Generalized Anxiety Disorder, and Substance Abuse
Nicole Gapp
University of Minnesota
School of Nursing
Case Analysis of Comorbid Major Depressive Disorder,
Generalized Anxiety Disorder, and Substance Abuse
Major Depressive Disorder (MDD) is a mood disorder with symptoms that greatly affect the life of the individual. MDD could in fact be called a public health crisis, as it is projected that it will soon overtake heart diseases as the major worldwide health concern (Boyd, 2008). Diagnostic criteria for MDD are depressed mood or loss of interest or pleasure in nearly all activities, present for at least 2 weeks. Findings and behaviors associated with MDD are disruption of sleep, suicidal ideation, feelings of worthlessness and hopelessness, and fatigue and loss of energy. MDD is also associated with a high impairment in occupational, social, and physical functioning, causing as much disability and distress as chronic medical disorders (United States Department of Health and Human Services, 1999). MDD has been shown to be associated with increased medical illnesses. MDD can make everyday living a challenge, as research shows that depressive symptoms are associated with impaired everyday problem-solving ability directly and indirectly mediated through learning and memory, and reasoning (Yen, Rebok, Gallo, Jones, & Tennstedt, 2011). It is important for MDD to be identified and treated early on, as MDD that is not treated appropriately results in recurrent depressive episodes, with each successive episode increasing in severity. As MDD is highly associated with suicidal ideation and suicide, it is imperative that MDD be treated to ensure patient safety. Risk factors for MDD are a prior episode of depression, lack of social support, lack of coping abilities, medical comorbidity, substance use, and presence of life and environmental stressors. In
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