Shane was a 51-year-old woman who was brought to the emergency room by her husband. She said, “I feel like killing myself.” She had lost her interest in life about four months before. During that time, she reported depression every day for most of the day. Symptoms had been getting worse for months. She had lost 14 pounds without dieting because she did not feel like eating. She had trouble falling asleep almost every night and woke at 3:00 a.m. several mornings a week (she normally woke at 6:30 a.m.). She had low energy, trouble staying focused and less ability to do her office job at a dog food-processing plant. She was convinced that she had made a mistake that would lead to the deaths of thousands of dogs. She expected that she would soon be arrested and would rather kill herself than go to prison.
Both of her parents, her brother, and her sister suffered from depression. A maternal aunt suffered from dementia. Her mother also struggled with alcohol abuse until her death from emphysema in 2004 at the age of 89. At the time of referral, she was taking fluoxetine, 40 mg, and venlafaxine, 37.5 mg, prescribed by a pyshiatrist. Shane showed all nine symptoms of major depression for at least two weeks: depressed mood, loss of interest or pleasure, weight loss, insomnia, restlessness, loss of energy, extreme guilt, trouble staying focused and thoughts of suicide. Her doctor diagnosed her with major depressive disorder.
1) One psychotherapeutic activity and management applicable for MDD
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