I need you to paraphrase this paper. Pls. I need a 100% plagiarism free paper

Decision Tree

The purpose of this paper is to read, assess, and analyze a patientpresenting with depressive-like symptoms. The patient presents as afirst initial visit. Her presentation and reported history suggest adiagnosis of a cyclothymic disorder and an appropriate treatment planmust be created based on the diagnosis assumed.

Decision #1

Which Decision did you select?

Thefirst decision that I made was to diagnose this patient withcyclothymic disorder. This patient meets criteria for a diagnosis ofcyclothymic disorder based on her persistent depressed mood withperiodic episodes of feeling “on top of the world,” going 3 days withoutmuch sleep and then finally feeling fatigued stating that sheeventually “crashes,” her decreased ability to concentrate when shefeels sad, and inability to get things done with periodic “bursts ofenergy.”

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

Iselected this diagnosis because the patient meets criteria, accordingto the DSM-5, for cyclothymic disorder. The patient reports she has beenstruggling with these symptoms for years and an individual withcyclomania must have had the symptoms for at least 2 years with manyepisodes of hypomanic symptoms and depressive symptoms without meetingcriteria for an episode of either. Also, cyclothymic disorder can have asignificant negative impact on functioning in the individual’s social,occupational, or other facets of their life. No other mental illnessmeets criteria in the DSM-5 with this presentation (American PsychiatricAssociation, 2013). Because Stefanie does not meet criteria for eitherhypomanic episode or major depressive episode and because she is notusing substance while exhibiting these symptoms, she meets criteria forcyclothymic disorder

What were you hoping to achieve bymaking this Decision? Support your response with evidence and referencesto the Learning Resources.

I was hoping to confirm adiagnosis for this patient so she could be treated accordingly with theappropriate medication based on her symptoms. The patient is not gettingan adequate amount of sleep and is not completing daily required tasksby allowing them to pile up. The instability in her mood can be managedwith a medication to help stabilize her mood which is why a properdiagnosis is so important.

Explain any differencebetween what you expected to achieve with Decision #1 and the results ofthe Decision. Why were they different?

I expected thatthis patient would get some clarity by receiving her diagnosis. It mayhelp her make sense of her behaviors and why she struggling in certainareas of her life, This could also give her hope that her troublesomesymptoms can be alleviated with pharmacotherapy treatment options.

Why did you select this Decision 2? Support your response with evidence and references to the Learning Resources.

Thesecond decision that I made was to start this patient on 10 mg ofAbilify by mouth daily. Cyclothymic disorder is similar to bipolardisorder and is treated accordingly. Abilify is FDA approved for acutemania/mixed mania, and bipolar maintenance. It works by decreasingdopamine when dopamine is high and increasing dopamine output whendopamine levels are low (Stahl, 2014). Abilify is a good choice becauseit tends to work sooner than mood stabilizers and can take effect assoon as 1 week.

What were you hoping to achieve bymaking this Decision? Support your response with evidence and referencesto the Learning Resources.

By starting this patient on10 mg of Abilify, I was hoping that this patient would haveremission ofher symptoms. I was hoping she would be able to get some consistentsleep, her mood would be improved mood and more consistent withoutrandom ups and downs, and that she would be able to consistentlycomplete more goal directed activities on a daily basis.

Explainany difference between what you expected to achieve with Decision #2and the results of the Decision. Why were they different?

AfterStefanie returned to the clinic in four weeks for a follow-up, shereported that her mood was more stable. I did expect the Abilify tostabilize her mood at least some. The patient reported, she has not feltas sad which goes hand in hand with her mood being more consistent.Stefanie reported that she felt lightheaded upon standing up for thefirst two weeks of taking the medication which is a common side effectso that was not too surprising. Common initial side effects includedizziness, insomnia, akathisia, activation, nausea, vomiting, andorthostatic hypotension (Stahl, 2014).

Decision #3

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

Stefaniereported orthostatic hypotension after the initial doses for the first 2weeks but reports that the symptoms have subsided. Therefore, I madethe decision to maintain the current dose of Abilify. Orthostatichypotension is a common side effect when starting the medication andshould just be monitored. At this point, because it has not happened in afew weeks and the medication seems to be working well by stabilizingher mood, maintaining the current dose of Abilify at this point seemslike the appropriate choice.

What were you hoping toachieve by making this Decision? Support your response with evidence andreferences to the Learning Resources.

I was hopingthat the patient would not have any more dizziness upon standing andthat the medication would continue to relieve her symptoms related toher cyclothymic disorder and stabilize her mood. It appears to beworking well without major side effects at this point.

Ethical considerations might impact treatment plan

Anethical consideration to keep in mind with this patient is herpotential to not comply to treatment and medication regimen. Individualswith cyclothymic disorder can have irregular moods and unpredictablebehaviors which can make it hard to tell what the patient might do ordecide to do. She also could start feeling better and stop taking hermedication which would not be productive or benefit a positiveprognosis. Before starting a medication, the pros and cons of taking themedication need to be weighed out and the potential side effects mustbe considered (Newhouse-Oisten, 2017). Considering the patient’s medicalhistory or problems should be considered ethically. For example, if thepresents with diabetes mellitus already, an antipsychotic for thisdisorder may not be the best decision with its potential for negativemetabolic effects. Also, monitoring the patient for any movementdisorders after taking the medications is important as the patient couldpotentially develop a movement disorder that could be life-long andinterfere with their quality of life.

Conclusion

Inconclusion, this patient ended up being diagnosed with cyclothymicdisorder. She did not meet criteria for bipolar or depressive disorder.Her symptoms were interfering with her daily life as she was notsleeping or getting daily tasks performed appropriately. Her up and downmood swings was confusing for her as well, and all of her combinedsymptoms made her want to seek treatment and tell someone what was goingon with her. Abilify was the chosen pharmacological treatment optionsas it can help to stabilize her mood and allow her to get some moreconsistent sleep.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders

(5th edition). Wahsington, D.C: Author.

Laureate Education. (2017d). A young woman with depression [Interactive media file].

Baltimore, MD: Author.

Newhouse-Oisten, M. K., Peck, K. M., Conway, A. A., & Frieder, J. E. (2017). Ethical

Considerationsfor Interdisciplinary Collaboration with Prescribing Professionals.Behavior analysis in practice, 10(2), 145–153. https://doi.org/10.1007/s40617-017-0184-x