Consider the following problems:

1) A 26 year old mother comes to see you because her 3 month old daughter seems to be awake half 
the night. When you discuss the problem, she becomes distressed and tearful as she talks about 
her own lack of sleep. She is worried that she may harm the baby and tells you of her fears that 
she may smother her.


How do you manage the problem?


2) Two weeks after her husband has died suddenly of a heart attack, Mrs Smith (aged 55) comes to 
ask for something to help her depression. She feels desperate. Life has no meaning any more and 
she might as well be dead too. She cannot face the future alone.

How can you help?


3) A 63 year old farmer is brought to see you by his daughter.  The whole family are terribly 
worried about him because he seems to have lost all interest in his work.  He sits in his chair 
wringing his hands and ruminating about the mistakes he has made in his life. He is obsessed by 
the bad news in  the newspapers.

How do you manage him?


4)   When might you:

Consider that a patient is unhappy but not depressed?

Use low-dose flupenthixol (1mg daily)?

Suspect depression in a patient who does not seem overtly depressed?

Refer a depressed patient to a psychiatrist?

Invoke Section 4 of the Mental Health Act?  Or Section 2 of the Mental Health Act?

Use a S.S.R.I?

Use a tricyclic anti-depressant?

Suggest St John's Wort




                                       Tutorial supplied by Andrew Crawshaw - 1998 - Mevagissey










The Cornwall Trainers' Web Site is maintained by Andrew Crawshaw - 
contact address: Crawshaws@aol.com Mevagissey