Major Depressive Disorder Case Study

Case #4: T. F., A 28-year-old Government Employee

Diagnosis

296.33 (F33.2) Major Depressive Disorder, recurrent, severe with melancholic features A 28-year-old male government employee referred to as T. F. is displaying signs and describing symptoms that meet criteria for major depressive disorder (MDD) in the depressive disorders diagnostic class of the Diagnostic Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association [APA], 2013). Therefore, a diagnosis of MDD is presently appropriate.

Evidence for Diagnosis During the evaluation, T. F. displayed signs and described symptoms that allows Criterion A, which requires five or more signs and symptoms (at least one being depressed mood or loss of interest or

After evaluating the information gathered through observation and client report, it is determined that T. F. is experiencing significant distress and impairment as a result of his symptoms. As previously described, T. F. reported that committing suicide is a viable alternative to continuing such distress and was observed being tearful during the evaluation. Because of his reported suicidal ideation and observed emotions, it is assumed that his level of distress is rather high. Concerning his functioning, T. F. has reported experiencing impairment in two domains—that is, academic and occupational—as a result of his symptoms. As can be recalled, T. F. reported that he is experiencing an inability to concentrate at work, perhaps resulting in decreased work efficiency. Moreover, T. F. reported that, in a past depressive episode, he was unable to attend classes while in college, thus leading him to almost fail the semester. It should be noted that it is likely that T. F. is experiencing impairment in other domains as a result of his symptoms. As LeMoult, Castonguay, Joorman, and McAleavey (2014) have noted, individuals with depression experience significant impairment in role performance across many domains of

For one, concerning the severity of disturbance, it is possible that the severity level is moderate in nature rather than severe. Although this could be the case, it is not likely for a few reasons. For one, as described in DSM-5, psychomotor disturbances are uncommon but are indicative of a greater overall severity of a disturbance (APA, 2013). As mentioned before, it was observed that T. F. was experiencing severe psychomotor retardation. Moreover, T. F. is experiencing an MDD episode with melancholic features, which is primarily characterized by severe anhedonia. As described in DSM-5, a depressive episode with melancholic features is more likely to occur in severe episodes of MDD than in milder episodes (APA, 2013). And of course, as described previously, T. F., as a result of his great number of symptoms, is experiencing considerable distress and