A Case Study of the Signs of major Depressive Disorder

M shows some signs of the major depressive disorder. M has been experiencing intense sadness without any real cause which is causing her to feel overwhelmed and perplexed. The most recent incident was when a dish fell on the floor and broke which led her to sit on the floor, hit the floor with her fist, and cry. She stopped crying when she became startled at the fact that her hand was bleeding from pounding the broken glass. She then went into her car to go to work, when she began to cry again for no reason. She eventually called in sick to work. Mrs. M”s intense sadness, the above being one example is a symptom of a major depressive disorder.

Mrs. M has also been experiencing melancholic features such as a loss of interest in activities that are usually pleasurable. She has withdrawn herself from activities with her children, leaving the job to her husband. She has also withdrawn from her social contacts at work, no longer eating with her colleagues, but being alone as often as she can. Her usual close to infallible work performance has decreased having several mistakes. Mrs. M”s lack of motivation and companionship are also signs of the major depressive disorder. Mrs. M has also been under some stress at work within the past week. Her boss has become fairly demanding and short with her. In addition, Mrs. M has picked up several new responsibilities from a former paralegal. All of these stressors could have triggered the depression.

To further investigate my hypothesis, I questioned Mrs. M on her physical well being during the past four to six weeks. Mrs. M said that she has lost ten to fifteen pounds and seems to be tired all the time. She was confused as to why she was always tired because she was getting a lot more sleep than usual. Mrs. M may be suffering from hypersomnia, which is also a symptom of major depression.

I was very curious about the comment made about wanting to “run away” or “get away from it all.” When I questioned her about this, Mrs. M stated that she was ashamed of feeling sad all the time and is frustrated with her poor work performance. She gets distracted very easily at work and her constant desire to go to sleep does not help. She wants to go away where she can be by herself and not be a negative influence or burden on anyone else”s life. She is determined that she has ruined the lives of her children and her husband. Although she wants very much to return to her “old self,” she feels that this is impossible.

To further prove my hypothesis I asked Mrs. M about her family history of mental illness since mood disorders greatly involve genetics. Mrs. M stated that her mother was often on antidepressants when she was a child. She often heard her parents talking about it. This is a very important piece of information. In families in which one parent has a mood disorder, approximately 30% of the children are at risk of developing a disorder.

Mrs. M has been experiencing seven of the nine diagnostic features of a major depressive episode. Her symptoms are not part of a mixed episode and are not attributed to a medical condition, use of a substance, or bereavement. The symptoms are causing significant distress and impairment. Because of all of these symptoms, I feel confident that my hypothesis is correct in diagnosing Mrs. M with the major depressive disorder.

There are many etiologies for this disorder. The catecholamine hypothesis states that a relative shortage of norepinephrine causes depression. Clinical evidence suggested that people who take certain antihypertensive medications become depressed, presumably because the drug depletes the levels of norepinephrine and other catecholamines. Another hypothesis is the indolamine hypothesis, which states that a deficiency of serotonin contributes to the behavioral symptoms of depression. The processes that cause a deficiency of serotonin are thought to be similar to those that cause norepinephrine deficits.

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