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A Case Study of a Patient Suffering from Major Depressive Disorder

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A Case Study of a Patient Suffering from Major Depressive Disorder

The patient is a 29-year-old White man who has been experiencing symptoms of

depression. He claimed he experienced daily weeping bouts, was always upset, could not sleep at

night, and was overeating. He said his sleep was disrupted since it took him many hours to take

naps most nights, that he could not fall asleep at all in some nights, and that if he did, he slept for

a few hours. He said he spent his time awake "worrying" as well as "thinking." He admitted that

a few of his concerns were feelings that he was not a good father and was a burden to his wife.

He stated that he was thinking about his paternal relatives and his unpleasant relationship with

them. He claimed that with the birth of his second child ten months ago, his depression had

increased. The patient expressed at the first interview process that he felt "fine, but always

down." The "all okay" reaction came quickly and almost instinctively. "Ever down," he

continued after a brief pause. He admitted that he was always wondering and fretting and also

that he felt "as if everybody was watching at me." He denied any suicidal actions or thoughts. He

admitted that it would be good to go away from his issues and knew he could not.

He said that depression had a significant impact on his life. He stated that it was impacting

his connection with his wife and children, for example. Second, he indicated that depression had

a social impact on him because it prevented him from attending family activities. He stated that

he could not work outside of his household and that this was affecting his finances. He expressed

dissatisfaction with himself, saying that he was not the man he intended to be and his sadness

was "ruining my life." Months after the birth of his second kid, he sought assistance for post-

partum depression six months ago. He claimed that he felt depressed after learning he would not

be able to provide for his family and that his depression worsened after the child was born. Often

a week, he remembered being exhausted, unhappy, and lacking energy throughout the early
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months. The Client shares a home with his 32-year-old wife, 12-year-old daughter, and ten-

month-old baby. The family has a house in a quiet neighborhood. The Client had no recollection

of any issues around his birth or perinatal history. He indicated that no strange happenings

happened during this time. He had no head injuries nor trauma, according to him. He stated that

he had no previous neurological issues. He said that he had no difficulties meeting his

developmental stages.

The Client recalls a tumultuous upbringing marked by a high level of stress and volatility.

While upbringing, he lived with his father, mom, and younger siblings. He said his parents often

fought, typically about his mother's alcoholism. His mother abandoned him and his family while

he was 11 years old, and she was gone for so many years. His mother, according to the patient,

was an alcoholic. His mother communicated with the kids by telephone but could not touch them

throughout this time. When the patient was 16 years old, his mother came to the family, and she

now lives with her husband and a younger sibling at home. After his mother came home to the

family, the Client reported that he still harbored significant feelings of bitterness and hatred

toward her. As a result of his homecoming, he began acting out and engaging in impulsive

actions. After and during high school, he recalls having a couple of significant girlfriends. He

previously revealed how he had dated a few "bad" young women in the past. They sounded

thrilling, but he recognized they were not the type of people he wanted to be around. He saw his

childhood as psychologically unsupportive and chaotic in general. He despised being forced to

play the role of a parent as a teenager. He admitted to having tremendous unresolved feelings of

frustration towards his mother, which he said still surface in their current relationship.
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Differential Diagnosis

The Client has symptoms that mirror those of a Major Depressive Disorder, as per the

DSM-IV-TR. Many activities have lost their appeal or joy. Sleeping patterns have shifted.

Weight, hunger, and activity levels, and also psychomotor exercise habits are all measured. He is

filled with emotions of inadequacy and guilt. He has trouble thinking and concentrating, which

hinders his capacity to make decisions. He claims he seems to have no suicidal thoughts, but he

does want to disappear to get away from his current predicament. For at least two weeks, these

symptoms have persisted for the majority of the day, each day. These symptoms are

accompanied by distress, resulting in social, professional, and other aspects of function. The

Client expresses his sadness and hopelessness. He frequently cries or thinks like sobbing. There

have also been outbursts of rage. Worry, anxiety, physical symptoms, and phobia have all

surfaced. Must first be demonstrated that perhaps the Client fits the criterion for the diagnosis

depressive episode before a diagnostic of Major Depressive Disorder can be assigned. At least 5

of the signs required to diagnose a severe depressive episode found present in the patient, and all

these symptoms persisted for more than two weeks.

The patient had a depressed mood for the majority of each day, almost every day.

Reduced interest and enjoyment in practically all tasks for most of the day, whether he was

gaining or losing weight; Insomnia is a common ailment. Each day, he suffered from exhaustion

and a decreased energy. Almost every day, feelings of inappropriate shame and hopelessness, as

well as indecisiveness and inability to focus. Criteria A for Major Depressive Disorder was met

since the patient fulfilled seven of the requirements for a Major Depressive Episode. "Symptoms

do not meet criteria for a Mixed Episode," (DSM IV-TR) according to Criteria B. He has never

admitted experiencing a manic or hypomanic deep depression; hence his signs do not fulfil this
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requirement. "Symptoms cause clinically significant distress or impairment in social,

occupational, or other crucial areas of functioning," (DSM IV-TR) according to Criteria C. His

signs caused his social problems. The "symptoms are not due to the direct physiological effects

of a chemical or a general medical condition," (DSM IV-TR) according to Criterion D. However,

this individual is in excellent health and denied using any drugs. "Symptoms are not better

explained for by grief," (DSM IV-TR) according to Criterion E. Bereavement is not the cause of

this patient's symptoms.

Because the patient has not been depressed in 2 years, the dysthymic disorder has been

ruled out. Manic episodes are not present; hence bipolar is ruled out. For a variety of factors,

Adjustment Disorder has been ruled out. It usually starts three months after the stressor has

occurred. This is not the case with this Client. The stress-related disruption does not match the

following specific axis illness criterion to be diagnosed with Adjustment Disorder. It meets the

requirements for a Major Depressive Episode in Reaction to stress in his case, which would be

more severe than an Adjustment Disorder. His family also has a background of mood disorders.

This diagnostic looks to be a good fit for this patient. As a result, "adjustment disorder" is not

applicable.