Severe Depression Case Study: The Steps That Led to Recovery
Table Of Content
Patient Information
Age: 32
Gender: Female
Background: Divya is a 32-year-old woman who has been a marketing manager for a tech firm. She is well-educated and lives in a metropolitan region with her husband. Recent problems in life have now begun showing their deep effects on Divya, suggesting that personal and professional issues in her life can be drastic for her mental well-being.
History or Cause
Depression results from a sequence of events throughout her entire life that very slowly chew her down and therefore take their toll on her emotional and psychological well-being. Its beginning can be traced back to her early 20s, when she lost her father to cancer. The grief was intense, but Divya coped with it by throwing herself into typical accomplishments in her job and relationships. For the last two years, however, she began to feel a heavy sense of dissatisfaction with her work life and had experienced a whole slew of personal setbacks, which included difficulties in her marriage and dealing with a toxic workplace.
The turning point occurred when she was denied a promotion at work - a position she had worked to achieve for several years. From that point, it was obvious that she had experienced a mood shift, a lack of energy, and a significantly different outlook. Divya has also stated, "I often feel hollow" or "empty," and most inherent pleasures are deprived of meaning. She started isolating herself from the people she was connected with, and she gradually severed ties with anything pleasurable, such as her previous fondness for painting and hiking activities, to which she devoted great time and effort.
Diagnosis
Severe, major depressive disorder (MDD) was diagnosed by a mental health professional now. All the different diagnostic procedures were followed:
- Initial Consultation: In the beginning, Divya's therapist called her for a complete assessment. With her family history by now, she has talked about her treating physician, the stressors, recent and the symptoms that she was observing herself started to impact her day-to-day functioning.
- Assessment Tools: Divya completed standardised depression scales (e.g., Beck Depression Inventory) to measure her current level of depression symptomology.
- Psychiatric Evaluation: Divya met with the psychiatrist, who assessed her presenting symptomology for exclusion of other disorders and for confirmation of a major depressive disorder (MDD) diagnosis. She was also screened for generalised anxiety disorder (GAD), which she met criteria for in a mild form that was not a main concern.
The symptoms of depression that Divya had endorsed or experienced included low mood or sadness with extreme fatigue, feelings of worthlessness, poor concentration, and a lack of interest in activities or things she previously enjoyed.
Treatment
Approach
The intervention had many components. Along with medications, therapy, and lifestyle changes, we were trying to not only address Divya's depression but also provide her with the tools she needed to manage stresses in her life, to develop resiliency, and to improve her mental health in general.
Program
Divya had several components of rehabilitation because this was a multifaceted intervention:
- Psychiatric Medication
Divya was started on an antidepressant medication (selective serotonin re-uptake inhibitor or SSRI) to assist with managing the biochemistry of depression. Overall, Divya's medications were carefully monitored over the whole course of her treatment, and she continued using antidepressant medications since she was tolerant to them and they appeared to be effective. Follow-ups with the psychiatrist were as needed to assess psychiatric medications and make any adjustments as needed. - Cognitive Behavioural Therapy (CBT)
The main therapeutic approach used was Cognitive Behavioural Therapy (CBT). While meeting with her therapist, Divya spent time exploring and identifying negative thought patterns that she held and agreed to try to change her thoughts to healthier, more accurate ones. It was also important to teach Divya skills and develop methods to handle her daily stressors and confidence issues. - Mindfulness-Based Stress Reduction (MBSR)
Mindfulness-Based Stress Reduction (MBSR) was introduced as one of the intervention methods, where Divya learnt mindfulness techniques that would keep her in the present and eliminate intrusive thoughts that perpetuated her depression by understanding the basic premise of mindfulness practice would provide her with emotional regulation and develop compassion for the self. - Physical Activity
Regular physical exercise was introduced into Divya's life. She began walking every day, then slowly introduced yoga, and after that, began light jogging. Divya was told about the role of exercise as a natural mood enhancer and a crucial element of her recovery. - Social Support and Family Therapy
Divya's husband was encouraged to participate in therapy sessions with her to support her recovery and growth. They focused on communication skills and addressing their relationship that had been negatively impacted by Divya's depression.
Improvements/Recovery Timeline
Week 1-2:
The initial couple of weeks involved a gradual build-up in Divya's adjustment to her antidepressant medication and making contact with a therapist. She felt a little tired at first, but was noting a slight improvement in mood by the second week.
Week 3-4:
Divya was becoming a more active participant in therapy. She was able to recognise a number of cognitive distortions, such as "black and white thinking" and "catastrophising," which had contributed to her depressed state. Additionally, she was starting to incorporate mindfulness practices into her daily schedule and was finding them useful in the midst of stress.
Week 5-6:
Divya entered the sixth week with progress visible. She noted an increase in energy and felt that she was able to start feeling her feelings, rather than being consumed by them. She was attending family events and socialising with friends again. She said that her husband reported there was improved communication between them, and she was being more open about her feelings.
Week 7-8:
At this point, Divya reported feeling more empowered in her recovery. She had reduced sadness episodes and felt a greater sense of accomplishment with her work, although it was not an immediate trade-off. In fact, CBT had enabled her to reframe her disappointments in her work and use this energy to build engagement and change instead of operating from a place of evidence of failure.
Week 9-12:
Divya experienced a major transition during week twelve when she picked up a hobby that she had given up, painting! She rediscovered a creative energy that once motivated her, which, in turn, made her feel more engaged in her professional identity. While she did not entirely feel "cured" of her depression, she had made substantial inroads in reducing her symptoms to a manageable level, and she felt ready to carry on to deal with the next challenge with the tools she acquired.
Our Success
Impact on Patient’s Life
The treatment rendered to Divya made a significant difference to her quality of life. By the end of the 12-week program, she had reported more than an 80% reduction in depressive symptoms. It is now that she found her motivation and capabilities to have a purpose, both personally and professionally. Divya went back to her former social networks and even engaged in some new activities like learning photography.
While doing things differently, her performance at work also improved. She had been doing these tasks with renewed focus and positivity, which led to more positive interactions with colleagues and a much more rewarding experience overall at work. Although she recognised that mental health is an ongoing issue in your life, Divya had coping strategies to manage her depression in the future.
Family and Community
Divya's recovery was a life-changing event not only for herself but also for her family. Her husband had seen noticeable changes in Divya's demeanour and energy level, and they rebuilt their relationship. They began communicating more, and Divya could be present for her family and friends.
Her journey had an impact beyond her family as Divya helped others in her community. She started sharing her experience with friends and other colleagues and thus carved a niche for herself as someone who is a support system to others who struggle with similar issues.
Talking about her journey has made it easier for other people in her social setting to have conversations about mental health without being seen as 'crazy.' This was also contributing to a broader shift in the community towards mental health acceptance and normalising behaviours and events surrounding mental health awareness.
Future Steps
While Divya had made a lot of progress, she knew how imperative it was to continue receiving support. So instead of inpatient-form therapy, she decided to continue her sessions on an outpatient basis with monthly check-ins with a psychiatrist and mindfulness practice.
Divya also joined a support group for persons recovering from depression. This had meant a great outlet for her for discussing the journey itself and, by hearing from the journeys of others, finding loads of inspiration by learning from their experiences. She felt that further support would enable her to maintain her progress and cope with setbacks into the future.
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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.
