“Sad and Lonely”

Bianca is a 32-year-old sales consultant for a local department store for the past 4 years. She is divorced with two young daughters, 6 and 9 years of age. She is being seen at the clinic for evaluation. The nurse notes a sad affect with no eye contact, no make-up and hair is messy and uncombed. Bianca is teary-eyed and states, “My husband not only left me alone in this world, but left me with all of the bills too. I just can’t do anymore!”

1. “What is the nurse’s best response at this point?”

2. What symptoms would support the health care provider’s diagnosis of depression?

3. What leading questions might encourage Bianca to continue talking?

4. The provider prescribes the antidepressant drug Escitalopram (Lexapro). What side effects may occur with this drug?