29th January 2024

A 36-year-old office worker presents to the mental health team for assessment after complaining of fatigue

A 36-year-old office worker presents to the mental health team for assessment after complaining of fatigue and a lack of interest in her usual hobbies. She is currently on leave from work as she was finding it challenging to remain calm and often conflicted with her co-workers. She is well supported at home by her partner but describes being irritable with him, for which she feels guilty. She lies in bed watching TV until late at night, struggling to sleep and often wakes before her alarm.

She first noticed these issues a year ago, but they have worsened over the last 2 months.

She describes feeling ’empty,’ struggling to motivate herself to shower and admits to thoughts of dying but does not wish to act on these as she does not want to harm her family.

She has well-controlled asthma and remembers being admitted to a hospital at age 19 and again at 22 for feeling ‘very high’ and believing herself to be the Virgin Mary, although she cannot recall specific details beyond this. She was prescribed medication following this but has not been taking it for some time.

What is the most appropriate treatment for this patient?

Select the SINGLE most appropriate option from the list below. Select ONE option only.