NUR135 Nursing Practice 1

Introduction

Today mental illness has become a major issue that has the potency to affect a person mentally. It can also effect a person to such an extent that he/she finds it deficult to perform jis/ her daily works. (Horwitz 2020). Various mental health issues might occur due to stress or trauma, and depression is one of them. Globally about 264 million people suffer from depression irrespective of gender. (Friedrich 2017). Depression causes loss of self-worth, loss of pleasure, sadness, tiredness, loss of appetite, lack of focus, etc. A patient with depression often complains about physical pain although without having any actual physical issue. (LeMoult and Gotlib 2019).  The effects of depression can be recurring and it hinders a person’s normal functions at work, school, etc.

In this paper a discussion will be made regarding a patient named Mary O’Hagan. In this paper, the challenges that the patient faces while performing her daily activities will be discussed along with other health conditions that she has. Further, the strength that helped her in reducing her pain and sufferings will be discussed. In the end recovery goals will be set along with nursing interventions and a conclusion will be drawn. The paper focuses on the patient named Mary O’Hagan and the challenges that she faces due to her mental condition along with recovery goals.

Discussion

Precursors of the experience of mental ill-health

The patient Mary was suffering from an existential crisis. At the age of 18, she had psychotic depression and this traumatic episode was there till she has 26. At this age, she decided that she will try her best to recover from this situation and show everyone that depression is not a life sentence. (O'Hagan 2015).  Along will depression she was suffering from manic episodes and it was devastating. More than that she was devastated with the standardized care that she was receiving. She was finding it difficult to cope with the judgmental society and the not-so-personalized healthcare treatments. The patient and the healthcare providers should not be limited to their expectations related to the process of recovery and the outcomes. Cure and recovery are two different things and healthcare professionals must encourage self-growth while discovering the patient’s uniqueness and personality. (O'Hagan 2015).  Mary first experienced the feeling of loneliness when Mary’s mother left her feeling abandoned at kindergarten. However when her mother returned her security was restored. The events like pulling her pants in front of boys created a burden on Mary as if she has committed a mortal sin. She even encountered the death of her baby brother. (O'Hagan 2015). All these together caused depression in a 16-year-old Mary.

She was admitted to a psychiatric ward but even after going through various treatments, thing were not working out in her favor and it only exaggerated her mental disorder. She was even on wrong drug for quite some time, her diagnosis was not done well and after Dr Lackland made diagnosis that she has temporal lobe epilepsy, her medication changed from lithium to carbamazepine which generated a feeling of distrust towards the healthcare providers. The behavior of the healthcare professional was only making her guiltier of his conditions and when his doctor said that she has been histrionic. (O'Hagan 2015).   And she started believing that her mood swings were her fault. She was struggling between whether the disorder was controllable and whether it was just happening beyond her control. She even started having suicidal thoughts and desires to consume high amount of anti-depressant to kill herself.

Challenges of living with mental ill-health

When a person suffers from depression, there are various challenges that they encounter while performing their daily activities. This also includes the issues that the family members and friends face who are close to the patient. The love life, relationship, career, studies, work, everything gets affected. These issues can result in more stress and side-effects of the medicines can also exaggerate the situations. (LeMoult and Gotlib 2019). Evidences show that discrimination is the major reason for distress. At some point of time, the patient might start believing what the society says about him/her. Mary was told that her mental condition will remain the same and it will continue throughout her life span. She was made to believe that she would not be able to do anything in life with this disorder. Her self-esteem was low and she was not being able to express what’s going on inside her head. She used to feel terrible as if she has murdered someone and she was seeing things that never existed in the first place. The healthcare system was of no help and her condition was deteriorating day by day. (O'Hagan 2015). Mary was found saying that health providers consider her mental health as a biological disorder and they were trying to correct it with medicine. However the only think that she thinks could have worked in his favor was empathy, support and therapies. Even after being discharged from the hospital she was fearful and unable to concentrate on things. His mental health was deteriorating and a feeling of emptiness prevailed.

The co-occurrence of other problems

As the patient was suffering from depression, she was also suffering from bipolar disorder with episodes of mania. The patient’s experience regarding an extensive variety of quality of mental health care, and the inability of the healthcare staff to connect with patients made the situation worst. Amongst this anecdote of failings, the most common situation was the arbitrary experience of medication prescription.  The notion of side effects was comfortably neglected. (O'Hagan 2015). Later she was also diagnosed with temporal lobe epilepsy.

The strengths identified by the patient to support themselves

Self-control, self-motivation, willpower, etc. were the main strength that helped the patient to overcome her disorder. Everyone has an invisible and uneven power resource. People generally notice the power they are lacking and recovery is both an inner and outer journey. After entering the psychiatric ward her credibility was stripped off and her dreams were shattered but she was lucky enough to start with a good personal power supply. (O'Hagan 2015).  She considers herself fortunate to have a strong and supportive bond with her friends and she was privileged to have a social and emotional background, a critical mind, and an indifference to the convention, which together helped her to overcome her mental illness and later became a commissioner. While being in the psychiatric ward, she started to ask questions to the psychiatrists as well as the nurses instead of relying on them for every treatment as well as assessment. She started to disagree with the assessments and doubted the ability of the healthcare providers to treat her effectively. Though they didn’t like it, it helped the patient to prove her point. (O'Hagan 2015). 

After being stabilized, she started looking for a psychiatric patients who were like her and who didn't believe in the world according to the psychiatrist/ healthcare providers. The patient organized and challenged healthcare providers to change their care process and many of them did it. The discourse of the mad movement was changed to a discourse of the mental health system and slowly the logic and language started to change. (Sayce 2015). People generally confuse recovery with recovery in medicine. Holistic care, support, and therapy should also be part of the changes. The perspective of the people towards a mental patient is something that should be changed. (LeMoult and Gotlib 2019).  The patient was able to bring a revolution in the care process when she joined as a commissioner and emphasized on personal recovery. There was a call for a new philosophy in mental health services that focused on equality, ending the deficit-based approaches, and questioning the compulsory interventions. Mary’s recovery started when she learned to stop curling herself into a terrifying ball and began to let herself float in the blackness. (O'Hagan 2015).  Her inner strength helped her to achieve where she is today.

The Recovery Goals Identified

Empathy and support are very necessary for improving the health of a mental illness patients and Mary was not getting enough support. She was blamed for her condition which was devastating. The patient identified that the healthcare system was not effectively treating the patients. There was an unnecessary but compulsory assessment that was not even needed. The inner strength, motivation, support, and belief were something that the healthcare organization should have that would lead to improved quality of care of the patient. The recovery goals that were identified were development of coping skills, self-control and changes in thought processes. The glass wall that the patient believes existed between her and the world was needed to be broken. At the later stage of the disorder, she got a nurse who was quite supportive. (Carr 2015). The nurse didn’t say hurry up, she was very kind towards the patient.

Nursing Plan

As a patient of depression, various negative thoughts can enforce a person to commit suicide. Thus a nursing care plan for a depressive patient must focus on building a therapeutic relationship between a patient and a nurse. (Okamoto et al. 2019). It is important to understand the patient’s feelings. Only the administration of medicines is not enough for a patient's recovery and it should also involve counseling and talking therapy to strengthen a patient's mind and soul. The healthcare settings have evolved and various therapies like cognitive behavior therapy, mindfulness-based approaches, and relaxation therapy are effective for improving the mental health of a psychiatric patient. (Cunningham and Shapiro 2018). It is also important that the surrounding is supporting and understanding which will encourage the patient to tell her feelings without being judged. (Loureiro, Quaresma and Santos 2018).

Conclusion

Thus in this paper Mary O'Hagan mental health experiences were used as a living experience for mental disorder. Depression can affect a person's ability to perform daily tasks and healthcare organizations should support the patient through assistance and care. Emotional support is vital for strengthening the mind and soul. Development of self-control, coping skills, improved self-esteem, etc. will positively influence a patient’s recovery. Psychotherapy plays a vital role in dealing with mental disorders. Building therapeutic communication between the patient and the healthcare providers is highly recommended to understand the pain and sufferings of the patient and propose an effective intervention for them. Cognitive behavior therapy that involves changing the thought process of the patient can lead to better outcomes in comparison to the administration of medicine alone. Care and support can improve the quality of life of Mary and help her to live her life without any burden. 

References

Carr, S., 2015. Madness made me: a memoir.

Cunningham, J.E. and Shapiro, C.M., 2018. Cognitive Behavioural Therapy for Insomnia (CBT-I) to treat depression: A systematic review. Journal of psychosomatic research, 106, pp.1-12.

Friedrich, M.J., 2017. Depression is the leading cause of disability around the world. Jama, 317(15), pp.1517-1517.

Horwitz, A.V., 2020. Creating mental illness. University of Chicago Press.

LeMoult, J. and Gotlib, I.H., 2019. Depression: A cognitive perspective. Clinical Psychology Review, 69, pp.51-66.

Loureiro, C., Quaresma, H. and Santos, J.C., 2018. Psychiatric/Mental Health Nursing Core Competencies: Communication Skills. In European Psychiatric/Mental Health Nursing in the 21st Century (pp. 259-267). Springer, Cham.

O'Hagan, M., 2015. Madness made me. Potton & Burton.

Okamoto, A., Dattilio, F.M., Dobson, K.S. and Kazantzis, N., 2019. The therapeutic relationship in cognitive–behavioral therapy: Essential features and common challenges. Practice Innovations, 4(2), p.112.

Sayce, L., 2015. Madness Made Me: A Memoir. Mental Health and Social Inclusion.

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