Case 5: Major Depressive Disorder
Case Studies in Abnormal Psychology
Gorenstein & Comer, 2015
DSM Application (10 points): List the DSM criteria for Major Depressive Disorder. Next to each criterion, detail the specific symptoms that match.
Major Depressive Episode:
1. For a 2 week period, person displays an increase in depressed mood for the majority of each day and/or a decrease in enjoyment or interest across most activities for the majority of each day.
2. For the same two weeks, person also expiriences at least 3 or 4 of the following symptoms: Considerable weight or appetite change, daily insomnia or hypersomnia, daily agigtaion or decrease in mootr activity, daily fatigue or lethargy, daily feelings of worthlessness or excessive guilt, daily reduction in concentration or decisiveness, repeated focus on death or suicide, a suicide plan, or a suicide attempt.
3. Significant distress or impairment.
Major Depressive Disorder:
1. Presence of a major depressive episodes.
a. Carlos: feelings of despair, poor concentration, difficulty sleeping, loss of interest in activities, and tearfulness that lasted several weeks before seeing a psychologist.
2. No pattern of mania or hypomania.
a. Carlos: did not display mania or hypomania.
Assessment Questions (6 @ 5 points each):
#1: What are the first signs that a person might be depressed?
There are many signs of depression. In Carlos’s case, he began to ruminate and worry on possible health issues. This brought him to an overwhelmeing sense of despair where he would subsequently begin to cry. Next, he lost interest in his home life and work activities and told his wife that he could no longer be of help to her and the children which also indicates withdrawal.
#4: Why did Dr. Willard recommend a psychiatrist?
Dr. Willard recommended a psychiatrist because he thought Carlos would benefit from psychiatric drugs like antidepressants.
#9: What were the criteria for Carlos’s diagnosis of major depressive disorder?
Carlos met the DSM criteria for major depressive disorder. These criteria included the presence of a major depressive episode. Within those episodes, Carlos reported symptoms of feelings of despair, poor concentration, difficulty sleeping, loss of interest in usual activities, and tearfulness.
#10: What are some of the concentrated methods that must be used to rid depressed persons of their cognitive bias?
A large part of the treatment plan seemed to be cognitive behavioral therapy (CBT). In CBT, concentrated methods include time spent in determining the areas of Carlos’s thinking and behavior that were contributing to the depressive episodes that Carlos was having. To alleviate symptoms, Carlos would monitor his thoughts and emotional reactions to environmental stimuli and also take data on their intensity. During sessions, the psychologist and Carlos would review the data and then discuss the degree of reality to which Carlos’s thoughts met reality. Later in treatment, a behavioral aspect was added in which Carlos was expected to engage his family members and old work habits more and more. The behavioral component helped to reinforce the reality of Dr. Walden’s suggestions about how poor thinking habits rob Carlos of truth.
#12: What was the first assignment Carlos was given for the first week of therapy?
The first assignment that Carlos was given was to monitor his thoughts and emotional reactions and then record which thoughts and emotions produced distress. He was also to record their intensity. In addition, Carlos was to record his activities.
#13: Why did Dr. Walton want Carlos on medication as well as the cognitive therapy approach?
Dr. Walden wanted medication and cognitive therapy as a part of the treatment plan because according to research, 60% of patients respond favorably to cognitive therapy. Similarily, 60% of patients respond well to antidepressents. When combined however, the results appear to be more effective.
Bible Application Question (10 points, 50 word minimum): Discuss this case and disorder from a biblical perspective using at least 1 Scripture reference (direct quotes do not count towards length requirement).
“Whether you find yourself at a funeral or just in the middle of everyday life, self-centeredness can turn anything into a crisis” (Wommack, 2012, p. 1). Being totally consumed with the self leads to many behaviors and thinking styles that develop into depression where many small matters become giant obstacles. This type of thinking does not reflect reality in the world nor does it reflect God’s truth for who people are under the blood of Jesus. Depression is a self-preservation tool that people use when they are threatened by what they perceive to be reality. It is a way of removing responsibility from the self and onto an illness, another person, or circumstance. When one uses depression as a way of protecting the self from one negative happenstance or another, they are essentially removing God from the equation and saying that they can go about life on their own. Jesus clearly states that we cannot do anything on our own (John 15:5, NIV), therefore it is quite sinful to be so selfish as to think that self-preservation works to the glory of God. Rumination, withdrawal, and negative self -talk for example, are all ways of avoiding reality and protecting the self from a perceived crisis. Instead, “but seek first the kingdom of God and his righteousness, and all these things will be added to you (Matthew 6:33, ESV). Focus must be on God and others. Needs are then added as a byproduct of trust in the Lord.
Wommack, A. (2012). Self-centeredness: The source of all grief. Colorado Springs, CO: Andrew Wommack Ministries.