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A Case Study in Major Depressive Disorder, Recurrent Leanne came to the office because she stated that her depression had worsened in recent months and that she was feeling nervous and panicky almost daily.
She is 31 years old.
She noted that she was laid off about 18 months ago from her former job and was unemployed for one year. She found a new job in her field about six months ago, but she is making less money than she was even receiving from unemployment benefits. Leanne describes the living arrangement as difficult.
Leanne states that the house is too small to accommodate her belongings and she is storing things in her camper in the backyard. She misses her old house which was bigger and had a nice yard.
She also misses her dogs that live with her ex-husband.
She said that she feels like a long-term houseguest and that her presence is an intrusion. She found her former position to be stimulating and exciting.
Leanne feels that the job description misrepresented the actual duties and that she is basically fulfilling the obligations of a secretary, rather than a marketing professional. Diagnosis Leanne had symptoms that included all of the DSM-IV-TR criteria for an axis I diagnosis of major depressive episode, except weight change and psychomotor agitation.
Figure 1 below lists the criteria for a major depressive episode.
Axis II includes personality disorders and developmental disorders. Leanne does not fit the criteria for an Axis II diagnosis. Leanne has been regularly seen by her general practitioner and has no illnesses that would fit the criteria for an Axis III diagnosis.
Axis IV covers severity of psychosocial issues. Under this diagnostic section notation is made regarding problems with primary support group, educational issues, social environment problems, occupational problems, housing problems, economic problems and legal issues.
American Psychiatric Association, Leanne has marked disturbances with her support system recent divorcehousing living arrangement primary complainteducational stress from grad schoolsocial environment inadequate social supportoccupational job dissatisfactionhousing discord with tenancy arrangementand economic inadequate financial resources.
Axis V rates the level of functioning at its highest during the past year and where it is currently. This rating is done on a scale ofwith being superior functioning. Leanne presents with a current rating of 20, as she is functioning by going to work and attending class, but also having suicidal ideations and performance issues.
Her functioning has declined from a high of 75, where she was experiencing only minor symptoms of depression, but was not having functional issues related to it. One of the symptoms must be depressed mood or loss of interest.
Markedly diminished interest or pleasure in all or almost all activities. Psychomotor agitation or retardation. Fatigue or loss of energy.Faces Interactive (Abnormal Psych) Discipline Specific Topics.
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