential complications, and appropriate nursing interventions.

Mental Health Diagnosis

Ivy’s presentation is consistent with MDD as defined by the DSM-5. MDD is marked by persistent low mood, diminished interest in daily activities, cognitive impairments, sleep disturbances, and substantial functional decline (Bains & Abdijadid, 2023). Ivy reports ongoing sadness, frequent crying episodes, and feelings of hopelessness following the sudden end of her 38-year marriage. She experiences anhedonia, losing interest in activities she previously enjoyed, such as walking and socializing with family. Additionally, she has lost 10 pounds due to a reduced appetite, suffers from insomnia, feels chronically fatigued, and has difficulty concentrating. Although she denies suicidal ideation, her social isolation and emotional distress heighten her risk, necessitating close monitoring.

Several factors contribute to Ivy’s depressive state. Her recent divorce is a significant psychosocial stressor triggering her depressive episode. A family history of depression—including her mother and brother—suggests a genetic predisposition. Moreover, Ivy has a medical history of hypertension and previous depressive episodes, particularly during major life transitions, such as her youngest child leaving for college. She was previously prescribed venlafaxine, a Serotonin-Norepinephrine Reuptake Inhibitor (SNRI), but discontinued it due to withdrawal symptoms, potentially leading to her current relapse. Non-adherence to antidepressant medication is a well-documented risk factor for worsening depression and symptom recurrence (Naudín et al., 2022).

Despite the presence of a clear stressor—her divorce—Ivy’s condition aligns more with MDD than situational depression. Situational depression is typically transient and directly related to stressors, whereas MDD persists beyond the stressor and is associated with biological factors such as neurotransmitter imbalances and Hypothalamic-Pituitary-Adrenal (HPA) axis dysregulation (Remes, 2021). Given Ivy’s prolonged symptoms, prior depressive episodes, and the severity of her distress, an MDD diagnosis is well-supported. A multimodal treatment approach, including pharmacological intervention (escitalopram), psychotherapy, and lifestyle modifications, will be essential to improving her emotional well-being, treatment adherence, and overall quality of life.

Concept Map for Ivy Jackson

Conclusion

Ivy Jackson’s case highlights the importance of a structured approach in diagnosing and managing Major Depressive Disorder (MDD). The concept map provides a clear framework for identifying risk factors, symptoms, diagnostic criteria, pharmacological treatments, potential complications, and essential nursing interventions. A comprehensive, evidence-based care plan incorporating psychological, physiological, and pharmacological strategies will optimize Ivy’s treatment outcomes and overall mental health.

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

NURS FPX 4015 Assessment 3

Naudín, M. A.-P., Abejón, E.-G., Gómez, F.-H., Lázaro, D.-F., & Álvarez, F. J. (2022). Non-adherence to antidepressant treatment and related factors in a region of Spain: A population-based registry study. Pharmaceutics, 14(12), 2696. https://doi.org/10.3390/pharmaceutics14122696

Remes, O. (2021). Biological, psychological, and social determinants of depression: A review of recent literature. Brain Sciences, 11(12), 1–33. https://doi.org/10.3390/brainsci11121633