Mental Health

Mental Illness Case Study: Rebuilding a Life After Severe Depression and Anxiety at Jagruti Rehab

Written By

Jagruti Rehab

Last Updated on: 02 Jul 2025

Patient Information:

• Age: 28
• Gender: Male
• Background: The patient (referred to as Ravi to maintain anonymity) is a 28-year-old male patient who has been diagnosed with severe depression and anxiety consistently since the age of 20. He has a steady job as a software developer and lives on his own. Yet, his mental health difficulties have impacted all aspects of his life, including his social and professional life.
• Personal Situation: Ravi comes from an educated and privileged background. Ravi's family is emotionally supportive; however, growing up, Ravi experienced extensive academic and social pressure. It is suggested that this has produced excessive pressure on Ravi since childhood. Ravi's mental health difficulties were seen by age 17 during high school, but continued to worsen through early adulthood (approximately ages 20-22), and it was only after reaching his breaking point that he pursued professional support.

History or Cause:

Ravi began to experience mental health challenges around his late teens, and the pressure of achieving academically and socially affected his mental and emotional well-being. Ravi was high-functioning with a tendency to feel inadequate and suffering from perfectionism to the extent that he identified it as a cause of his feelings of worthlessness, which continued to amplify over the years. Despite achieving high levels of success as a software developer, Ravi experienced an ongoing sense of disconnection from those around him. Used to wearing a mask, he also lived with ongoing social anxiety. 

Ravi's mental health began to slip when he was around age 24, after a close friend died by suicide, and he was dealing with issues related to a relationship. When thinking about what he went through, he reported a deep sense of isolation and sadness that lasted for months. Ravi began experiencing panic attacks and was fatigued at work and beyond. 

Diagnosis:

Jagruti Rehab mental health professionals conducted an extensive evaluation of Ravi. Ravi's evaluation yielded four formal diagnoses. 

• Major Depressive Disorder (MDD): Ravi experienced persistent symptoms of sadness, hopelessness, worthlessness and was unable to enjoy any of the activities of daily living. Ravi's MDD severity was rated in the moderate to severe disability range.
• Generalised Anxiety Disorder (GAD): Ravi also experienced excessive and uncontrollable worry about numerous areas of his life, including his job, his social relationships, and his health. Ravi's anxiety produced physical symptoms, including heart palpitations and tightness and burning in his chest.
• Social Anxiety Disorder (SAD): Ravi experienced immense judgments or perceived judgments in social situations. The presence of these judgements caused Ravi to avoid them altogether, taking him further into isolation. 
• Panic Disorder: Ravi experienced a lot of panic attacks. The panic attacks occurred frequently, some relating to increased stressors in his life and others that occurred unexpectedly and made him feel and behave out of control. 

Ravi's diagnoses were consistent across multiple psychological tests, self-reports, and the clinical interviews conducted by Ravi's treating psychologist in Mumbai.

Treatment:

Given the seriousness of Ravi's depression and anxiety, an integrated approach was chosen to treat both his psychological and physical complaints. The intention was to help Ravi regain control over his emotions, develop confidence, and learn coping skills.

The treatment plan utilised at Jagruti Rehab was mainly designed around three key areas:

1. Cognitive Behavioural Therapy (CBT): To assist Ravi in identifying and re-coding his negative thought processes causing his depression and anxiety. The CBT approach has us disrupt and extinguish the negative feedback loop of self-criticism, catastrophizing, and automatic negative thinking.
2. Mindfulness and Relaxation Techniques: Given Ravi's level of experienced anxiety, we incorporated an aspect of deep-breathing exercises, progressive muscle relaxation and mindfulness meditation, which helped improve his anxiety symptoms and emotional regulation.
3. Group Therapy: Ravi engaged in group therapy sessions where others with similar experiences shared their life experience, coping strategies, and realities of living as people who experience mental health issues. The group experience provided Ravi with a sense of belonging and calmed his feelings of isolation.
4. Exposure Therapy: Ravi had social anxiety, so he had exposure to social situations that helped desensitise him to his fears and build his confidence.
5. Medication Management: Due to the severity of his symptoms, Ravi was prescribed medications that are selective serotonin reuptake inhibitors (SSRIs). These help regulate mood and lessen some of the physical symptoms of his anxiety. He was also given benzodiazepines for a short period to manage his panic attacks, but he was closely monitored while he took this medication.

Program:

The rehabilitation program for Ravi at Jagruti Rehab had manageable stages for gradual development:

• Week 1-2: Assessment and stabilisation. The priority was to relieve his anxiety and panic upon arrival using medication. He started daily sessions of cognitive behavioural therapy (CBT) to allow him to examine the negative thinking patterns that helped to support his anxiety and depression.
• Week 3-4: Began group therapy. During this week, Ravi began participating in group therapy with other clients once a week. Ravi began to reflect on this experience, especially how other clients dealt with similar challenges, behaviours, and coping strategies discussed during the group therapy attendance.
• Week 5-8: Continued personal CBT sessions. Completed the series of CBT sessions, and was now concentrating on reframing regular thought processes, developing healthy coping behaviours. Ravi's frequency of panic attacks began to decrease (which was also evident through self-report self-reflection), and self-report measures of anxiety level began to decrease.
• Week 9-12: By the first to second week of the 9-week review session, Ravi was starting to implement his newly learned coping skills effectively, and panic attacks were now almost removed altogether. He had made outstanding progress in alleviating depressive symptoms. 

Medical Treatments:

• SSRIs (Selective Serotonin Reuptake Inhibitors): These medications were trialled for Ravi with the hopes of stabilising levels of serotonin and thermoregulating mood swings.
• Benzodiazepines: These medications were used, on an as-needed basis, for severe panic attacks; however, within a few weeks, the individual was weaned off them.
• Sleep Aids: Were prescribed at a low dose for a short time to help with Ravi's insomnia, common for anxiety and depression.

Improvements/Recovery Timeline:

• Week 1-2: Ravi's acute anxiety symptoms were somewhat relieved using medications. He started to work through the therapy process, but continued to experience deep sadness and feelings of being disconnected and alone. His panic attacks did lessen as he utilised calming techniques and medications.
• Week 3-4: Ravi was beginning to show some willingness in group therapy, discussing some situations he experienced and getting to know others with similar experiences. He was beginning to attempt to challenge his social situations, including ordering food when out or making small talk with strangers. His depression was still present, but it wasn’t as debilitating as before.
• Week 5-8: Ravi maintained taking a more active role in social activities, and his panic attacks were becoming negligible. His self-esteem was improving as he recognised a slow decrease in the severity of his symptoms.
• Week 9-12: Ravi observed a significant reduction in depressive symptoms. He had created a stronger belief in self-worth and confidence. His anxiety was tolerable, and he was taking the initiative to meet social situations on his own terms. 

Our Success:

Impact on Patient’s Life:

By the end of the rehabilitation program, Ravi had substantially improved. He was no longer ruled by his anxiety or depression, as he had strategies to cope with stress that allowed him to diffuse his emotional reactivity, or immediacy, and clarity for thinking about the future and the type of future that he wanted in his life. He returned to his career as a software developer with significantly increased focus and motivation, as well as being more present in his relationships. He began to be re-engaged in his old hobbies, such as playing guitar and going on nature walks.

Family and Community:

Recovering from a major accident had a profoundly positive impact on Ravi's family and social supports. He was now more available to talk, emotionally show up and relate as a son and a friend. The families realised their supportive roles were contributing to Ravi’s recovery, whether it was a gesture of taking him for lunch as a way of communicating supportiveness, encouragement and fun. 

Future Steps:

Ravi will continue with outpatient counselling to stay anchored to the process and continue to utilise healthy coping skills. He has committed to regular check-ins with his therapist and participation in alumni support groups at Jagruti Rehab to maintain his recovery process. Ravi is positive about his future and is committed to keeping his emotional level in check while pursuing his career and other interests. 

Author

Jagruti Rehabilitation Centre is a leading facility specializing in mental health, dementia, and addiction recovery. The team of psychiatrists, psychologists, and caregivers is committed to empowering individuals on their journey to recovery.