Psychiatric Interviews for Teaching: Depression

University of Nottingham

31 Jan 201214:44

Summary

TLDRIn the video script, Alison Wells visits Dr. Taylor, expressing feelings of being 'fed up' and overwhelmed by life, as noticed by her sister. Alison discusses her low mood, lack of energy, disrupted sleep, and diminished appetite, which have been affecting her ability to cope with daily life and her children. She reveals a past suicide attempt and current fleeting thoughts of self-harm, but denies any plans or actions towards it. Dr. Taylor identifies Alison's symptoms as indicative of depression and suggests exploring treatment options to improve her condition.

Takeaways

😔 Alison is experiencing persistent feelings of being fed up and miserable, which have been ongoing for a few months.
🏠 She mentions that her sister noticed her condition and encouraged her to seek medical help.
👨‍👩‍👧‍👦 Alison's responsibilities with her children and the recent changes at her workplace, including wage cuts, have added to her stress.
😴 Alison is struggling with sleep, taking hours to fall asleep and waking up in the middle of the night, which affects her energy levels.
🍽️ Her appetite has decreased, and she's lost weight without consciously trying, indicating a potential loss of interest in food.
🧠 She's having difficulty concentrating and remembering things, which affects her daily life and work.
😢 Alison has had episodes of tearfulness over minor incidents, which her sister has also noticed.
🤔 She questions the point of activities she used to enjoy, such as going out with friends, indicating a loss of interest in pleasurable activities.
💊 Alison has a history of a depressive episode four years ago, during which she overdosed on paracetamol after having a few glasses of wine.
🏥 Despite her current struggles, Alison feels she can keep herself safe and hasn't made any plans to harm herself, unlike in the past.
🤝 She acknowledges having a support system in place, including her sister, friends, and partner, although she feels her relationship with her partner is strained.

Q & A

What is the reason Alison Wells came to see Dr. Taylor?
-Alison came to see Dr. Taylor because she has been feeling fed up and overwhelmed, as noticed by her sister who suggested she should come to the surgery.
How long has Alison been experiencing these feelings?
-Alison has been experiencing these feelings for a few months.
What does Alison describe her daily life as feeling like?
-Alison describes her daily life as feeling like swimming in treacle, indicating a sense of struggle and difficulty in coping with everyday tasks.
How has Alison's mood been affecting her interactions with her children?
-Alison mentions that she used to do a lot with her kids, like going swimming and playing, but now she spends most of her day on the sofa unless she has to go to work, indicating a decrease in her engagement with them.
What is Alison's occupation and how is it related to her current situation?
-Alison works in a supermarket, and she has been struggling with work due to the supermarket being taken over, wages being cut, and her feeling exhausted.
What difficulties is Alison facing with her sleep?
-Alison is having trouble falling asleep, which takes her a couple of hours, and she wakes up around 4 o'clock in the morning and cannot get back to sleep.
How has Alison's appetite changed during this period?
-Alison's appetite has decreased; she used to have a weight problem, but she has lost weight over the last couple of months and doesn't bother eating much.
What impact has Alison's current state had on her memory and concentration?
-Alison's memory and concentration have been affected; she has forgotten important things like the swimming money and parents' evening, and she finds it hard to focus even on activities she used to enjoy, like watching TV.
What past episode did Alison mention that is relevant to her current state?
-Alison mentioned an episode four years ago when her husband left, and she felt very low, leading her to take an overdose of paracetamol after having a few glasses of wine.
How does Alison's relationship with her partner, Dave, seem to be affected by her current state?
-Alison's relationship with Dave appears to be strained as he is getting fed up with her not wanting to go out and is pressuring her in other ways. She also mentions that she doesn't think he will be around for much longer.
What does Alison think about the possibility of seeking help and discussing treatment options with Dr. Taylor?
-Alison is open to discussing treatment options and believes it is sensible to explore ways to improve her situation, indicating her willingness to seek help.

Outlines

00:00

😔 Initial Consultation and Expression of Emotional Struggles

In the first paragraph, Alison Wells visits Dr. Taylor for a consultation. She expresses feeling 'fed up' and overwhelmed by life's challenges, which she has been experiencing for a few months. Alison mentions that her sister encouraged her to seek help. Dr. Taylor inquires about her mood, energy levels, and coping mechanisms. Alison describes her days as dark and exhausting, with episodes of tearfulness triggered by minor incidents. She also admits to reduced activity levels, spending most of her day on the sofa, and feeling too exhausted to engage with her children or maintain her job at the supermarket, which has been affected by wage cuts and increased financial stress.

05:06

😞 Deepening Discussion on Depression Symptoms and Impact on Life

The second paragraph delves deeper into Alison's symptoms of depression. She talks about her difficulty sleeping, waking up at night, and feeling tired the next day. Her appetite has decreased, and she's lost weight without intending to. Alison also struggles with concentration and memory, forgetting important events and responsibilities related to her children. Her enjoyment of activities like watching TV and going out with friends has diminished. She expresses feeling 'useless' and her relationship with her partner, Dave, is strained due to her lack of interest in social activities and intimacy. Alison recalls a past episode when her husband left, leading her to take an overdose of paracetamol after drinking wine, although she did not seek medical help afterward.

10:10

🤔 Assessment of Current Mental State and Consideration of Treatment Options

In the final paragraph, Dr. Taylor summarizes Alison's symptoms, which indicate severe depression, and discusses the broader impact on her life, including her relationships and self-care. Alison acknowledges her struggles and agrees that she needs help. Dr. Taylor reassures her that there are treatment options available and suggests they discuss these to start improving her condition. Alison expresses a desire to change her situation and agrees to explore treatment options. The conversation also touches on Alison's past suicide attempt and her current suicidal ideations, highlighting the seriousness of her mental state and the need for immediate support.

Mindmap

Keywords

💡Depression

Depression is a mental health condition characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in activities. In the video, Alison Wells exhibits symptoms of depression, such as feeling 'fed up', 'miserable', and having episodes of tearfulness. Her condition affects various aspects of her life, including her mood, energy levels, sleep, appetite, concentration, and enjoyment of activities, which is a central theme of the video.

💡Coping

Coping refers to the process of dealing with difficult situations or emotions. Alison mentions that she 'doesn’t seem to be coping with things', indicating her struggle to manage the challenges in her life, such as taking care of her children and dealing with work-related stress. This concept is key to understanding her emotional state and the impact of depression on her ability to handle everyday tasks.

💡Tearfulness

Tearfulness is the tendency to cry or become emotional easily. Alison describes how she 'burst into tears' over a minor incident, like dropping sugar, which is an example of tearfulness. This keyword is significant as it illustrates the heightened emotional sensitivity often associated with depression.

💡Energy Levels

Energy levels refer to the amount of vigor and vitality a person has. Alison's energy levels are affected by her depression, as she mentions spending the day on the sofa and feeling exhausted. This lack of energy is a common symptom of depression and is a critical aspect of her struggle.

💡Sleep Disturbances

Sleep disturbances are disruptions in the quality, timing, or patterns of sleep. Alison experiences difficulty falling asleep, taking 'a couple of hours', and waking up in the middle of the night without being able to fall back asleep. These disturbances are indicative of the sleep problems that often accompany depression.

💡Appetite Changes

Appetite changes refer to significant increases or decreases in the desire to eat. Alison's appetite has decreased, as she mentions not bothering to eat much and her weight being 'looser'. This change in appetite is another common symptom of depression and is relevant to understanding Alison's overall health.

💡Concentration

Concentration is the ability to focus one's attention on a task or activity. Alison reports difficulty concentrating, forgetting important events, and being easily distracted, such as when watching TV. This lack of concentration is a common symptom of depression and impacts her daily functioning.

💡Enjoyment

Enjoyment is the feeling of pleasure or satisfaction derived from an activity. Alison indicates that she is not enjoying things anymore, including activities she used to like with her friends. This loss of enjoyment is a key symptom of depression and reflects the impact on her quality of life.

💡Relationship Strain

Relationship strain refers to the tension or difficulties that arise within personal relationships. Alison's relationship with her boyfriend, Dave, is affected by her depression, as he is 'getting fed up' with her lack of interest in going out. This strain is a common consequence of depression and is an important aspect of Alison's situation.

💡Self-Harm

Self-harm involves intentionally causing harm to oneself without the intention of ending one's life. Alison reveals a past incident where she took an overdose of paracetamol after drinking wine, which is an act of self-harm. This keyword is crucial for understanding the severity of her emotional state and the risks associated with depression.

💡Support System

A support system consists of people who provide emotional, practical, or informational assistance. Alison mentions her sister, friends, and Dave as part of her support system, although she doubts Dave's continued presence. The support system is vital for individuals with depression, as it can provide a network of care and assistance.

Highlights

Alison expresses feeling 'fed up' and 'miserable', prompted by her sister to seek medical help.

Alison describes her daily life as overwhelming, with tasks 'piling up' and feeling unable to cope.

Dr. Taylor identifies Alison's mood as 'very black', with Alison confirming feelings of misery.

Alison experiences episodes of tearfulness over minor incidents, noticed by her sister.

Alison's energy levels are low, spending most of the day on the sofa and struggling with work attendance.

Work-related stress is highlighted by Alison due to wage cuts and increased financial pressures.

Alison's sleep pattern is disrupted, taking hours to fall asleep and waking up at night unable to return to sleep.

Alison reports a significant decrease in appetite and weight loss without specific measures.

Concentration and memory issues are affecting Alison's daily life and responsibilities.

Alison's enjoyment of previous activities has diminished, including social outings and hobbies.

Alison's self-care has suffered, with a lack of interest in personal grooming and appearance.

Relationship strain is evident as Alison's partner, Dave, shows frustration with her social withdrawal.

Alison discloses a past suicide attempt during a depressive episode four years ago.

Alison did not seek medical help after her suicide attempt, considering it a moment of being 'silly'.

Dr. Taylor confirms Alison's current symptoms align with depression and suggests available treatments.

Alison acknowledges the need for help and agrees to discuss treatment options to improve her condition.