Marla is a 42-year-old Hispanic female who comes to the mental health clinic complaining of having trouble sleeping, feeling “jumpy all of the time,” and experiencing an inability to concentrate. These symptoms are causing problems for her at work, where she is an accountant (Axia College). In order to determine Marla condition a clinical interview must be conducted so more information in regards to Marla’s past life and present life can be obtained. Clinical Interview: Clinician: “Hello Marla what brings you to my office today? ” Marla: “I am not sure I know there is something wrong with me but I don’t understand what or why?
I just know that I am having trouble sleeping, I feel jumpy all the time, and I am even having trouble doing my things at work. I have never been the type to not finish something or to just give up I am really confused. ” Clinician: “What do you expect to receive in this therapy? ” Marla: “To be completely honest what I am really looking for is control. I want control of my life again. I want to be Marla. ” Clinician: “Ok Marla that is what we are going to accomplish but in order to do so I am going to need you to be completely honest with me and not hold back on anything whether it be good feelings or not. Clinician: “Let’s begin how was your home environment growing up? ” Marla: “It was ok I guess you know a normal life just like everyone else. ”
Clinician: “Do you feel like there was a good relationship between you and your parents? ” Marla: “ My father worked a lot so he was always away on business trips. So my Mother and I were alone most of the time. She missed my father I remember her being sad a lot because he was gone. My mother had a beautiful voice but one day she just stopped singing. ” Clinician: “How is your relationship with your parents today? Marla: “I don’t see them much maybe only on Holidays. My mother seems detached to the world I think my father is going to end up putting her in a home. ” Clinician: “What do you think of that? ” Marla: “Nobody understands her so I guess it is for the best. ” Clinician: “ Did you have close friends growing up? ” Marla: “I did while I was in highschool I was what you would say a social butterfly until I went to college. After that I just mainly kept to myself and concentrated on school. I spent a lot of time in my dorm and as a result I gained a lot of weight.
I just always felt like I had to study a little harder than the other kids. I don’t know maybe I just wasn’t as smart as everyone else. ” Clinician: “ Do you have any close friends now? ” Marla: “I never really stayed in touch with anyone and at work well I am always really busy. I had a dog but he ran away. Other than my laptop I guess there really isn’t anyone. ” Clinician: “How do you feel about your current career? ” Marla: “I like my job I mean it pays the bills. It is very repetitive and sometimes the numbers just all seem to run together.
It just seems like it is the same thing every day all day. ” Clinician: “ Do you feel like you have accomplished most or any of your goals? ” Marla: “ I feel like I accomplished some like college and a degree. But I do not have a family or kids. I was told that I could get a manager position. Well if I don’t mixed up the files again I have been there for almost 20 years that’s the least they could do for me. ” Clinician: “You mentioned in the beginning that you did not understand what was going on with you. Can you think of any other time of your life that you felt hopeless or like your losing control? Marla: “ Thinking about it two years into college I guess would count I just felt overwhelmed but since I dedicated my time to study I really did not have anyone to turn to.
So I just stayed more busy and eventually it went away. I don’t know the feeling comes and goes but it just hasn’t ever lasted this long it has been almost a year. ” Clinician: “So when you don’t have this “feeling” like you stated you feel happy with your situation, choices, and life? ” Marla: “ Happy? I think for the most part I have been satisfied! Clinician: “Marla today was all about you and you did a great job. ” Full personality profile: Marla is a 42-year-old Hispanic female who comes to the mental health clinic complaining of having trouble sleeping, feeling “jumpy all of the time,” and experiencing an inability to concentrate. These symptoms are causing problems for her at work, where she is an accountant. Marla grew up with no siblings and a father who was constantly working. Marla’s description of her mother suggests that there may have been some type of depression going on with her.
High School seemed to be normal as she talks about being a “social butterfly. ” However things seemed to change as she reached early adult hood. Marla began to keep to herself not making any fiends. Lack of social interaction lead to Marla’s overeating, which explains her physical appearance today. Marla has been doing the same job for over 20 years and has yet to receive a promotion but still seems to want to stay there. No husband no kids and no mention of significant other suggests that Marla lives a lonely life. The subject of parents seems indifferent to her.
Marla has been experiencing these problems on and off almost her completely adult life. Marla’s main concern is that her symptoms have been constantly ongoing for almost a year and slowly seem to be getting worse. Analysis: Based on Marla’s clinical interview I feel that I can rule out ADHD because she mentions no history of it as a child and her symptoms typically come and go. Major depression can also be ruled out since there are no thoughts of suicide, lack of interest, or extreme weight change. However, Marla’s current condition can result as Major Depression if not handled soon.
My diagnosis for Marla would be Dysthymic Disorder since she meets all of the DSM-IV criteria for it poor concentration, insomnia, overeating, and feeling of hopelessness. Marla has been suffering from this condition since early adult hood as a result she is a social outcast with no family no friends, and stuck with a mediocre job. The main reason she has cried out for help is because of the duration of the symptoms. Marla has come just in time for help a few more months would have led to Major Depression. Information and Treatment
Dysthymic Disorder is a condition that affects 10. 9 million people in the US every year it also seems to be more common in women. This condition is known as depression usually lasting from weeks to years often coming back and forth. It does not come as a result of drug abuse or any type of endocrine condition. Given Marla’s history of her mother perhaps having depression and how she has been living her life as a social outcast and low self-confidence I believe that both the biological and socio cultural theory are in affect.
Marla has a predisposition to depression from her mother and the lack of structure growing up as a result of her father always being gone. Treatments that would benefit Marla would be both therapy and medications. Antidepressants such as fluoxetine and imipramine have shown a great improvement in patients with depression one of the leading medication that falls in this category is Prozac. Along with the medication Marla would benefit greatly from group therapy, which will allow her to fight against her antisocial nature that she has grown accustom to almost her whole adult life.
Group therapy will allow her to meet people with the same problem and as a result can help her talk about it and overcome it (Comer, 2005) Many people like Marla at times recognized that they have a problem unfortunately not all of them get the help they need like Marla has and sometimes the results can be fatal. Marla knew there was something wrong but she did not realize that she had been dealing with her issues for almost 20 years. Now with the help of therapy and medication Marla can come to know a life that she has never imagine.
Comer, R. J. (2005). Fundamentals of abnormal psychology (4th ed.). New York: Worth.