Can you answer the questions about this case written by Dr Meadows as part our Major Depressive Disorder series?
Mary is a 27-year-old female Google employee currently on disability leave. She recently ended a long-term relationship and has been diagnosed with Major Depressive Disorder (MDD), Borderline Personality Disorder (BPD), Post-Traumatic Stress Disorder (PTSD), and Obsessive-Compulsive Disorder (OCD). She has a history of chronic suicidal ideation (SI) and self-harm, along with severe emotional dysregulation and cognitive rigidity. Previous treatment attempts have included multiple medication trials and electroconvulsive therapy (ECT).
Mary's current treatment plan involves medication adjustments, psychological testing (which confirmed traits of Autism Spectrum Disorder), transcranial magnetic stimulation (TMS), family therapy, a wellness plan (including a behavioral contract), vocational counseling, and collaboration with her disability attorney. As a result, she has experienced improvement in depressive symptoms, more effective communication with her parents, completed the sale of her home with her ex-fiancé, moved from supportive housing to an independent apartment, returned to work with accommodations, and actively participates in an alumni program.
This program is funded by an independent grant from Takeda. This online education program has been designed solely for healthcare professionals in the USA. The content is not available for healthcare professionals in any other country.
How can Mary's family therapy continue to play a role in her recovery, particularly in addressing residual symptoms and maintaining healthy relationships?
How can Mary's family therapy continue to play a role in her recovery, particularly in addressing residual symptoms and maintaining healthy relationships?
Given Mary's history of SI and self-harm, what ongoing monitoring and support systems should be in place to ensure her safety and well-being?
Given Mary's history of SI and self-harm, what ongoing monitoring and support systems should be in place to ensure her safety and well-being?
What specific challenges might Mary face in returning to work, and how can her vocational counseling and accommodations be tailored to support her success?
What specific challenges might Mary face in returning to work, and how can her vocational counseling and accommodations be tailored to support her success?
How should Mary's treatment plan be monitored and adjusted to target both her acute symptoms and any residual effects that may emerge over time?
How should Mary's treatment plan be monitored and adjusted to target both her acute symptoms and any residual effects that may emerge over time?
What non-pharmacological approaches could be beneficial in managing Mary's residual symptoms, considering her multiple diagnoses and past treatments?
What non-pharmacological approaches could be beneficial in managing Mary's residual symptoms, considering her multiple diagnoses and past treatments?
How can Mary's treatment team effectively identify and address these residual symptoms to further improve her quality of life?
How can Mary's treatment team effectively identify and address these residual symptoms to further improve her quality of life?
Despite Mary's progress, what potential residual symptoms might she be experiencing given her complex psychiatric history and diagnoses?
Despite Mary's progress, what potential residual symptoms might she be experiencing given her complex psychiatric history and diagnoses?