Depressive Disorder Diagnosis
The learner would consider diagnosing Christina with major depressive disorder. Nolen-Hoeksema (2014) defines major depressive disorder as an episode with severe depression symptoms that lasts at least 2 weeks or longer (Nolen-Hoeksema, 2014). The case study reports that Christina has experienced severe symptoms for the last month, and the lack of energy is very concerning. The learner also though that the overeating and drinking might be a sign of her self-medicating to cope with being away from her family, and it contributes to her depression.
Accurate Diagnosis
Knowing that there is a high rate of co-morbidity with depression and other disorders, it would be prudent for the learner to assess other possibilities. The learner would want to assess for any possible eating disorders and for an alcohol abuse disorder just to be able to rule all of that out. Christina admits to overeating in the case study, so utilizing an assessment to rule out bulimia would be wise (that disorder involves binging and purging). Assessing her drinking patterns is very important and the learner would likely use the SASSI-3 as an assessment. Nolen-Hoeksema (2014) states that depression is commonly co-morbid with substance abuse and eating disorders (Nolen-Hoeksema, 2014).
V and Z Codes
The learner would need to consider diagnostic codes based on it being a recurring episode. The APA (2013) says that there are different codes for major depressive disorder and they differ based on whether it is an isolated episode (APA, 2013). She is leaning towards saying it would be recurrent because she stated feeling sad and low since she left college 3 years ago, which would indicate this goes beyond an isolated episode. When reading in the DSM-5 further, it also describes where the severity of the disorder ranges which can be helpful when trying to put it into a clearer picture for the client and to help the clinician gain a better perspective.
Social and Cultural Factors
It would be important to account for Christina’s culture and how her cultural beliefs might impact how she views her situation. A lot of her symptoms stem from her missing her family and feeling disconnected so maybe her family and Mexican culture can be used as a resource in her recovery. The separation from her family seems to add to Christina’s symptoms and exacerbate them because family is such a big aspect of her life. The only multigenerational issue the learner could think of is the possibility of Christina feeling guilty from having to move away from her family.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. (5th ed). Retrieved from: Capella
Nolen-Hoeksema, S. (2014). Abnormal Psychology. (6th ed.). New York, NY: McGraw-Hill
