Rose has lost interest in activities that she used to enjoy such as playing in a local card game with other people from her area.  She says that she tries to do her housework, but is not as interested as before.  She does however, tell you that she enjoys the company of Jacinta.

Rose sleeps poorly at night and cannot get back to sleep if she dreams of Doris.  She finds that she gets a ”bit angry” with Jacinta at times and feels unhappy about this.  She finds it difficult to remember things compared to before.  She worries about Jacinta and fears for her safety at times.  Rose says that she feels sad and this becomes worse when she thinks of Doris.  Rose denies any thoughts of suicide.

Rose is prescribed SSRI antidepressant medication for her elevated anxious arousal and low mood.  You explain to Rose via Jacinta about your conclusions and what you are planning for treatment.  You also communicate your conclusions to the renal team and check that the medication is compatible with Rose’s current renal therapy.  You also recommend that an Aboriginal Mental Health Worker be used to liaise with Rose, Jacinta and the renal team to ensure cultural safety in the treatment of her condition.

Rose’s mood and anxiety levels improve with the antidepressant treatment.  She is experiencing fewer intrusive thoughts about Doris and the dreams are less frequent.  After a few review sessions in the company of Jacinta and an Aboriginal Mental Health Worker and you hand her treatment back to the renal team.