Chronic IllnessChronic Illness – A 28-year-old Female Presents to the Facility Complaining of Weight gain, Increased Sleeping, and Fatigue – A 28-year-old Female Presents to the Facility Complaining of Weight gain, Increased Sleeping, and Fatigue The patient is a 28-year-old female who presents to the facility complaining of weight gain, increased sleeping, and fatigue. Her medical history shows that she has been suffering from depression on and off since the age of 17 years. She has never had any medical problems apart from depression. Despite being aware of her condition with depression, she has never taken any medication to manage the condition. Differential diagnoses include depression, sleep-related disorders, central nervous system diseases such as multiple sclerosis, drug-related conditions such as the use of central nervous system depressants and abuse of cocaine, and endocrine disorders such as hypothyroidism, Cushing syndrome, and hyperthyroidism. The patient’s evaluation in
The patient is a 28-year-old female who presents to the facility complaining of weight gain, increased sleeping, and fatigue. Her medical history shows that she has been suffering from depression on and off since the age of 17 years. She has never had any medical problems apart from depression. Despite being aware of her condition with depression, she has never taken any medication to manage the condition.
Differential diagnoses include depression, sleep-related disorders, central nervous system diseases such as multiple sclerosis, drug-related conditions such as the use of central nervous system depressants and abuse of cocaine, and endocrine disorders such as hypothyroidism, Cushing syndrome, and hyperthyroidism. The patient’s evaluation includes the patient’s history, physical assessment, measuring of vital signs, and laboratory tests. Essentially, a thyroid-stimulating hormone test is conducted to rule out hypothyroidism and hyperthyroidism, while toxicology screening and blood alcohol level are done to rule out substance abuse (Pirahanchi et al., 2022). HBA1c level, fasting plasma glucose test, or a random plasma glucose test is done to rule out diabetes (Goyal & Jialal, 2022). A cosyntropin stimulation test is done to rule out Addison’s disease. Laboratory tests include complete blood cell count, vitamin B12, liver function traits, arterial blood gas, and electrolytes.
The patient’s current weight and height are used to determine her BMI. If the BMI shows that the patient is overweight or obese, the patient’s treatment plan focuses on weight loss. Dietary and lifestyle adjustments are recommended to prevent unintended weight gain and ensure weight loss. The patient’s sleep hygiene is assessed to determine the causes of increased sleeping. Notably, the patient has a history of depression without treatment since the age of 17; therefore, her treatment plan should include the management of depression. The treatment plan includes psychotherapy and pharmacological therapy (Chand & Arif, 2022). Pharmacological therapy includes the prescription of atypical antidepressants such as bupropion, tricyclic antidepressants such as amitriptyline, selective serotonin reuptake inhibitors such as fluoxetine, monoamine oxidase inhibitors such as selegiline, serotonin dopamine activity modulators such as aripiprazole and serotonin/norepinephrine reuptake inhibitors such as duloxetine (Chand & Arif, 2022). Any other underlying disorders are also treated.
References
Chand, S. P., & Arif, H. (2022). Depression. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430847/.