1a. Refer to the DSM-IV checklist and list all symptoms that Ellen has that match the criteria for major depressive episode. Which of Ellen’s symptoms meet any of the criteria? (Be sure to match specific symptoms with specific criteria.) DSM criteria #1 depressed mood most of the day. Correlating Behaviors v Ellen has reported that she had been distracted for part of the day, but quickly returned to her depressive state. DSM criteria #2, disminished intrest or pleasure for most of the day. Correlating behaviors, Ellen was back to thinking about suicide and her feelings of depression. DSM criteria #7 feelings of worthless ness and guilt. Correlating behaviors, Ellen reported that her mother had died and that she should have been there, even thought she was 800 miles away. DSM criteria #8 reduced ability to think or concentraite.
Correlating behavior, Ellen had went through 4 different issues at one time none of which where thought through to make sense or was logical. DSM criteria # 9, reacuring thoughts of death and sucide and making a plan. Correlating behaviors, Hellen had prepared a plan to get a new gun to improve her aim and how she was going to write a note for her ex-boyfriend and murder herself at the school. Also in according to DSM Cruteria Ellens appitite is very limited as well. 1b. Can Ellen be said to be suffering from a major depressive disorder? Yes, I do believe that Ellen is suffering from a major depressive disorder. 1c. Explain and defend your diagnoses or lack thereof.
Helen has met 6 DSM criteria for that disorder, and clearly had a plan to take action, along with having a poor appatiate and feeling depressed. 2. Where does Ellen fit with Shneidman’s taxonomy of people who intentionally end their lives? Ellen does fit into the roll of Shneidmans taxonomy. Ellen seems to belive that her death will be some sort of way to become “even” with her ex-boyfriend. She has only been fixated with revenage. This is planned to the point that she would make sure she shot herself in an area close to him so that he can be present, along with a letter. 3. What factors are present that may trigger a suicide attempt by Ellen?
1. Ellen had depressive disorder along with another mental disorder, from her eating disorder.
2. Ellen has suicude ideation, talk and preparation.
3. Lethal methods, as Ellen plans on using a gun.
4. Isolation, living alone, loss of support. Ellen reported that she does not have any close friends for support.
5. Marital problems, family pathology. Ellen has reported that she had gotten pregant young and then married an older man, in hope he would be a provider. This marriage did not last.
6. Stress and stressful events, Ellen’s mother has passed away and her former boyfriend had confessed that he was in love with one of his studnets. 7. Physical illness, as Ellen is not eatting well right now and has struggled with wanting to be very small.
Explaining Ellen’s Depression and Suicidality
1. What genetic factors might play a role in Ellen’s depression? Ellen’s father was a alcoholic, and also struggled with some mental illness. 2. What biochemical factors might play a role in Ellen’s depression? The complexity in the alteration that Ellen has expernenced with her events of depression currently and also in the past, that appeared to be untreated. Ellens serotonin also may be producing at low levels that are keeping her from getting out of the depression. 3a.What would a psychodynamic theorist say about the origins of Ellen’s depression? They would want to link it to her child hood experiences. Such as the issues with her fathers drinking and being neglated as a child, having to clean and cook for the family.
4. How might Freud’s concept of symbolic or imagined loss help explain Ellen’s depression? It might show Ellens feelings of losing her mother’s and father’s death. Ellen also has a loss for her older sister as well. 5. What evidence is there that Ellen is engaging in the cognitive triad and automatic thoughts? Ellen tends to be more on the the selfish side, and instead of thinking things through she responds to the first thoughts that she is experiencing. Ellen is under the false assumation that if she does go through with the sucide, she will come out on top and will have revenage. There is no thought about any effect this will have on her daughter or anyone else that could be involved for that matter. 6. How might the hormone theory help explain Ellen’s depression? Ellen is in her 40’s, but with her boughts of depression her neurological system could be having issues trigging through-out her body.
Also with Ellens eating disorder her body fat is extremely low, aslos which would be effecting her hormone production. 7. How would the body dissatisfaction explanation lend to understanding Ellen’s depression? Ellen has shared that she has always struggled with her weight, and has strived to remain thin. 8. With regard to Ellen’s wish to commit suicide, which of Durkheim’s categories does Ellen belong and why? Ellen has not had a very close relationship with any of her family members, with the exception to one of her siblings when she was a child. Ellen has lost 2 parents that prior to death was not supportive of Ellen and her educational goals, and progress. Ellen also had been force to attend church and had a distane for that. Ellen also had walked out on her daughter and husband when her child was 10 years of age. Ellen reporte that she has a better relationship with her now. Ellen is lacking much social support, in which she would best fit, antomic suicide, as her environment was not beneficial to her development in making healthy, beneficial and lasting relationships.
1. Explain how a psychodynamic therapist would treat Ellen for her depression and suicidal tendencies. I would think that first they would want to address the fixation on Ellens odsession for revenage. As Ellen was starting or at least surviving on some sort of advaptive skills prior to the boy friend and mother passing away. It would believed that they would need to address the deaths and also Ellens feelings of self-hatred. “Freud believed the depressive then develops feelings of self-hatred” (Comer, 1992). 2. Explain how a behavioral therapist would treat Ellen for her depression and suicidal tendencies. Ellen would need her thoughts to be challenged. Ellen seems to belief that her negative actions will result in positive rewards. Ellens therapist would review her conditioning view to overcome this distorted way of thinking and acting. 3. Explain how a cognitive therapist would treat Ellen for her depression and suicidal tendencies. A cognitive therapist would be much more challenging. They would want to challenge the way that Ellen thinks such as her plans for revenage as sucicide.
This would be hopeful that Ellen would be kinder to not only her self but also to others that have not been an adiquite need for support or friendship/relationship. 4. Explain how an interpersonal therapist would treat Ellen for her depression and suicidal tendencies. Ellen would need to work through all of her negative and unfulfilling areas in life. Steming back to when she was “stuck as the middle child” and really wanted and need the extra attention growing up. Ellen would also need to review her role as a parent her self for the way that she had treated her own daughter. Ellen appears to be lost, and is wanting to find a male to bring her meaning in her life for balance. Ellen would be challenged to develop a new life plan, or goal for herself. 5. Explain what biological treatment might be appropriate for Ellen. Ellen was open about speaking with a therapist, because she had wanted to talk to someone so much as lonely as she is. Ellen could start with interaction with this biological therapist and they could help encourage Ellen to rethink mediciatons, and educate her on the benefits, as Ellens also appears to have a co-disorder as well.
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