Fifteen to twenty percent of Americans will experience major depression at some point during their lives. People aged 18 to 24 are most likely to have experienced it during the past thirty days. Major depression can happen at any point during one’s lifetime. Biological factors may predispose an individual to depression. A sense of helplessness, as well as an external locus of control also may be causal factors for Major Depressive Disorder (Gregiore & Kohn, 2010).
According to the American Psychiatric Association (1994), the following criteria must be met in order to receive a diagnosis of Major Depressive Disorder:
Five or more of the following must be present in the same two week period and constitute a change from previous functioning with at least one of the symptoms being depressed mood or loss of interest or pleasure.
- Depressed mood most of the day, nearly every day.
- Diminished interest or pleasure in most activities most of the day.
- Major weight loss or gain, or a decrease or increase in appetite nearly every day.
- Insomnia or hypersomnia nearly every day.
- Psychomotor agitation or retardation nearly every day.
- Fatigue or loss of energy nearly every day.
- Feelings of worthlessness or excessive, inappropriate guilt nearly every day.
- Diminished ability to think or concentrate.
- Recurrent thoughts of death, suicide, or suicide attempts.
These symptoms must cause significant distress or impairment in social, occupational, or other areas of functioning and are not due to a general medical condition or the effects of a substance such as medication or drug abuse.
- Briefly describe the client’s background.
Tara is a young woman who presented with enough symptoms to meet the criteria for Major Depressive Disorder. She can recall feeling depressed since at least the fourth grade, and even admits to hating her teachers and her family members. She was a self-described loner who “mostly kept to herself and felt angry and sad” (Gregiore & Kohn, 2010). Things worsened during high school, when Tara’s boyfriend died. She descended into a deep darkness, sleeping most of the day, eating little, and having recurring thoughts of suicide. Tara’s depression persisted throughout college. She made several suicide attempts and was hospitalized. It was during that time Tara was diagnosed with Major Depression.
During adulthood, Tara has made several more suicide attempts. She has been hospitalized several times, on both a voluntary and involuntary basis. She has been treated for Major Depression with therapy and medication, and most recently, with electroconvulsive therapy. Tara has been able to sustain employment as a drug abuse counselor, although she does so reflexively with no emotional involvement. Tara engages in no outside activities and has no interests with the exception of an occasional shopping trip after work. She is not involved in any significant relationships, although she does maintain contact with family members.
References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC: Author.
University of Phoenix. (2007). Faces Interactive [Computer Software]. Retrieved from University of Phoenix, Simulation, PSYCH515 - Abnormal Psychology website.
