Can you answer the questions about this case written by Dr Meadows as part our Major Depressive Disorder series?
Sally is a 44-year-old Haitian immigrant who is a high-achieving executive. She is married with three children. Sally has a history of early life emotional trauma and neglect, as well as postpartum depression after her first child. She has responded well to Sertraline in the past. Sally currently presents with Major Depressive Disorder (MDD) and is undergoing treatment with Escitalopram, Cognitive Behavioral Therapy (CBT), outpatient transcranial magnetic stimulation (TMS), and FMLA support with return-to-work planning. Over an 8-week period, her Montgomery–Åsberg Depression Rating Scale (MADRS) score has improved from 30 to 8. She has successfully returned to work, made psychotherapeutic progress, and reports an improved sense of resilience, increased acceptance and flexibility, greater presence and connection with her family, and a heightened sense of spiritual awareness and meaning.
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What long-term strategies can be implemented to prevent relapse and maintain Sally's mental wellbeing?
What long-term strategies can be implemented to prevent relapse and maintain Sally's mental wellbeing?
How does Sally's high-achieving career and family responsibilities factor into her depression and recovery?
How does Sally's high-achieving career and family responsibilities factor into her depression and recovery?
What role does the combination of medication, psychotherapy, and TMS play in Sally's recovery? Could any of these modalities be reduced or eliminated?
What role does the combination of medication, psychotherapy, and TMS play in Sally's recovery? Could any of these modalities be reduced or eliminated?
How does Sally's cultural background and experiences as an immigrant potentially influence her experience of depression and response to treatment?
How does Sally's cultural background and experiences as an immigrant potentially influence her experience of depression and response to treatment?
Given Sally's history of response to Sertraline, was Escitalopram an appropriate choice for her current episode of MDD?
Given Sally's history of response to Sertraline, was Escitalopram an appropriate choice for her current episode of MDD?