Читать книгу Dynamic Consultations with Psychiatrists - Jason Maratos - Страница 68

On the first consultation in February, Margaret was found to have low mood and to be calm and settled, even though she was weeping. She presented within the normal range. Her speech was coherent and relevant and was of normal tone and tempo. She claimed that she had been troubled by fewer suicidal ideas. No psychotic features were detected. She had no violent ideas or any harmful ideas toward her children.

The overall impression was that Margaret was suffering from a moderate depressive episode whose onset was well before the birth of her last child and which was related to multiple stressors. Margaret felt initially relieved to live away from her family of origin but found that since moving to the city she was facing more problems, such as financial stress and stress in relation to the care of the children, with limited social support.

Treatment options were discussed with Margaret who was then started on Sertraline 25 mg and was referred to a medical social worker and to the community psychiatric nurse service. The issue of the use of benzodiazepines while breastfeeding was also considered.