Persistent Depressive Disorder Case Study

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The Case of Susan Domain 1: Persistent Depressive Disorder Domain 2: None Domain 3: None Domain 4: GAF = 70-61 Rationale for Domain 1: Domain 1: The individual presents with a history of depression which appears to meet the criteria for persistent depressive disorder because of its occurrence for the last couple of years. It was suggested that she was to see a psychiatrist but her husband as well as her health care provider during a routine checkup. She reported getting little sleep, believing it was normal because she has not been a good sleeper for some time. Due to the lack of sleep, she is constantly tired and fatigued. During her session, she did mention that there were not times where she was very happy. There were times were she felt…show more content…
Once that term was noticed, she began to fit under major depressive disorder. Her symptoms where very similar (i.e. insomnia, overeating, fatigue, constant depressed mood, ect.), but I did notice at the beginning of her session that she has been having these symptoms for a couple years. If she did go into the clinic earlier, she may have been first diagnosed with major depressive disorder. She also had similar symptoms (at first) to bipolar disorder. She had a history of at least one major depressive episode and these episodes where creating significant distress. The main factor that ruled out both bipolar I and bipolar II disorder was the fact that she did not have any manic episodes. She did state there were times were she felt “good”, but not in a manic state. The period of feeling “good” would not even constitute as a hypomanic episode because it only lasts a couple of hours, not a minimum of four days to a week eliminating the possibility of bipolar II disorder. Once I ruled out both bipolar disorders, the thought of cyclothymic disorder came into mind. She has had depressive symptoms for a minimum of 2 years, but there are rare period of feeling “good”. The description of her feeling “good” does not signify hypomanic symptoms and does not happen often. She does not have any ongoing substance use disorders and clearly stated that she did not want sleeping pills because…show more content…
The individual did say she was at one point prescribed Elavil, but discontinued use after it made her sleepy and did not ease the depression. Domain 3: She did not report any psychosocial or environmental problems. She stated that her life was not exactly a happy one, but no negative life event occurred to make her life an unhappy one. She has the support of her husband, and did not disclose any problems related to their relationship. There has been little difficulty with her job, and it appears as her job has been stable (without promotions or demotions). Throughout her session, it appears as if there are no significant psychosocial or environmental problems. Domain 4: The individual’s overall level of functioning during the clinical interview appears to be fairly high. The GAF rating was given because even with the high level of functioning during the interview, it appears to be consistent throughout her time outside of the clinic with no major impairment in the social context. She does appear to have some mild symptoms which include depressed mood and
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