Hadley appears casually dressed, groomed, and alert. She is cooperative during the interview. Her speech is quiet and calm, and her mood seems low. She reports that she is tired because she has not been sleeping very well. She frequently stays up until three or four in the morning on most nights, even if she has school or work the next day. This makes her have a lack of energy during the day, so on her down times between class or work, she sleeps for hours at a time. Hadley has gained about thirty pounds over the last several months. This has made her self esteem drop. She realizes there is something wrong, because she has recently seen her sister go through a similar battle after a miscarriage.
The client is frustrated with her current situation. She goes to school, lives at home with her parents, and does not have much of a social life. Hadley struggles with getting up and getting herself moving in the mornings and has said that some days she “would rather lay in bed all day.” She lacks enthusiasm for her education, which has led to several dropped or failed courses, putting her behind most of her friends for graduation. The client feels that she needs direction.
The depression and energy loss has been severe for the past two or three months. She missed the first two weeks of school, because she would not get out of bed. Her classes begin after her parents have left for work, so they do not know about her current problem. The dishonesty from her parents leaves the client ashamed. She doesn’t like to lie to them, but she does not know how to tell them what is wrong. Hadley feels that she should be further along in school and is embarrassed about living with her parents. Her weight gain and lack of self-esteem have made her lose or avoid contact with many friends. The client began to notice a change in her behavior three years ago, when she first started college, but never received help because the feelings “went away.” Since she has moved back home two years ago, Hadley noticed the depression gradually getting worse.
Hadley is confused as to what brought on her depression, but knows that it can be biological and even genetic. In her mind, depression occurs when a traumatic event has happened. She states that nothing really happened to her, other than suddenly losing her grandmother in high school, but she pushes that aside and says she knows that “it shouldn’t be a big deal.” The client seems to be used to belittling her feelings and putting herself down, like they should not matter. She says she knows “there are so many other people with ‘real problems’ and they get through them” and she feels bad for letting her situation have such an effect on her. Since this problem has gotten worse, Hadley’s grades have dropped dramatically from being on the Dean’s List to being on academic probation. The client’s increase in weight and drop in self-esteem have also been consequences of her depression.
Hadley has thought of some ideas that could help her out of her “rut.” She used to be active in the young adult program at her church, and has thought about rejoining it. She also expressed her love of singing and has thought about joining the church choir. As for her weight, she is knowledgeable about health and fitness, but she does not act on her knowledge. The client has a very strong support system in her family, especially her two sisters and her cousins, who are around her age. She could use a stronger support system outside of her family and a more active social life.
The client has many skills. She is very intelligent and has proven that she can do well in school when she tries. She enjoys herself when she is around people, but recently, she has stopped putting herself in situations with peers her own age. Hadley describes herself as a natural extrovert, but lately, she has made herself more introverted because she is self conscious of her looks and does not want to be judged for being behind in school. She is at the appropriate level developmentally, but she seems to be struggling with intimacy. Instead, she is increasing her isolation.
Hadley is struggling with depression and seems to be lacking in direction. She has the capability to do well and succeed in school and her social life, but lacks the energy and enthusiasm to get her to where she needs to be. She has gained weight and plans on losing it, in order to boost her self-confidence. She is aware that she needs to change, but will need assistance helping her get there. Hadley is open to speaking with a psychiatrist about the possibility of being out on medication to improve her mood and discuss some coping techniques for the future.
Hadley and I discussed a set of goals for her to work on before our next session, so she will have two to three weeks to either begin them or get information on them, depending on the goal.
- Hadley will work on her health:
- She will plan on joining the exercise class that her friend invited her to.
- She will begin planning meals with her family so they don’t have to eat so late.
- She will begin a food and exercise journal
- She will make a list of positive attributes about herself.
- Hadley will work on being more honest with her family:
- She will tell her parents the truth about her missed classes.
- In the future, if she has a problem or is feeling depressed, she will try to be more honest about it. She needs to realize that her family cares about her problems, no matter how minor she thinks they are.
- Hadley will work on being more socially active:
- She will rejoin her youth group at church.
- She will get information on how to join the church choir.
