Sylvia is 28 years old, stay-at-home mother raising two small children with her husband, who travels frequently for his work. Sylvia finds herself feeling bored and isolated a lot of the time. She finds herself overeating and then feeling bad about her weight gain. She has trouble sleeping at night and takes frequent naps during the day. She has persistent thoughts that she is an unlikable person and cannot manage to do anything right. She feels guilty that she is not a good enough mother to her children. When her husband is home, she questions if he loves her and secretly wonders if he does not. She feels hopeless that her life will get better and no longer enjoys doing things that she once did. It appears that Sylvia is struggling with Major Depression. In regard to case study 2, Sylvia’s husband is traveling a lot and not home very much. She is raising two children and doesn’t work. Sylvia questions if her husband still loves her and she feels hopeless, and no longer enjoys things she once did.
Sylvia finds herself over eating and feeling bad about her weight. In addressing these issue Sylva is having, I’d like to address Charles Darwin’s evolutionary theory. The need to belong, having social bonds with family, friends, co-workers, our spouse creates a sense of happiness and joy in people. Humans are social beings by nature and when something good is happening in their lives and they share it with others, it makes them even feel better about the good news. People spend a great deal of time thinking about relationships, the joy and happiness these relationships bring them. When our need for social bonding is satisfied in balance with two other basic psychological needs, autonomy (a sense of personal control) and competence, we experience a deep sense of well being, and our self-esteem rides high (Myers, 2014).
Therefor, ones self-esteem is gauged by how valued, loved and accepted they feel. In the case with Sylvia she is suffering from attention and isolation not only from her husband, but other people. She is lacking a social bond with her husband because he is not around much and she has little social interaction with people because she is a stay at home mom. Sylvia is also lacking a career and that would challenge her and give her a feeling of accomplishment and being needed. Although Sylvia has children that need her love and attention, Sylvia is feeling isolated and lonely because of her need to interact with her husband who is not paying enough attention to her. Her husband is not acknowledging and praising her enough for how hard she works to raise the children and keep the home up. Which is making her feel ignored and unneeded, causing her to question herself worth and her husbands love for her. Sylvia is becoming depressed and using food for comfort and out of boredom.
Because Sylvia is gaining weight, she feels unattractive, and her self-esteem is low do to her appearance and the lack of social interaction from her husband. Sylvia doesn’t feel loved by her husband, and most likely feels its do to her gaining weight and she thinks he does find her attractive anymore. Sylvia may feel her husband is ignoring her even when he is home because she is gaining weight. Sylvia’s husband ignoring her it’s causing her to feel rejected, which is causing her extreme pain and leading to her overeating and depression. There seems to be a lack of communication between Sylvia and her husband. The lack of communication, possibly even a silent treatment is causing Sylvia to feel hopeless because she doesn’t know what is wrong and she is longing, and in need of a relationship and attachment with her husband. The lack of outside interaction with other friends, family, and social events is causing Sylvia to feel isolated and lonely too.
All of these environment stimulants taking place in Sylvia’s life maybe a direct cause to Sylvia’s depression. Sylvia is lacking the ability to pass on to the next level of the need for self-esteem, achievement, competence, and independence (Myers, 2014). Which could be contributing and triggering her major depression episode. A major depressive episode is not a disorder in itself, but rather more of a description or symptoms of part of a disorder most often depressive disorder or bipolar. A person suffering from a major depressive episode must have a depressed mood or a loss of interest in daily activities consistently for a minimum of a two-week time span (Psych Central, 2013). In diagnosing the mood must reflect a change from the person’s normal mood. A person’s daily activities and functions, such as work, social routines and friends, education, family, and relationships must also have been negatively impacted by the change in their mood.
A major depressive episode is also identified by presence of five or more of the following symptoms. The patient can show signs of significant weight loss or weight gain even not dieting or trying to lose or gain weight. The patient will also display a change in appetite almost everyday, either with an increase or a decrease in their normal eating habits. The weight change is typically set at an increase or decrease in weight of more than 5% per month. The patient will display a depressed mood almost the entire day and this sadness, emptiness, loneliness, crying, and distant is observed by others or indicted by the patient, is typically consistent every day for at least two weeks or more. Children may report the patient as being irritable or sad all the time. The patient can exhibit noticeable decrease in things, and pleasures they normally enjoy and love to do. These decreases in pleasures and activities that they normally enjoy will progressive decrease more and more everyday.
The patient can have either insomnia or hypersomnia and is present everyday. Insomnia and hypersomnia can even alter from not being able to sleep at all, to sleeping all day. The patient will express feeling of worthlessness or even excessive inappropriate guilt almost everyday. The patient can have decreased ability to think and concentrate, even maybe very indecisive almost everyday. The patient may have repetitive thoughts of suicide without a plan or any idea of how they would kill themselves (Psych Central, 2013). As a general rule major depressive episode is not diagnosed when the patient has experience the loss of a loved one. Generally speaking, the above listed symptoms are common when morning the death of a loved one (Psych Central, 2013). Most practicing clinicians believe that depression is caused by equal combination biological, social, and psychological factors (Grohol, 2006).
First off and most important is to get Sylvia’s major depression under control and she should be put on medication, an antidepressant, such as Zoloft to help treat her symptoms and stabilize her imbalance. I would recommend that Sylvia and her husband start psychotherapy together, such as marriage counseling to help repair their marital bond and help make her husband more aware of how Sylvia is feeling. By making her husband more aware of how his wife is feeling and correcting the issues of lack of attention, lack of communication, lack of feeling needed, wanted and loved by her husband. Sylvia could also benefit from other forms of psychotherapy, such as group therapy. With Sylvia feelings of loneliness, isolation and worthlessness, it my opinion that putting Sylvia in a social environment, with other people experiencing similar problems, it will help her engage with others and identify with other people (Grohol, 2006).
Psychotherapy can range from a wide variety of effective therapeutic treatments such as, cognitive behavioral therapy, behavioral therapy, interpersonal therapy, rational emotive therapy, to family therapy and psychodynamic approaches. Both independent and group sessions are commonly used, but it does depend on the severity of the depressive episode (Grohol, 2006). In this case study with Sylvia, my opinion would be to recommend her to get on an antidepressant and attend a group therapy, one on one cognitive behavioral therapy, and finally that her and her husband start family therapy.
In my opinion it’s important to get both Sylvia and her husband working as a team together and making them both aware of how each is causing the other to feel and react. Sylvia’s doctor and psychiatrist should observe her for a period of time for the possibility of bipolar disorder. In many cases, mental disorders can be misdiagnosis, and really need observation from the doctor and therapy sessions to really pin point what is really going on with a patient. Many of these illnesses and disorders have symptoms and characteristics that are the same, so it’s important to work closely with your doctor and follow the treatment plans, including medication and therapeutic treatments, to accurately diagnosis and effectively treat the disorder correctly.
1. Grohol, J. (2006). Depression Treatment. Psych Central. Retrieved on August 12, 2014, from http://psychcentral.com/lib/depression-treatment/000646 2. Myers, David G. Exploring Psychology with Updates on DSM-5, 9th Edition. Worth Publishers, 06/2014. VitalBook file. 3. Psych Central. (2013). Major
Depressive Episode Symptoms. Psych Central. Retrieved on August 11, 2014, from http://psychcentral.com/disorders/major-depressive-episode-symptoms/
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