Biological Considerations in Mental Health and Mental Illness for Advanced Practice

The physical health problems are considered to be a major issue for the patient as it increases the complication for the patient by decreasing the functionality of the patient. The physical health issue leads to the poor capacity of the individual to perform the daily task which leads to poor social life and deteriorated health (Harris, 2018). Mental illness is the state when the individual encountered the issue that directly decreased the mental wellbeing and increase behavioral issue in the patient. Mental health stability is very important to improve the overall wellbeing of the patient but mental illness increase the risk for deteriorated mental health which can lead to poor health outcome (Malla et al ., 2015). Diabetes mellitus is one of the major non-communicable disorders that occur due to the chronic hyperglycemia state that leads to an increase in blood glucose levels. Two types of diabetes increase complications for the patient it includes type 1 and 2. The prevalence of type 2 diabetes reveals that around 14 million population are affected by diabetes mellitus type 2 that increases the complication of the patient (Kharroubi, 2015). The patient with type 2 diabetes increases risk for the mental health issue and depression is one of the most issues due to the poor health state. Depression leads to a deteriorated mental state which directly increases social isolation and decreases the interaction of the individual with the surrounding population (Das et al., 2013). The case study is about a 70-year-old individual diagnosed with diabetes one year ago that has increased his complication and recently after his wife died he is facing a mental health issue. The essay is going to present a case study related to the co-morbid physical health problems with mental illness by reflecting on its different aspects and will provide nursing intervention. 

Jack a 72-year-old individual and he has recently visited his general practitioner because of the issue he is facing due to poor physical health. He complains about his fatigue, blurred vision, and numbness in the lower extremities which have hampered his daily activity and he is also facing depressive episodes. After the assessment, it was revealed that he has complete his post-graduation from the prestigious university and currently has been retired from his past job that leads to a sedentary lifestyle. His family history reveals that his wife died due to cardiac arrest six months ago after which he is a coping thing solely. He is now living alone in the apartment and some friend around he visits his friends on weekends for the get-together. Jack explained that after his wife died he doesn’t feel right and continuously feel depressive that also decrease his social presence as he prefers to remain isolated. After the mental health assessment, it was revealed that Jack is facing mental health issues which have led to his low self-esteem and social isolation which is deteriorating his mental wellbeing. The medical history of the patient indicates that he has been diagnosed with diabetes one year ago along with obesity. He has been using metformin to maintain his blood glucose level normal but he is unable to be adhering to the right medication dose that has increased his complication. The personal information of the patient revealed that he is the habit of smoking with occasional drinking on regular basis but after retirement, he is spending his whole day at home. The current issue that has increased jack complication is due to the deteriorated physical health that has been added with the depression to increase overall complication.

Diabetes has been associated with a major physical health problem as it directly disturbed the metabolism of the body which lead to a hyperglycaemic state. The inconsistency in the insulin amount in the body leads to the hampered glucose metabolism cycle which leads to an increase in the level of blood glucose level in the body that increase complication for the patient. 90% of all the cases related to diabetes are type 2 diabetes mellitus that occur due to the insulin diminished effect that is defined as insulin resistance. The prevalence of type 2 diabetes mellitus is more in older individuals as compared to young individuals. Type 2 diabetes mellitus is an insulin resistance state which occurs due to beta-cell dysfunction. The dysfunction of the beta-cell leads to poor regulation of insulin secretion which alters the glucose homeostasis which causes the patient to be in a hyperglycemia state (Goyal & Jialal, 2020). Different risk factors directly increase the risk for type 2 diabetes mellitus in the patient and these factors can be personal, environmental, or genetically. One of the risk factors that lead to an increased risk for type 2 diabetes mellitus is increasing age that leads to the poor metabolism of the individual. Another risk factor that leads to the increasing prevalence of type2 diabetes mellitus is the medical history of obesity which directly increases the burden over the body's metabolic process. Family history also contributes to the increased chances that the individual will encounter type 2 diabetes. A sedentary lifestyle also added the complication for the patient which eventually led to the increased chances for the occurrence of diabetes mellitus. Unhealthy eating habits and pancreatic disorder also are some other risk factors for the prevalence of type 2 diabetes mellitus in the patient (Begic et al., 2016).

The type 2 diabetes mellitus greatly impact the individual as it leads to the deteriorated physical health and increases complication that leads to an increase in the need for medical assistance. The increase blood glucose level that is the major complication of the type 2 diabetes mellitus leads to the poisoning effect over the different organ and eventually decrease right functioning. The increased blood glucose level harms the different organs and it eventually acts as a risk factor for multiple disorders. One of the negative impacts of the increased blood glucose level is on the pancreases as it leads to lipotoxicity, dysfunctional proteasome, and ER stress which increase complication. The liver is also negatively affected by the increase in blood glucose level that leads to the cirrhosis or liver failure that increase patient complication. In the intestine of the patient with the type 2 diabetes also face negative episode that includes leaky gut or gut microbiota dysbiosis which lead to poor individual state. Blood vessels are also affected by the increased blood glucose level that includes disruption of the vascular homeostasis, induces micro or macro angiopathies, and increase atherosclerotic plaques formation (Daryabor, et al., 2020). These factors can negatively impact the individual leading to increase complications like Jack is facing issues with the vision. 

There are pharmacological and non-pharmacological treatment options that can be adopted to improve the individual physical health and help to decrease the complication related to type 2 diabetes. One of the studies presented by Thrasher, (2017) discussed the pharmacological treatment option that utilizes the medication to control the blood glucose level of the patient which eventually decreases the health complication. Different noninsulin glucose-lowering agents are used to improve the individual condition and they belong to different classes of drugs. Some of the drugs include Albiglutide, Dulglutide, Exenatide, and Lixisenatide these belong to GLP-1 RAs and they work by activating the GLP-1 receptor which helps to improve insulin secretion and decrease glucose secretion to maintain the balance. Another drug class that has been used to improve the glucose level in the blood is SGLT 2 which includes Canagliflozin and Empagliflozin that work by inhibition of SGLT2 in the nephron that directly blocks the glucose reabsorption in the kidney.

On the other hand, the study presented by Forouhi et al. (2018) discussed the importance of dietary intervention in reducing the risk for elevated blood glucose levels and it helps to improve the balanced nutrition intake. The dietary approach includes helping the patient to understand the risky and profitable dietary material so that a proper diet can be maintained to improve the sugar intake. A balanced diet can help the individual to maintain the intake and expenditure of the different dietary components to improve the health status. A balanced diet includes the use of whole grain in the diet with improving the fruit and vegetable intake that is important to maintain the good health status of the patient with type 2 diabetes.

One of the major mental health illnesses that have been a burden over society is depression which increases lifetime complications for the patient. The data presented in the study indicate that around 25 % of the women currently facing issues due to depression and around 12% of men are affected by the prevalence of depression. The prevalence of depression decreases the quality of life of the individual and it increases lead to the negative behavior of the individual which causes the behavioral issue in the patient. Most of the cases that are related to depression are remain unscreened which increases the future complication for the patient due to elevated symptoms of the patient. The depression not only deteriorates the mental well-being of the patient but it holistically decreases the wellbeing of the patient which increases complications. The depression leads to a fluctuated mental state that leads to sadness, loss of interest, and behavioral issue which eventually increase complications for the patient (Wang et al., 2017).

Different risk factors lead to the increased risk for the prevalence of depression and thus for the diagnosis consideration of these factors is also important. One of the factors that increase the risk of depression is genetic as the family history of depression increases the prevalence of depression in the individual. The brain chemistry imbalance can also lead to an increased risk for the prevalence of depression by increasing complications for the patient. The lack of right nutrition is also one of the risk factors that lead to the increased chances of the prevalence of depression. The presence of a physical health issue is also one of the reasons that increase the risk of the individual to encounter depression. Persistent stress is also a major contributing factor in the prevalence of depression which leads to a negative impact on the individual. Some other factors that lead to the increased risk for depression are environmental factors and lifestyle factors that lead to increased risk for mental illness (Razzak et al., 2019).

Depression has a negative impact over the physical as the well mental or social aspect of the patient as it directly decreases the wellbeing of the patient which lead to the poor patient outcome. One of the impacts of depression is the decreased dyspnoea score that directly reflects the patient face respiratory issue due to the shortness of breath. Another impact of the depression over the individual is reduced functional status that eventually leads to the isolation of the patient and it increases complications for the mental status of the patient (Beiko & Strange, 2019). Some other negative impact of the depression over the individual includes weight loss or gain that lead to increased risk for obesity or other complication. The vision of the individual is also impacted after the patient encountered depression. The immune system is also facing negative episodes due to the prevalence of depression which increases patient complications (Gu et al., 2017).

The pharmacological treatment option is considered to be more of the preferred treatment option for depression as it helps the patient to improve mental wellbeing. But the treatment options of the depression patient are framed concerning the patient symptoms and behavioral aspect. If the patient is facing mild depression then the treatment option should include a non-pharmacological treatment option that has no side effect and it improves the support with the patient. If the patient is facing issues due to depression that are higher than mild then a combination treatment option is preferred like antidepressants with psychotherapy to improve the patient's mental wellbeing. Some of the drugs that can help the patient in reducing the depressive symptoms include selective serotonin reuptake inhibitors, Contraindication of tricyclics, Milnacipran, Mianserin, Agomelatine, and Mirtazapine. Some other drugs that can help the patient in the care include Olanzapine, thyroid hormone, Lithium, Risperidone, and Antipsychotic agent (Gabriel et al., 2020).

The non-pharmacological option that can help to reduce the complication linked with depression includes Psychodynamic therapy (PDT). The therapy session will follow the holistic approach that helps the individual to improve their mental and emotional processing of the individual. The therapist will help the patient to understand the importance of their lives and identify the present-day problems that are required to be addressed to decrease complications for the patient. It helps the patient to decrease the negative behavior that is linked with the patient's depressive episode and it improves the individual thinking ability to improve individual mental health. The Psychodynamic therapy session will help the individual to connect with the therapist to understand the different aspects of a positive thing and develop the skills that are important to support the mental wellbeing of the patient by improving their self-efficiency to deal with fluctuated mental health (Fonagy, 2015).





Increase blood glucose level

· To improve the insulin amount in the body

· To decrease the complication linked with diabetes

· To maintain the blood glucose level to normal range

· An educational intervention to improve the medication adherence of the patient can help to improve the blood glucose level of the patient.

· Self-management intervention is important to help the individual in improving the skill that is important to routinely monitor blood glucose levels and reduce the fluctuation of health status.

The study presented by Witry et al. (2017) added that lack of medication adherence can increase complications for the patient. The educational intervention will help to aware of the patient concerning the importance of medication and potential side effects to improve the knowledge.

Cani et al. (2015) discussed that self-management intervention is important for diabetic patient as it helps to individual ability to deal with fluctuated blood glucose levels and continuously monitor the blood glucose level to keep track which is important to understand the health status.


· Better though the process of the patient

· Decreased isolation of the patient

· The better social presence of the patient.

· Cognitive-behavioral therapy is considered to be one of the most-popular non-pharmacological interventions that improve the thought process of the individual.

· Social intervention is also one of the methods that can help to improve the individual social presence as loneliness is one of the factors of depression that need to be reduced.

The study presented by Gautam et al. (2020) added that cognitive-behavioral therapy is important for patients facing the psychological issue as it helps to improve the thought process that will reduce the symptoms of the patient. Cognitive-behavioral therapy helps to reduce the risk of recurrence and improve individual ability to deal with the issue.

Nagy & Moore, (2017) added that social intervention is important to improve the participation of the individual at the community level by engaging in different community groups that reduce the isolated state of the patient.


· Decreased dependency on alcohol

· Better commitment to quit alcohol

The counseling sessions will help the patient to effectively understand the different aspects of alcohol over the health of the patient.

· Educational intervention can also be adopted by the health care professional to support patient dependency on alcohol.

One of the studies presented by Kelly et al. (2017) added that counseling session helps the health care professional to develop a rapport with the patient to improve the understanding concerning the issue linked with the alcohol consumption and strategies that can help the patient to decrease dependency over the alcohol.

One of the studies presented by Barnes et al. (2017) added that patient-provided educational intervention can help the patient to understand the importance of the negative effect of alcohol on the patient health and possible complication that can arise in daily consumption of alcohol. The educational intervention will help to support the patient's thinking ability to quit the alcohol by analyzing all the different aspects of the health.

The essay can be concluded that Jack has facing physical health issues due to unmanaged diabetes which has been diagnosed one year ago. Jack's case study reveals that he is facing an issue due to her medical history and current decrease in mental wellbeing that need urgent attention. The current issue he is facing is depression after his wife's death which has eventually led to a poor mental and physical state. Type two diabetes increase complication for the patient as it deteriorates the physical health that includes fatigue, poor diet, or increase urination and it also increases complications for other diseases due to its negative impact on the different organ systems. Type2 diabetes negatively impacts the individual as it increases the functional complication for the pancreas, liver, intestine, and blood vessel. The two treatment option that can be adopted to improve the health of the patient includes pharmacological therapy and dietary intervention to support the patient. Depression is a psychological issue that leads to a negative impact on the mental well-being of the patient and eventually deteriorated the health status of the patient. There is a different risk factor that increases the prevalence rate which includes family history, misbalanced brain chemistry, and stress. Depression has a major impact on the individual and eventually deteriorated the physical as well as mental wellbeing of the patient. Both of these issues have increase complications for Jack due to their impact on physical and mental health. Some of the issues that have been identified in the case study of Jack are increased blood glucose level, depression, and alcohol use of the patient. Different interventions can help the patient to improve their health status by increasing adherence to the care and improving lifestyle by attending the different sessions. These interventions will help to empower the patient which eventually reduces their health-related complication which is increasing physical health issues for the patient.

Reference for Physical Health Problems

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