Major Depressive Disorder a clinical case for MSC Psychology students. Major Depressive Disorder Name: Eeyore Source: xxx Background Information xxx is an older gray donkey. There are no documents indicating the exact age or specified background information, and he chooses not to share this information. Eeyore does not have an occupation. His health compared to other donkeys is slightly underweight, but slender. He chooses not to share his family background. One main difficulty Eeyore has elaborated on is his detachable tail, which seems to cause him several problems. He has indicated that his goals are to remain strong for his friends despite his lack of confidence within himself, and as a result he often feels lonely without support from others that he is close to. Some forms of coping mechanisms include trying to feel useful in the presence of others and also trying his best to find pleasure in life. Description of the Problem Eeyore constantly insists that his tail falls off rather frequently. Eeyore’s posture typically involves a slumped head, droopy eyes, and commonly says “thanks for noticing me.” Sluggish movement is also apparent, without any physical cause for movement delay. He seems to step on his tail often and fall down. Eeyore indicates that sometimes it seems that even his close friends do not need him. Around friends, he typically makes comments about his relative unimportance and travels near the back of the pack. He also stated that although he tries to force a smile, a real smile has not existed in a long time, even though others try to cheer him up. He often feels empty even when accompanied by friends. Eeyore also seems to experience a loss of energy throughout the day, although sleeping habits are not explicitly expressed. Diagnosis 296.2x Major Depressive Disorder, Single Episode Eeyore exhibits five symptoms of a major depressive episode, and has also experienced these for several years, therefore meeting full criteria. Criteria met include depressed mood most of the day, markedly diminished interest or pleasure in activities, fatigue or loss of energy nearly every day, feelings of worthlessness, and diminished ability to think or concentrate were indicated. Overall, Eeyore exhibits severe clinical major depression without psychotic features. Further diagnosis will be needed to determine catatonic, melancholic, or atypical features as details are limited at this point. Postpartum onset is not a factor. Accuracy of Portrayal Eeyore is a character that displays a relatively accurate example of major depressive disorder. One major issue with the character portrayed is his consistent involvement with a support group. A lack of interest in activities is common with this disorder, causing most persons with depression to not frequently spend time with others. This is in contrast to Eeyore, who seems to be surrounded by friends much of the time. Also, his support groups seems rather sarcastic at times, as well as exhibiting their own issues so it may be hard to diagnose if environmental factors may prolong the depression longer than it may otherwise last. Some would argue that this may be closer to a diagnosis of Dysthymia, but since Eeyore seems to exhibit more severe symptoms closer to major depression and each season of the show lasts less than two years, it is hard to fully identify a long term timespan of his disorder. Treatment Although various treatments exists, I would recommend cognitive behavioral therapy, and possibly electroconvulsive therapy if CBT does not work alone. Since donkeys have not been tested with medication normally given to persons suffering from depression, I would not advise any type of tricyclics, MAO inhibitors, or SSRIs be used. Regarding cognitive behavioral therapy, it is important that Eeyore first understands the relationship between events, emotions, and cognitions. As mentioned, he must first realize that if his tail falls off that he is not less of an individual. Furthermore, he must also realize that the need to be of worth can be self-induced and that he does not need to rely on others to find this feeling. Treatment would then be followed by instructing Eeyore on identifying, evaluating, and modifying automatic negative though patterns that exist. He acknowledges his feelings of worthlessness, but also having the tools to evaluate his negative thoughts as something he can control should enable him to eventually take control over his thoughts. Stress management, social skills, and activities training will then follow to give Eeyore a path to improve his well-being by being able to optimally connect with others and join in on activities that spark his interests.
Posted on: Thu, 16 Oct 2014 04:58:52 +0000