Question

Hi! Below is the case study and I want to make sure I'm on the right track. I bolded the questions I'm interested in (1-5). Looking for people who are familiar with the DSM-5/abnormal psychology and able to answer all questions completely. Thank you! Detailed answers extremely appreciated!

Questions:

1. Diagnosis; what is the evidence for it?

2. Treatment; typical treatment used for this diagnosis AND most effective treatment. IF the person is in treatment, what should we target first in terms of symptoms? How likely are they to stay in treatment and how likely are they to recover? Are meds involved and if so, what broad “type” of meds work for this disorder,?

3. Differential diagnosis (why is it this disorder and not this disorder)

4. Does the person have more than one diagnosis, what would DSM say about the criteria for diagnosing that

5. What would the primary causal theories be?

CASE STUDY:

Paul is a 30 year old engineer who is quite successful and lives in New York with his girlfriend. He normally loves his life, but over the past four or five months he just can’t seem to get excited or happy about anything. He has a lot of work issues - the company was sold and the owners, who were his friends, pretty well just took the money and ran - leaving all the employees (including Paul) in chaos (with the new owners) .Paul is now very unhappy at work and most of the other employees (all of his friends) have left for new jobs, but Paul just can’t seem to get his act together to even look for a new job. His girlfriend notes that he is moody, irritable and always tired, he never wants to go out and he has stopped exercising and stopped pretty well all of his fun hobbies or activities. He does not even enjoy taking his dog out for a walk, and his dog was always his favorite thing in the world (next to his girlfriend). Mostly Paul just seems to sit around on the couch watching television and doing nothing when he is not at work. He does not drink or do drugs, but he does not eat healthy either. He has gained 20 pounds is six months and he does not really care. He says that he often thinks that he would be better off dead. Medically he is fine and he has tons of money and lots of friends who care about him and he even has a great family who are in frequent contact with him. His girlfriend is concerned, as is his family, as Paul does not seem to be “snapping out of it”. They send him to a psychologist to try to figure out what is wrong (his medical doctor said there were no medical problems evident).

Answer 1

1.Diagnosis

REACTIVE DEPRESSION

Symptoms of Paul

• Unhappiness
• Moody, irritable and always tired.
• Lost interest in activities that once brought pleasure as excercise,fun hobbies and activities and taking dog for walk.
• Change in appetite -gained weight
• Frequent thoughts on death
• Difficulty in concentration

As Paul has been showing these symptoms from last 4 months due to issues in his work it can be diagnosed that Paul has Reactive Depression.

2.TREATMENT

• Simple talk therapy to encourage Paul to express his feelings and worries, motivating to come up with a plan to overcome the depressive feelings and emotions.
• Cognitive behaviour therapy to help him use his rational in combination with behavioral changes to overcome the " reactive" behaviors.
• Seeking support of his family members and girlfriend.
• Encouraging self care skills
• Use of antidepressants

2.Differential Diagnosis

Reactive Depression in Paul are temporary than the major depressive disorder and milder than the post traumatic stress disorder.

Most of the Paul's symptoms are milder and if intervened with appropriate measures can be normalized within a month or two. Major Depressive Disorder lasts longer and the symptoms of PTSD are more prominent.

4. From the case study it doesn't appears that Paul has any other disorder other than Reactive Depression.

5. The primary cause for Reactive Depression in Paul is due to the issues in his work life, the people whom he trusted and loved to work with him had left him and broke his trust as they cheated the company.This would have sent Paul in a shock state.Paul is finding difficulty to work with the new owners and most of colleagues of him are leaving the company.Paul is in complete confusion and as a reaction to this he had developed this depression.