ABNORMAL PSYCHOLOGY CASE SUMMARY
Table of Contents
The client is a 32-year-old woman, whose heterosexual, and presented on the first day with an overwhelming number of symptoms signifying increased depression. It is important to note that she has been fired from her one job. Jessica has a roommate and obligations such as rent as well as other bills to meet. Her history was clearly filled with marked depression. This began at an early age, in her early teens. At this time, the family doctor took the time to prescribe anti-depressants to manage her increasing shifts in moods. However, despite the prescription, the patient has described an increase in the consistency as well as the persistence of the symptoms over the years. Having a cousin, who committed suicide, validated the feelings that justified the possibility of suicide by hanging. In the past month, the condition of her depression has increased so much that she now has a very low appetite, losing more than 20pouns in a span of a few weeks. Despite the increase in depressive moods, the patient shows no symptoms of physical illness and in the same breath has denied the use of drugs.
There are several symptoms which were exhibited by the patiaboutd to the diagnosis. The first and most frequent of the symptoms was constant crying and prolonged periods of silence. During the sessions, the patient not only described periods of uncontrolled crying but in turn exhibited the same symptoms during conversations with the doctor. Consequently, she continually exhibited slow speech even with subjects that showed and had been of interest to her in the past. This was often followed by long periods of silence. Though comfortable in the silence, the prolonged periods were followed with continued crying jags which at the time were measured through uncontrolled sobs even when interesting subjects as indicated by the patient were the focus of the discussion.
A second symptom was described by the patient through her history. She described constant feelings of lowliness and worthlessness. When such moods struck, the patient indicated that they were unable to get out of bed. For years, the patient has encountered low-intensity depression which has been managed through constant intake of anti-depressants. Due to the intensity of hopelessness and frustration with the inability to cope with her mood swings, the patient not only entertained the possibility of suicide but in turn planned for the same.
Further, Jessica described the low energy periods which though in the past were shorter and shorter had recently prolonged to the point that she no longer felt productive. She described the scenarios where she was unable to move, and even get dressed due to periodic and prolonged periods of lethargy. Her physical appearance appeared to be haggard, and she showed little signs of caring about her own appearance. The patient admitted that she often felt that she was a burden to the people who cared about her including her roommate. The result was an intensity in the feelings of committing suicide through hanging since everyone else would be much better without her existence.
Finally, Jessica has completely lost her appetite. She had no interest in food even for their own basic existence. Due to the lack of appetite, the patient had lost more than 20 pounds already so that she is already underweight, condition which worsened her lethargy.
The diagnosis was done through observation as well as the pointed questions. There were four areas of diagnosis which were applied by the doctor:
Periods of constant mood swings: the patient was asked questionstions such; “do you experience constant periods of sadness”. The patient described the same feelings of constant sadness almost every day. Further questions such as problems or challenges in conducting normal tasks such as work and chores. Jessica showed the same symptoms not just periodically, but for long periods of time. Crystal et al. (2003) state that, depression diagnosis is based not just on the presence of fluctuating moods but rather the length of such fluctuation. Sadness is present in all humanity; it is the prolonged periods of sadness and loss which in turn hinder normal productivity that culminates in depression diagnosis. The patient feels hopeless for long periods of time so that they do not feel productive or even have the desire to be productive.
Loss of interest in normal activities: the patient displays a constant lack of interest in normal activities. Despite having pleasurable activities, such as hobbies and even normal work the patient has no normal interest in the same activities. Despite having the desire to enjoy the same activities, the patient participates and in turn, lacks the same interest and feelings of joy that they enjoyed in the past.
A major weight change: Constant lack of appetite and lack of interest in food has led to drastic loss of weight. The patient has lost more than 20 pounds which can be easily seen from the hanging clothes and the lack of structure I the body weight. Even aware of the increased loss of weight, the patient still shows little interest in food.
Recurring thoughts of death: Jessica has not only exhibited increased suicidal thoughts she also seems to have planned the way she wants to commit suicide. Jessica feels that the most ideal world is one in which she does not exist. She, therefore, has constant thoughts of death by hanging.
Although the above episodes may occur periodically, it is the constant recurring and longstanding. The symptoms are often precipitated by a lifetime event, which in this case has worsened an already existing condition. Whereas in the past, the patient exhibited low key depressive thoughts which were easily managed by the anti-depressants, after the suicide of her cousin the same symptoms became more persistent so that the patient feels that they can no longer manage the same thoughts. The above symptoms are also coupled with lab tests conducted on the blood of the patient. Such tests are only conducted to support already-established symptoms.
Use of anti-depressants: according to Alegría et al. (2008) psychotherapy works best in acute depression when combined with medication. It is important to note that in the past, medication has played a crucial role in managing the depression symptoms of the patient. Thus, with medium doses of medication, it is possible to manage the acute symptoms that are showing in the patient.
Psycho-therapy: constant monitoring and care are vital to ensure that the patient is managing and has developed proper coping strategies. There is the possibility of bigger and more traumatizing life events ahead (Fletcher, 2008). Without the proper coping mechanisms, likely, the patient will continually have to seek treatment, and there may be a time where treatment may not be available in good time. Psychotherapy, therefore, allows the patient to develop proper coping mechanisms for all life events which in turn makes treatment structures and processes more sustainable.
Alegría, M., Chatterji, P., Wells, K., Cao, Z., Chen, C. N., Takeuchi, D. & Meng, X. L. (2008). The disparity in depression treatment among racial and ethnic minority populations in the United States. Psychiatric Services, 59(11), 1264-1272.
Crystal, S., Sambamoorthi, U., Walkup, J. T., & Akıncıgil, A. (2003). Diagnosis and treatment of depression in the elderly Medicare population: predictors, disparities, and trends. Journal of the American Geriatrics Society, 51(12), 1718-1728.
Fletcher, J. M. (2008). Adolescent depression: diagnosis, treatment, and educational attainment. Health economics, 17(11), 1215-1235.