| Type of Depressive Disorder |
Case Example |
| Other Specified Depressive Disorder |
- David is a 15 year old male who presents to his well visit. In response to depression screening measure, David endorses intermittent periods of sadness (3 out of 7 days for most of the day), as well as increased feelings of irritability over the course of the last several weeks.
- David has had increased difficulty concentrating during this same time period, as well as experiencing increased difficulty falling asleep at night, which has led to his getting significantly less sleep than before.
- David denies any change in appetite, nor any feelings of hopelessness. David does not indicate any change in his interest or pleasure in daily activities.
- David further denies any past or present wish for death, suicidal ideation or non-suicidal self-injury.
- David reports that his irritability and sadness has led to challenges in his relationships with family and friends.
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| Mild Major Depression |
- Juan is a 16 year old male who presents to his well visit.
- Juan experiences sad mood 5 out of 7 days, for the majority of the day.
- Juan has also stopped participating in extracurricular activities that he once enjoyed, stating that he now finds them boring.
- Juan has had increased difficulty concentrating. During this same time period, he has experienced sleep disturbance in the form of having difficulty falling asleep at night and waking frequently.
- Juan also reports experiencing increased feelings of guilt across various domains of his life.
- Juan denies any change in appetite, nor any feelings of hopelessness.
- Juan further denies any past or present wish for death, suicidal ideation or non-suicidal self-injury.
- Juan reports that his symptoms over the last 2 months has led to a slight decline in grades.
- Number of MDD Symptoms: 5 (sad mood, anhedonia, concentration problems, sleep disturbance, guilt
- Suicidality: None
- Comorbidities: None
- Level of Distress/Impairment in Functioning: mild (slight decline in grades)
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| Moderate Major Depression |
- Lauren is a 14 year old female who presents to her well visit.
- Lauren experiences sad or irritable mood 6 out of 7 days, for the majority of the day.
- Lauren has also stopped participating in extracurricular activities that she once enjoyed, stating that she now finds them boring.
- Lauren has also withdrawn from family and friends, stating that these interactions often result in increased feelings of irritability.
- Lauren has had increased difficulty concentrating. During the same time period, she has experienced sleep disturbance in the form of having difficulty falling asleep at night and waking frequently as well as significant daytime fatigue.
- Lauren reports that she has noticed a decrease in her appetite and has experienced weight loss without purposeful dieting as a result.
- Lauren endorses having experienced wish for death approximately once per week since the onset of her symptoms, as well as experiencing suicidal ideation without method, plan or intent on one occasion in the context of heightened distress.
- Lauren reports that her symptoms have led to challenges in her relationships with family and friends, and has contributed to her failing two classes in the last marking period.
- Number of MDD Symptoms: 6 (sad mood, anhedonia, concentration problems, sleep disturbance, fatigue, appetite disturbance, suicidal ideation)
- Suicidality: Yes
- Comorbidities: None
- Level of Distress/Impairment in Functioning: moderate (failing 2 classes, peer difficulties)
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| Severe Major Depression |
- Aniyah is a 17 year old female who presents to her well visit.
- Aniyah reports a history of social anxiety disorder which she reports has worsened in the past 6 months. In addition, Aniyah endorses unremitting feelings of sadness and irritability beginning 2 months prior.
- Aniyah experiences sad or irritable mood every day, for the majority of the day.
- Aniyah has also stopped participating in track which she once enjoyed, as well as withdrawing from her family and peers, stating that she these activities are both boring and cause increased feelings of irritability. Parent report indicates that Aniyah spends almost all of her time in her room.
- Aniyah is observed to be psychometrically slowed on interview, and endorses that family and friends have commented on her slowed speech and movements over the course of the last several weeks.
- Aniyah has experienced persisting insomnia, with significant difficulty falling and staying asleep at night, which has led to increased feelings of fatigue throughout the day.
- Aniyah has also had persistent difficulty concentrating, stating that she will often lose track of academic pursuits.
- Aniyah reports often blaming herself for her recent failing of three classes as well as many other problems in her life.
- Aniyah experiences wish for death daily, and intermittent suicidal ideation with and without method.
- Aniyah has a history of one self-aborted suicide attempt by hanging one month earlier. At time of well visit, Aniyah endorses wish for death, though denies having experienced active suicidal ideation in the preceding week.
- Number of MDD Symptoms: 8 (sad and irritable mood, anhedonia, psychomotor retardation, concentration problems, sleep disturbance, fatigue, guilt, and suicidal ideation)
- Suicidality: Yes
- Comorbidities: Yes (Social Anxiety Disorder)
- Level of Distress/Impairment in Functioning: marked (failing 3 classes, dropped track, peer difficulties, always in room)
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