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Tyler Durden showed signs of general low moods, delusions and hallucinations. He also complained of low levels of concentration in any activity that he was indulged in. this made him so withdrawn in social occasions and even contemplated suicide. He further exhibited signs of insomnia and lack of sleep. Finally, he complained of physical problems such as headaches and fatigue coupled with digestive problems. These signs and symptoms as described by Tyler Durden, prompted him to seek medical assistance in regard to his health developments.
History of the Presenting Problem
The patient seems to exhibit signs and symptoms of major depressive disorder. Hippocrates, a Greek Physician, had described this illness as a “distinct disease with particular mental and physical symptoms”. This was characterized by fears and despondencies that lasted a long time. It was later re-described by the American Psychiatric Association in 1980 to represent a cluster of symptoms related to mood disorder. This was contained in the Diagnostic and Statistical Manual of mental Disorder (DSM-III), Hays RD, Wells KB, Sherbourne (1995). It is most common in people aged between 20 and 30 years with more prevalence between 30 and 40 years. According to the Department of Health and Human Services, depression may be caused by biological, psychological and social factors.
The American Psychiatric Association’s DSM-IV-TR and the World Health Organization’s ICD-10 are the most common and widely used forms of diagnosing depressive disorders. It is classed as mood disorder in the DSM-IV-TR which is highly dependent on a single but recurrent major depressive episode, American Psychiatric Association (2000, p 412).
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DSM-IV can be assessed in two axes, Axis I and Axis II. Axis I involve testing for the clinical disorders characterized by all mental disorders with the exception of Personality disorders and Mental retardation. Axis II on the other hand involves the testing of Personality and Mental retardation. The DSM-IV symptoms were tested to determine the degree of concordance among all the AD symptoms. Univariate Logistic Regression (STATA 7) was also carried out with the realization of residual MDE symptoms conforming to Axis I. this was characterized by depressive mixed states, bipolar family history as well as psychotic features. In conclusion, all AD symptoms conformed to the DSM-IV AD.
Justification of Diagnosis
The diagnosis of major depression illness (recurrent depression illness) was reached after the conformity of the residual MDE symptoms with Axis I. furthermore, all the AD symptoms were in line with the DSM-IV AD hence DSM-IV test returned positive values. On the other hand, signs and symptoms that are characteristic of the major depression disease were also justified. This was exemplified by delusion and hallucinations. Moreover, insomnia, withdrawal from social occasions as well as contemplating suicide was also affiliated to the Major Depression Disease. Physical signs and symptoms such as headaches and fatigue also justified the diagnosis of Tyler Durden with Major Depression Disord4er.
The theory that may explain Tyler’s diagnosis may be grounded on the psychological aspects of the disorder. According to Raphael B. (2000), personality and its development contributed to the occurrence of the illness. This was marked by negative emotionality where the patient may have developed resilient ways of coping with an adverse situation. Furthermore, lack of self esteem and disillusionment may have led to the patient’s withdrawal as well as contemplating suicide. According to Aaron T. Beck, an American Psychiatrist, the cognitive model of depression (a triad of negative thoughts, recurrent patterns of depressive thinking, and distorted information thinking) may be some of the psychological factors that may lead to depression. In this regard, Tyler may have been experiencing the above mentioned psychological characteristics of depression hence the diagnosis of major depression disorder.
Patients diagnosed with Major Depression Disorder are believed to have a short life expectancy. This is due to the fact that most of the patients may fall victims of suicide. Nonetheless, due to their mental state, they may also die from other illnesses or causes, Kanai T, Takeuchi H, Furukawa TA (2003). This disorder may further develop into borderline personality disorders and it is estimated that 3.4% of the patients may die from suicide especially in the United States. These suicide attempts are high in women as compared to men. In conclusion, Electroconvulsive therapy, Deep brain stimulation, Physical exercise, Over-the-counter compounds and other somatic treatments can be used to help alleviate this disorder.
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