Clinical Vignette: Treating Depression

Eddie was first diagnosed with major depression at the age of 15. The roots of his depression were multiple. He grew up with two parents who neglected him emotionally. His mother only spoke Spanish, while Eddie only spoke English. This created a huge communication gap between the two of them. Eddie’s father was also away most of the time for work. Additionally, Eddie’s parents were legally married, but barely spoke to each other. Eddie was left to raise himself in a home that was very isolative. When Eddie, at age 29, walked into my office for his first session, I already knew by his body language that he was depressed. His shoulders were hunched in, his head was down, and he barely made any eye contact with me. Eddie felt sad, had a lack of motivation, withdrew from his friends, and had lost interests in the activities he used to do.

To cope with his depression, Eddie informed me that he would drink and smoke weed daily. He had been doing this for a year and a half. It took some convincing on the part of the psychiatrist, but Eddie ended up having a combination of therapy and pharmacological as his treatment regimen. I really had to work with Eddie through the stigma of taking medications because he thought he was “crazy” for taking them.

Treatment
Eddie’s therapy sessions were once a week. I took a non-judgmental stance and really helped Eddie plan small activities to bring him back to a functional state. A very important aspect of treatment for depression is psycho- education. I gave Eddie information about what depression looks like and also encouraged him to read about it as well. (Note: it is important to rule out any underlying medical conditions for depression). An important part of Eddie’s healing process was reaching out to his social support. I encouraged Eddie to talk to trusted family member(s) and/or friends. Once he got over the stigma, he disclosed to a few people that he was in crisis. When he shared with his friends that he was going through depression, a few of Eddie’s friends also shared with him the problems they were facing at home. In fact, one of his friends was also experiencing depressive symptoms. As Eddie began to deal more with the root of his depression, he began to use less alcohol and weed to cope with his sadness. We spent many sessions processing his feelings of sadness regarding his parents’ marriage. We also processed the lack of attachment he had with both of his parents and finding other means to get connected to others in a healthy way.

Eddie had to make some lifestyle changes to help treat his depression. He began to exercise regularly. Exercise is a great way to release some energy and boost serotonin, endorphins, and other brain chemicals. He also began to sleep better, which decreased his sadness and fatigue. Stress reduction was a big challenge for Eddie. It took some time to figure out what he needed to relax, but after experimenting with different coping mechanisms, Eddie began to use meditation as a means to deal with his stress.