A patient reports feelings of sadness and hopelessness along with difficulty sleeping and weight loss. The primary care NP learns that the patient's mother died 6 months earlier. The NP should:
a. offer a referral to a bereavement counselor.
b. begin pharmacologic treatment with fluoxetine.
c. determine whether medications are causing these symptoms.
d. tell the patient that these symptoms will go away in a few months.
A
Bereavement over the loss of a loved one may be associated with symptoms of major depression. Although only 17% of these patients receive pharmacologic treatment, 94% of symptoms have been found to resolve in 13 months or less. Bereavement counseling should be the first step. Pharmacologic treatment may be warranted if symptoms do not improve. This patient has a clear cause for depression. It is not enough to reassure the patient that the symptoms will resolve because this belittles their concerns.
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