Depression Case Study: Saving a 32-Year-Old from Depression
History or Cause:
The patient faced significant challenges in life. He experienced the death of a loved one and his wife even filed for divorce at one point in time. He did not receive adequate emotional support which led to depression.
Diagnosis:
The patient was diagnosed with Clinical Depression. He suffered from severe but the most common kind of depression as a prolonged phase of sadness and hopelessness marked it.
The duration of these emotions lasted more than 4 weeks. Other symptoms reported by him were loss of appetite and an altered sleeping pattern. The patient also reported intermittent headaches and experienced a lack of focus at work as he also felt restless.
To further determine the severity of the problem, the patient was assessed using a standard screening tool. A Patient Health Questionnaire-9 or PHQ-9 screening tool was used to assess the situation. Based on DSM-5, psychologists and psychiatrists asked 9 questions to the patient corresponding to the following symptoms:
- Low mood
- Loss of interest
- Sleep pattern
- Fatigue
- Weak concentration
- Inflicting self-harm
Mental health professionals use these parameters to score and determine the severity of depression. It is also helpful in monitoring the progress and guiding professionals in treatment decisions. In this case, the initial PHQ-9 score was 22/27 which indicated severe depression.
Treatment:
Approach: Holistic rehabilitation program as it included therapy, prescription of medicine and a balanced diet. The treatment included Psychotherapy, or talk therapy along with the introduction of lifestyle changes like practising yoga and meditating.
Since the patient took the initiative to report his illness independently, therapists encouraged him to discuss his emotions and challenges openly to learn the patient’s point of view of the condition.
Program:
1. Cognitive-Behavioural Therapy
- The patient was administered Cognitive Behavioural Therapy (CBT) and Interpersonal Therapy. The aim of the therapist was to trace the origin and help a patient identify negative thoughts to improve interpersonal relationships.
- Patients generally begin managing stress independently after therapy sessions are complete. In this case, CBT targeted the patient’s grief and divorce trauma. The main targets were hopelessness and distorted negative work thoughts.
- He was also trained to build coping skills for restlessness and alter behaviours that worsen these symptoms. Weekly 50-minute sessions over 12 weeks targeted at cognitive distortions were attended by the patient religiously.
2. Group Therapy Sessions
- Diagnosis of depression involves a detailed analysis of symptoms by experts at Calida Rehab Centre. Doctors began by understanding the patient’s routine.
- Time of meals was documented and his sleeping patterns were also analysed. For instance, the number of alarms set by the patients and the average duration of sleep were also analysed.
- Gradually, the therapists started documenting the frequency of mood swings and tried to recognise the triggers as well. Patients who are slow or feel low generally are interviewed thoroughly.
- Doctors seek a detailed report of their daily functioning, sleep cycle and appetite. Doctors may opt for screening tools like questionnaires and interviews for standardised assessments. The aim is to achieve an accurate diagnosis to understand the severity of the illness.
3.Medical Treatments:
- Since depression is commonly treated with medication and psychotherapy, the patient was also prescribed anti-anxiety medication.
- Treatment options further included SSRIs and SNRIs.
- Atypical antidepressants, tricyclics and MAOIs were also prescribed because they offer certain benefits.
However, the dosage of the patient was slowly reduced to avoid any dependence issues.
Improvements/Recovery Timeline:
Week 1-2: The patient showed extreme emotional vulnerability and societal pressure. Physical symptoms like headaches and mild brain fog as a result of altered sleep patterns were evident. He was closely monitored by medical professionals who worked closely with lifestyle experts who tried to re-establish a proper routine. This phase prepared the patient mentally and physically for deeper therapeutic interventions in the coming weeks.
Week 3-4: Introduction to structured therapy sessions at this stage helped therapists to explore emotional stress and suppressed trauma. Group and family therapy sessions were also initiated to rebuild communication skills. Coping strategies were initiated as the patient developed a rapport with the therapist. The patient experienced occasional emotional upheavals but the groundwork for a long-term recovery and positive change was laid.
Week 5-8: A remarkable improvement in emotional stability and daily functioning was noticed. CBT helped challenge negative thoughts to which the response of the patient was positive. The patient actively participated in sessions and began applying learned strategies in routine to manage triggers. The patient willingly demonstrated resilience and a growing commitment to recovery.
By the end of the eighth week, the patient’s PHQ-9 improved to 10.
Week 9-12: The patient showed remarkable emotional balance and independence. Triggers were recognised in advance and managed accordingly. Confidence and self-awareness further added to the restoration of his personality.
By the end of week 12, the patient’s PHQ-9 further came down to 4/27; sustained remission was also confirmed.
Our Success:
- Impact on Patient’s Life: The patient regained control over his life. He was able to resume work and return to work with an improved focus. Since his sleep pattern showed improvement, his remaining health parameters also got better. For instance, his blood pressure and blood sugar levels seemed to be more in control. His decision-making skills had improved and he was able to manage stress independently as he was following his exercise and diet regimen religiously.
- Family and Community: The patient was working on rebuilding trust with family independently. He voluntarily created an Instagram page to talk about this mental illness to engage the community. He is now helping people overcome ordeals in life and encourages them to seek professional help. This online group includes people from multiple age groups. Some are young, old, financially stable and even those who
● Future Steps: Continued outpatient therapy is encouraged in this patient’s case because he is working in a corporate environment. His participation in alumni support groups is active. This was done by the patient voluntarily as he wants to maintain a positive mindset.