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Mental Health And Mood Disorders

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Mental Health And Mood Disorders

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Question:
Discuss about the Mental Health and Mood Disorders.
 
 
Answer:

Introduction
Mental illness is used to describe many behavioral disorders and mental health problems which vary in duration and severity. The most common mental illness includes depression, anxiety as well as substance abuse disorders. In Australia, the Survey of Mental Health and Wellbeing which began in the 1990s give evidence on the prevalence of mental illness, comorbidity, its associated disability, and the available health services for people with mental problems (MHSA, 2016). According to the National Institute of Health 2016, depression is a common and a serious disorder that causes severe symptoms which affect the way a person thinks, feel and handle day to day activities such as working, sleeping and eating.  Diagnosis for depression depends on symptoms that last for more than two weeks. In this essay, depression, and related mental disorder; suicide is comprehensively discussed based on the first scenario.
Mental Illness and Depression
Mental illness is a common disease in Australia.  Black Dog Institute (2012) indicates that every year, about 20% Australians between the ages 16 to 85 suffer from a mental illness. The three common disorders depression, anxiety as well as use of the substance of abuse a lot occur in combination.  Among the 20% of people with mental illness in Australia, 11.5% have experienced one disorder while 8.5% have at least two disorders. Depression is the third highest disease burden in Australia at 13.3%. It is the leading cause of disability in Australia at 24% (Black Dog Institute, 2012).
Interestingly, there has been an upward trend in prevalence of depression in Australia. This disorder affected people between the ages 45-54 years old. In an extended period study between 1998 to 2008, Goldney, Eckert, Hawthorne & Taylor (2010) reported a significant rise in prevalence of depression from 6.8% to 10.3%. In this study, there was a substantial increase in males of age between 15 to 29 and between 30 to 49 years in females. However, the study did not show any significant increase among other subgroups. In this study, Goldney et al., (2010) reports that health status as the primary predictor of depression in Australia.
In another study by Mitchell et al., (2011), the prevalence of all types of depression, when combined, was 24.6%, and all kinds of mood disorders were 29.0%. In this study, there was no the consistent correlates of depression were few. Also there no effects of sex, age and clinical settings in depression cases. Wood et al., (2012) reports 18.5% prevalence among patients suffering from multiple sclerosis. In the study, he indicates that anxiety fatigue and depression cluster together and are common in people with multiple sclerosis; findings which are vital for managing individuals with multiple sclerosis and in the study of the involved biological pathways. Luppa et al., (2012) also indicates the prevalence rate of depression at 4.6% to 9.3% in a study of gender and age specific study of depression in elderly.
 
Prevalence of Suicide
In addition to about thirty people attempt suicide, more than six people die from suicide in Australia every day. Though suicide is only about 1.6% of deaths in Australia, it does not contribute to the bigger percentage of deaths in particular age groups. Men are highly exposed to the risk of committing suicide, though they are less likely to seek help. Out of the suicide-related deaths in 2010, men accounted for three-quarters 76.9%. In addition to men, other categories such as indigenous Australians, transgender people, children and individuals who live in remote and rural areas have a greater risk of suicide (Black Dog Institute, 2012).
According to the Bureau of Statistics 2015, the highest age-related suicide deaths among male in 2013 occurred in people with at least 85 years. In this group, 38 out of 100, 000 people died of suicide. The second group with the high rate of age-related suicide belong to the 40 to 44 year age group. In this category, 25 out of 100,000 males died of suicide. However, lowest percentages were observed in men belonging to the 15-19 age groups. Prevalence in female was highest among the 40-44 age group and lowest rate observed among 80-84 age groups.
Causes of Edward’s mental state and Depression
Based on the issued highlighted in scenario A, it is evidently clear that Edward is suffering from depression and other mental disorders. According to the National Institute of Mental Health 2016, certain symptoms are associated with depression. These include anxiety, persistent mood, pessimism, guilt, and irritability, reduced interest in activities, decreased energy, slow speech, difficulty sleeping, weight loss, pains and thoughts of suicide.  In this scenario, Edward is seen to present with most of these symptoms. Among the symptoms seen in Edward include; thoughts about suicide, unexplained weight loss of about 6kilos. He also experiences difficulty in sleeping as he wakes up early at four in the morning, reduced energy that caused inability to work in the field leading to low productivity, hopelessness, feeling of guilt because of failure to attend his father and mother’s funerals. Edward is anxiously waiting to meet his younger brother and sister who live in Malta. Based on these features, it is clear that Edward is depressed.
Depression is caused by a combination of factors. These factors can be genetical, environmental and stress at school, work or home. According to  Ekanayake, Ahmad & Mckenzie (2012), family and relationships, socioeconomic factors, culture and migration are causes of depression. In their study, they also indicate domestic abuse, interpersonal problems and marital problems in the family as the primary cause of depression. That said, in this scenario, Edward seem to have stress emanating from many factors. To begin with, emotional distress arising from the death of his son, Thomas. Since Thomas committed suicide by poisoning himself with carbon monoxide, Edward is left wondering what might have prompted him to take his life. Due to his old age, he cannot work in the field as before, a situation which has resulted to low produces and loss of business. Poor self-esteem is a possible cause of Edwards’s depression. The fact that Collins decided to move and stay in Sydney and leave his father’s farm is an indication of the ununited family. Edwards think that he, his wife and his son are socially apart. Also, anxiety might have caused the depression in Edward. Having failed to attend his parents’ funeral and his dire need to meet his two siblings in Malta stress him a lot thus causing the depression. 
 
One ethical issue arising from this scenario is the act of suicide by Edwards’s son and thoughts about suicide by Edward himself.  According to Danaher (2014), there are four ethical frameworks that relate to ethics of suicide. First is the theological framework which bases its values on the ground of religious premises. A theist believes that we are Gods creation and deciding to end our lives is ethically wrong in that it violate Gods authority over us. Secondly, the libertarian framework views the ethics of suicide based on political and moral theory. Libertarians believe that we have legitimate authority over ourselves. Therefore we have the right to end our life if we wish. The third approach is based on the consequential framework which uses the consequences of suicide to judge whether it is a permissible or a forbidden act. However, one disadvantage of this context is its association with counterintuitive conclusions. Lastly, ethics of suicide is judge based on Kantian framework. It is a consequentialist approach that focuses on our personal duties to others in line with the concept of dignity. 
Danaher (2014) further indicates that in dealing with Edward’s case, the nurse needs to adhere to the fundamental guiding principle. Which require psychologists to require that the client supported and their safety promoted while waiting for a better assessment of the patient’s situation. Psychologists must address patient’s autonomy in the process of delivering their assistance. The particular ethical guiding principles for psychologist handling potential suicide clients need to ensure adequate protection of consumer’s rights, need to maintain patient’s confidentiality and avoid work beyond their professional competence as per the code of ethics.  Another ethical issue is the possibility of leaking the information about the patient’s intent to commit suicide. This action can be unethical because the people who are mentally challenged require privacy and if they learn that their details are leaked to third parties may only worsen their situation.
The legal aspect of suicide in Australia is a bit different compared to other countries. According to the Australian Criminal Code Amendment Act of 2005, attempt to commit suicide or committing suicide is not an offense in South Australia. However, assisting someone to commit suicide is a serious criminal offense. There the fact that Edward thinks of committing suicide is not punishable in the law court. We note that despite Edward having such thoughts, he doesn’t know how to do it. If someone gives advice to him, then it becomes a criminal offense to the adviser.
There are two categories of nursing problems identified in this scenario; first, the physical problems may include neglecting personal hygiene and inability to eat or drink. The risk associated with neglect of health includes dental caries, body odor and infections, infestations, development of low self-esteem and social rejection (Dean, 2011). The risk associated with the inability to eat or drink includes dehydration, constipation, loss of weight and general weakness. In this scenario, we choose exhaustion and loss of energy as a physical problem. Exhaustion is of particular concern because if not managed timely, it can deprive body energy hence risking the client’s life. Secondly, there are psychological nursing problems associated with depression are connected to Edwards personality, circumstances environment, and relationships. Specific problems in depressed patients include hopelessness, guilt, anxiety and low self-esteem (Dean, 2011). According to this scenario, Edward admits that he had thoughts of suicide. This condition is particularly a psychological problem because if not managed well, the client may end up taking his life.
 
Nursing interventions are essential for depressed patients because it helps to prevent the condition from worsening. Suffering from depression can affect a person’s diet leading to loss of energy and exhaustion. This situation can threaten a patient’s life if not managed early enough. Lack critical nutrients may make people tired then run down (Lill, 2015).  Malnutrition problems can be solved by providing for and encouraging the client to eat enough balanced food with plenty of vegetables and fruits. Energy giving foods such as carbohydrates should be given in appropriate amounts to provide energy. Second intervention required is to allow the patient enough rest and provide counseling. Depression is related to tension, anxiety, and stress. Relaxation is the best solution for stress. Encourage the patient to listen to relaxation tapes, yoga or read some interesting literature. Let the patient decide what the best relaxation method is for them. Giving enough rest and counseling allow helps to reassure the patient and ensure the patient regain strength.
Depressed people may take their life through suicide. Having hinted of thoughts of suicide. Edward needs to be monitored closely to ensure he is as safe as possible. To begin with, proper risk assessment needs to be carried out to understand Edwards’s situation before commencing ant treatment. This risk assessment is particularly important for it helps in the diagnosis of the problem and provision of appropriate help (Lill, 2015). To solve this problem, psychological therapy will be done. Guidance and counseling can help treat the patient from bad thoughts about suicide.  Also provide social support. When people experience depression, they might feel no energy to socialize. This support will prevent the patient from negative thinking which might lead to suicide.
 
Conclusion
Summing up, indeed Edward is in depressive condition which requires urgent attention. Depression being the third highest prevalent medical condition in Australia, more need to be done to reduce the occurrence of cases.   Suicide in particular is a serious cause of many deaths in Australia, and Edward being in this mental state, proper risk assessment on her condition need to be done to help after him assistance. It is worth noting that family issues right from the death of his younger son, relocation of his elder son to Sydney as well as his current poor performance in business is the cause of his depressive condition.
 
References
Australian Bureau of Statistics (2015). Causes of Death, Australia, 2013: Summary of Results, 3303.0, 2013. ABS: Canberra.
Black Dog Institute. (2012, October). Facts and figures about mental health and mood disorders. Retrieved August 25, 2016, from https://www.blackdoginstitute.org.au/docs/Factsandfiguresaboutmentalhealthandmooddisorders.pdf
Criminal Code Amendment (Suicide Related Material Offences) Bill 2005 – Parliament of Australia. (2005). Retrieved August 26, 2016, from https://www.aph.gov.au/Parliamentary_Business/Bills_Legislation/bd/bd0405/05bd133
Danaher, J. (2014, May). The Ethics of Suicide: A Framework. Institute for Ethics and Emerging Technologies. doi:10.1007/978-94-017-7264-8_8
Dean, E. (2011). Major study shows nursing care benefits patients with depression. Nursing Standard,25(52), 8-8. doi:10.7748/ns.25.52.8.s10
Ekanayake, S., Ahmad, F., & Mckenzie, K. (2012). Qualitative cross-sectional study of the perceived causes of depression in South Asian origin women in Toronto: Table 1. BMJ Open, 2(1). doi:10.1136/bmjopen-2011-000641
Lill, S. (2015). Depression in Older Adults in Primary Care: An Integrative Approach to Care. Journal of Holistic Nursing, 33(3), 260-268. doi:10.1177/0898010115569350
Luppa, M., Sikorski, C., Luck, T., Ehreke, L., Konnopka, A., Wiese, B., Riedel-Heller, S. (2012). Age- and gender-specific prevalence of depression in latest-life – Systematic review and meta-analysis.Journal of Affective Disorders, 136(3), 212-221. doi:10.1016/j.jad.2010.11.033
Mental Health Services in Australia (MHSA). (2016). Prevalence, impact and burden. Retrieved August 25, 2016, from https://mhsa.aihw.gov.au/background/prevalance/
Mitchell, A. J., Chan, M., Bhatti, H., Halton, M., Grassi, L., Johansen, C., & Meader, N. (2011). Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: A meta-analysis of 94 interview-based studies. The Lancet Oncology, 12(2), 160-174. doi:10.1016/s1470-2045(11)70002-x
National Institute of Mental Health (NIMH). (2016, May). Depression. Retrieved August 25, 2016, from https://www.nimh.nih.gov/health/topics/depression/index.shtml
Goldney, R. D., Eckert, K. A., Hawthorne, G., & Taylor, A. W. (2010). Changes in the prevalence of major depression in an Australian community sample between 1998 and 2008. Aust NZ J Psychiatry Australian and New Zealand Journal of Psychiatry, 44(10), 901-910. doi:10.3109/00048674.2010.490520
Wood, B., Mei, I. V., Ponsonby, A., Pittas, F., Quinn, S., Dwyer, T., Taylor, B. (2012). Prevalence and concurrence of anxiety, depression and fatigue over time in multiple sclerosis. Multiple Sclerosis Journal,19(2), 217-224. doi:10.1177/1352458512450351

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