Greg is a sixty year old employee of a local taxation office, who claims that the IRS has been “observing him” for the past four weeks. He believes that there were errors he accidentally made at his job about a month ago. For this reason, he feels that the federal IRS suspects him of gross tax fraud on his own income tax return. Even though his wife and boss have tried to convince him that his perceptions are inaccurate, he is convinced that IRS agents are watching his house, tapping his phone, and even hiding in the attic. Because he fears the consequences of what the IRS will find while observing him, he often avoids going to work, and, when at home, draws all the curtains and turns off his phone.
Greg’s wife says that her husband seems to have changed significantly since he lost his first job, which was approximately one year ago. Before that, he was always very active with fixing up the house. Now, Greg spends most of his free time munching on food or dozing on the couch. Although he often stated that he enjoys his new job at the taxation office, he sometimes complains of “having trouble figuring out the numbers,” which surprises Greg’s wife because he was always very good at mental calculations. Greg says that “all this stuff really doesn’t bother me all that much,” and strongly denies any suicidal thoughts when the psychologist asked him about this possibility. “I only came to see a shrink because my wife and two sons suggested it.”
This is the scenario that a psychologist or therapist might face when a couple enters his or her office and shares a story simliar to the above. The task is to diagnose Greg with the appropriate clinical diagnosis in order to provide the right treatment.
In May 2013, the American Psychological Association published a new edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM), the standardized text and clinical reference used by psychologists and therapists across North America to diagnose their clients. The manual includes the names, features, symptoms, and demographical information on all the recognized mental illnesses, including addictions.
Despite the newer version of the DSM, little change was made to the clinical criteria for diagnosing depression in adults. Major Depressive Disorder is considered to be a medical illness that includes symptoms of persistent sadness, loss of interest in daily activities, occupational and educational impairment, along with eventual emotional and physical problems.
According to the DSM, to be diagnosed with depression, an adult must exhibit:
- a depressed mood for most of the day, nearly every day
- decreased interest or pleasure in most activities
- a change in sleep pattern – insomnia / hypersomnia
- fatigue or loss of energy
- poor concentration
At times symptoms of anxiety (such as irritability, paranoia, irrational worry, preoccupation with irrational concerns, a fear that something awful will happen, and paranoia) can also appear along with depression, such as the case with Greg. Other symptoms of depression include:
- Social withdrawal
- Poor memory
- Slow thinking
- Loss of motivation
- Appetite disturbance – weight loss/gain
Major Depression usually requires long-term treatment, including psychotherapy and medication. If it turns out that that you or someone you know is diagnosed with depression, keep in mind that with the right support and your continued presence in his or her life, depression is treatable. But, by all means, don’t ignore these symptoms. Treatment begins by being assessed by a mental health professional.
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