Major Depressive Disorder in a Latino Patient

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Grace is a Latino Female Portuguese speaking from Brazil. She has lived in the USA for six years and is presently undergoing an immigration procedure for a change in legal status. The client has a history of anxiety, is 10 years into a marriage with two children, and has experienced abuse from her spouse in the past. She is presently going through immigration procedures to change her legal status, but because of early warning signs of violence, she has gone as far as to consider divorce. Being a Christian, she aims to resolve her problem in line with biblical law. Grace has reported that she is quite unhappy with her life and the isolation from close friends and family for 6 years has taken quite a toll on her moods.

Grace seems to be suffering from a major depressive disorder which has forced her to take up a negative view of herself. The fact that she suffers from anxiety proves her low level of self-worth and worry which is not advisable for someone battling depression. Having moved to the united states 6 years ago implies that she has lost vital ties with her friends and family and the home environment she thrives in derives her from any pleasurable activities which can be applied to curb the aftermath.

Her goals for change in this case revolve around treatment achievements for a depressive disorder which can only be curbed through the application of CBT. She needs to understand the connection which comes with mood and negative self-talk as well as take up legal measures that can help curb her issues at home. She is required to increase positive talk towards herself and engage in numerous non-depressive activities. By so doing the treatment will enable her to reduce reinforcing depressed attitudes on herself and boost her intent to increase relational schemas towards blended activities which help reduce conflict thus resulting in a decrease in depressive establishers.

Currently, she has attended 10 individual sessions of CBT towards overcoming depression. Through the intervention, she has a better route in engaging self-worth which will allow her to realize the importance of self-care and positive self-talk. As a result, there is a need for a develop and test hypotheses related to her case. The skills learned during these sessions are meant to equip her with problem-solving skills that will come to play when handling her abusive husband, staying true to her marriage, and skills through which she can address her differences. To challenge normality, one is required to learn how distorted thinking works when handled with positive engagement.

By challenging herself to solve her problems instead of battling them out she is expected to increase her mastery and at the same time gain pleasurable experiences from her surroundings. The relaxation curve will in turn enable her to exist outside her issues while dealing with them.

Grace appears to be stuck in limbo since, her doctrines dont stand for divorce, and however they dont also support acts of self-centeredness which she would be tapping into if she holds on only to get the immigration done. The technique is bound to help her save her marriage and realize her worth without having to go against any of her beliefs. Assessing grace I came to realize that her being highly reliant on faith makes it hard to approach a legal path towards her marriage which would only end in divorce and termination of her immigration. Her position alone makes her desperate and vulnerable which in most cases results in manipulation.

By talking to her friend she had no intention of cheating on her husband instead she just needed a listening ear to vent out to. Her unhappiness is emanating directly from her marriage and this is causing her a great deal of pain which has left her prone to panic attacks resulting in major depression symptoms. By attending the sessions the client has depicted a high rank of bravery and signifies her hope for things to become better.

DSM-5 Diagnosis

F 41: Generalized Anxiety disorder

Rationale

Grace is experiencing a continuum of depressive situations and has met the DSM-5 Criteria for major depressive disorder. She has been experiencing unhappiness and a BDI level of 23 terming herself as feeling sad all the time. Her symptoms major around someone who wants to be alone most of the time just to avoid the chaos but is still required to be there for her family. Thus my diagnosis points out to a major depressive order. Based on the continued abusive behavior of her husband one can also term family disruption as a factor in her case (Bains & Abdijadid 2022). She remarked on how she had vented out and her husband had immediately signaled for divorce which is quite odd considering the established situation, however, more data is required to internalize this notion as an issue towards her marriage. Her husbands long abusive streak was considered first since she had held on for 6 years and managed to birth children which makes it null in this case. Her issue seems to be long-term which lays them in line with a depressive episode.

Case Conceptualization

Client Concerns

Unhappiness.
Low self-worth.
Worry about marriage.
Withdrawal from close family and friends.
Fear of venting out to friends.
Worried about immigration.
Abusive husband.

Descriptive Diagnostic

Major depressive disorder.

Theoretical Inferences

Grace has showcased maladaptive thinking towards her marriage, the fear of losing her husband and kids as well as staying true to her Christian doctrines resulting in low perceptive thing and lack of self-worth

Narrowed Inferences

Major depressive disorder

(CBT): I am always unhappy

Narrative

The main purpose behind the use of case conceptualization techniques is to comprehend the situation itself. Grace tried venting out to her friend which resulted in issues within her marriage. She has showcased a subtle amount of negative behaviors and maladaptive thinking which has generally resulted in her falling into depression. She states that she is always unhappy which in this case is quite unhealthy for someone in her position. Her belief of helplessness seemed to be majoring around the issue of her deportation to which her instinct is the application of faith and belief.

Treatment Plan

Problems

Major depressive disorder- Low self-worth, Unhappiness, lack of close relations with family and friends, violence, and helplessness.

Goals for change

Major depressive disorder (CBT)
Recognize differences between personal core beliefs and depression based on different levels of emotion
Improved positive thinking
Take part in activities that are non-depressive
Take up realistic goals within the family system putting up boundaries where necessary.

Therapeutic interventions

The client will engage in 10 sessions weekly majoring mainly in CBT

Major depressive disorder

The counseling will entail educating her on psychological balance when it comes to handling mood and self-analysis.
She will be provided with notes on how to master each sessions skills.
An evaluation will be held before every session to analyze her maladaptive assumptions and identify poor coping strategies that need to be curbed.
A mastery session will be held based on a scale for every session to identify learned skills and how to better polish them.

Measures of change

A distinct sense of happiness, increased outdoor association, improved moods, and acceptance of the need for support.

Pre-diagnosis based on Becks depression theory(BDI)
Sessional observations by the counsellor on better moods and reduction of depressive symptoms.

References

Bains, N., & Abdijadid, S. (2022). Major depressive disorder. In StatPearls [Internet]. StatPearls Publishing.

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