Case Study – Depression

• She did not go her college for the last 1 month.
• Cannot carry on even the routine work
• Does not want to do anything
• Takes sleeping peels to sleep.
• Anytime started crying.
• Does not want to go to college.
• Does not want to meet any classmates.

• Name: R
• Age: 45
• Sex: female
• Relationship: mother

Her mother told in the interview that her daughter Ms A is very shy and softly spoken. She is a very brilliant student. She was a rank holder in Uttrakhand in 12th standard. So her father decided to send her Delhi for further studies. And she was happy with her father’s decision, but after coming here she faced many problems as she is introverted, so she cannot express her feelings in front of everyone . 

She told her problem to us after a long time but her father said that she has to stay here to complete her studies everybody faces problems after coming to a new environment. But later everything becomes normal. Her mother said that I am concerned about my daughter’s feelings and carrier so I encouraged her to take counseling.    

 Patient’s relationship with family members:

• With mother: Her mother is very supportive. She is concerned about her daughter’s feelings and carrier.
• Father:  Her father is very strict
• Brothers:  Her brother is also very supportive and loves her a lot.

• In school/college: She was very good in her studies till the first semester in college.

• How is the client in studies and academic performance? – Her academic performance according to the report card of her school was too good she was a rank holder in 12^th in Uttrakhand.

•  Does the client come up to the expectations of parents and teachers? – yes

• Have they received any complaints from the school authorities regarding the client’s performance? – No, they never received any complaint regarding this.

• Since when have they noted that the client is not the same in regard to academics as she used to be?– In the 2^nd semester of college

• When did they decide to consult a counselor ?– when the client told the whole situation to her family and say no to continue the study at the same place.

Establish Rapport

• Movement and behavior
  • Clients gait: normal
  • Posture: restless
  • Coordination: the coordination was good.
  • Eye Contact: she was not able to make eye contact

Affect : She was emotional and giving answer , or responded emotionally.

Mood : She was very upset . Her mood was very sad.

• Speech :
  • The volume of the person’s voice: Soft and low.
  • The rate or speed of speech: Normal.
  • The length of answers to questions: Depends upon the Question.
  • The Appropriateness of the answer: The answers were appropriate.
  • Clarity of the answers and similar characteristics: Cleared

• Thought content:

 After establishing rapport, counselor asses that the client has adjustment problems in the new environment. She thinks that she is not able to adjust with such kind of dominating people. She got very bad experience from her college life.

Session Content

Client’s Name: Ms A

Interview No: 1                                                                                                                      Date: 15/1/2017

Session No: 1                                                                                                                          Time: 1 PM

Purpose of the interview:

The Client was referred to me for taking a detailed case history.

Start of the session: 

 The client Ms. A comes in. I greeted her and asked her to please come in and take her seat. She Was accompanied by her mother. I offered her also a seat. However as the interview started I asked Ms. A if it would be all right we both talked alone and her mother waited for a while outside, as she was not looking comfortable to talk in front of her mother.

The Client’s appearance:   The Client was well dressed, neat and clean. She looked bright but somewhat anxious.

I decided to make sure that the client is comfortable and told her that she can make herself at home here and whatever she would tell me will be kept completely confidential. Only that information, which she says can be passed on to other family members, would be done so. I am a psychologist working here and she can feel free to convey whatever she wants.

Then Ms. A started to tell me about the problems she is facing with her college mates. She told me that she was coming to Delhi 2 years from now to study masters. She was a rank holder so she got a top college in economics. She was so happy that she is doing her further studies at the top college in India. But after coming to Delhi she faced many problems like different cultures new environments new people around her.

But, she thought that after some time she will cope up with this environment. She makes new friends, the teachers were also impressed with her because she was a bright student in her class. But some students started to feel jealous of her because she got the first position in the first internal exams. Now they started game-planning against her. She observed a strange change in the behavior of her friends and other classmates. Suddenly, her friends too stopped talking to her.

She got disturbed from all of this and now she also not able to concentrate on her studies. And during this time period, some incidents also happened with her which totally broke her from inside.

She went to a party with some classmates and offered her a drink, but she said no, then the girl mix the alcohol in her cold drink and she went faint there. After this incident, she went on a trip to Dharamshala with some college friends for a project. She got fever there and her friends left her alone there in this situation. After all these things she got depressed and these incidents affected her grade in the next semester. Then she decided not to go to college and for the last 1 month.

End of the session:

As the time allotted to the client is generally one hour, I ended the interview in following manner.

Ms. A, I think today we have discussed your problem. It has been possible to understand when your problem started, what precipitated it and you have been handling the same. Your efforts are really appreciated. However there are many things we need to discuss with each other. The client responded that she would like to come next week for the next session. We both stood up , and shook hands, and the client and her mother took leave.

Observation:

When the client left I found that she was looking Slightly more relaxed and was happy that she was listened to and her problem could be put across by her clearly to the counselor.

Plan of Action:

Continue the interview and gather more information about the dynamics underlying the various conflicts that she has expressed. A session with the father is required to tell him her problem which she is facing for a long time.

Today’s session was able to achieve the purpose with which it was started.