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Wendy, a 41-year-old African American female, presents for an assessment with an immediate declaration: “it’s about time I got some help.”
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Wendy reports she was prompted to see a therapist after her close friend recently initiated a
“Heart to heart” talk. “My friend tells me she has never seen a time where I have been happy…
Sure, there are moments when I feel happy, but those moments are pretty fleeting.” Wendy and
her friend has known each other six years.
Wendy admits, for most of the time, she feels “just kind of blah.” “I can’t really
remember the last time I felt consistently good…Maybe in my early 30’s?” Wendy further
reports she struggles with her confidence level. “I’m just mediocre at things. What do I have to
offer people? Therefore, I’m single… No one really wants to be with me and I think my friends
just feel sorry for me.” Wendy doesn’t feel things can improve even when you attempt to engage
her in the possibility that circumstances always have potential to change. “Nahh… You don’t
know me… Things never really work out in my life.”
Wendy’s doesn’t report any incidents of elevated feelings or emotions; she is alert and oriented
in all four spheres. She has never heard voices or seen things that others have not.
Wendy reports her sleep is normal and her appetite is typically unchanged. There are no
medical issues – in fact, her recent physical indicated no abnormal findings. The only medication
Wendy takes is a daily multi-vitamin as she seems to always be tired despite getting adequate
sleep. Wendy denies any difficulty concentrating/decision making and denies current feelings of
suicidal ideation. Wendy consumes alcohol sparingly (“maybe a glass of wine every few
weeks”); she denies the use of illicit substances. Wendy’s friend told her during their
conversation that hanging out with Wendy was “kind of a buzz kill” and her friend thought it
best that their activities together be limited.
Wendy does report that about eight months ago she felt even worse than she does now. At that
time, for about three weeks, she found herself having all the aforementioned symptoms along
with increased sleep, poor appetite (she lost about eight pounds), an inability to make even the
most simple decisions (“I would stand in front of my closet for minutes at a time not being able
to decide what to wear”) and persistent thoughts of “driving into oncoming traffic” in order to
“end it all.” There was one other period when she felt the same way about a year a half
ago. That lasted for about three weeks as well.
Use the DSM-5 diagnosis and statistical manuel
Give the correct diagnosis and comprehensive description of process.
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