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Disease and its Symptoms - Essay Example

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Summary
Consultant: Charles B. Nemeroff
Clinician: I have a patient with the symptoms I have just described. Kindly advice
Charles Nemeroff: I think I understand Ms. Vega’s situation. …
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Disease and its Symptoms
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Neurobiologists have established that there are hormonal, genetic, and monoamine influences on depression. Alterations in the work of certain genes, alterations in the work of certain monoamines, and hormonal imbalance, all contribute to depressive moments in a depressed patient. It has not been established if all these factors work together, but one clear finding is that there is a relationship between traumatic childhood experiences, and depression later in life. This could be a perfect explanation to the development of her depression.

Your client seems to experience the episodes she describes more often because of stress. We recently developed a hypothesis (stress-diathesis model of mood disorders), in which we confirmed that there is an interaction between diathesis (inborn predisposition), and stress (experience). Ms. Vega’s violent episodes are as a result of stress, which trigger an interaction with her childhood experience; hence her violent reactions. Let me explain to you how this happens. There are certain people with genetic traits that lower the threshold for depression; she could be one of them (most likely).

The genetic factors, also affect the monoamine levels in the synapses. Monoamines as indicated earlier are associated with depression. Reduced levels cause depression. The genetic traits reduce the monoamine levels increasing the chances of such a person being depressed. The genetic traits also increase reactivity of the hypothalamic pituitary-adrenal axis to stress. She could therefore, be one of the people that are easily stressed. The genetic threshold can be pushed further by adverse life experiences, and serious stress.

Your client’s childhood’s experience therefore, activates her stress response, and induces neurons containing Corticotropin-Releasing Factor (CRF), thereby increasing their activity. CRF are known to be overactive in depressed people. Since your client has experienced the hyperactivity of these neurons since childhood, her reactions even to mild stressors would be very vigorous. Your client therefore, has a combination of factors that have led to her current condition: possibly her genetic condition, previous childhood experience, and stresses.

She has depression which needs to be treated, but dealing with her childhood experience would be best in helping her. She can also be taught how to cope with stress in the mean time. Consultant Kaiping Peng I would argue that there are certain influences to Ms Vega’s reactions. According to you as her clinician, she is depressed. She may be depressed. I would say however, that what you call depression may be her normal way of reaction to particular psychological situations in life. She is just different.

Having to react the way she does may be because of her beliefs, physical environmental influences, cultural environmental influences, as well as social environmental influences. People react according to the way their psychological, social, physical, cultural, and other environments around shape them. Ms. Vegas may have been brought up in a society where talking about one’s problems is a disgrace. This explains her silence with her problem for long. Ms. Vegas may have developed a different cognitive mechanism, based on her experience from childhood to adulthood, and now in marriage.

Her social and cultural lives have shaped her mechanisms to make her react vigorously the way she does. It is only Ms. Vegas who understands why she thinks of previous experiences. It is only her who knows why her uncle’s face appears when she goes into violent reactions, and it is only her who can explain what she connects in her memory to react in such a manner.

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