Depressive Disorder

Depressive Disorder
Depressive Disorder: Chloe’s case study
Chloe Belle is a 15 years old female, who is a freshman in high school. She was referred by her parents, Mr. and Mrs. Belle. In the past three years, Chloe has been exhibiting certain forms of behavior that suggest that she could be suffering from something. Her parents report that her grades in school have been decreasing and that she has lost interest in school life. She does not seem affected by her decreasing grades as she does not appear to care about it. She has also lost her social touch. Her parents report that they sometimes get frustrated by Chloe’s behavior because she does not seem to be interested in being with them. Chloe also admits that she feels more comfortable being in her room alone. She also admits to losing touch with her old friends. Her parents reported that Chloe does not even mention her friends, even when asked to. Chloe denies any substance abuse history and her medical report do not show any signs of health problems.
Diagnosis Formulation.
Problem presentation.
Cloe Belle, a 15-year Caucasian female, was referred by her parents over concerns about declining academic performances as well as withdrawal from her social life. Her parents explained that although declining performances are a recent development, Cloe has exhibited other distressing behaviors in the past year. Chloe has been having difficulties in concentrating on school work.
History of Problem
From her parent’s report, Chloe has been experiencing feelings for three years now. According to her parents, Chloe rarely experiences happiness. There were a few exceptions on the occasions when Chloe experienced happiness, such as when the parents visited a zoo six months ago. Chloe herself admitted to the report, saying that she has lost interest in most of the things that she used to find interesting. She says that she spent less time with her friends over the last year, something that she admits being occasionally regretting. She says that sometimes she feels that her friends deserve better. Chloe also says that sometimes she wonders what it would be like if she does not wake up in the morning. She, however, denies any current suicidal plans.
Although Chloe always has adequate sleep, she says she still feels tired the next day. She says that she finds it is easy to fall asleep, but finds it hard to keep the sleep and that she often wakes up at night with thoughts running through her mind. She also reports fluctuations in her appetite, but denies changes in weight. She also noticed that she always has stomach aches when she is feeling anxious. She denies any history of substance abuse.
Developmental/ Medical History
It was also reported that Cloe had no medical effects. Her parents say that Chloe had been subjected to medical evaluations, and it was noted that she reached all the developmental milestones on time. The medical reports were, however, unremarkable.
Family History
Chloe lives with both of her parents. She also has a senior sister, who is 17 years. Chloe says that her relationship with her sister is decent, although they do not often spend time together. Her parents, however, reported that Chloe and her sister often have verbal disagreements. They said that Chloe often becomes irritable when her sister tries to initiate a conversation. Both the parents and Chloe denied any physical altercation between Chloe and her sister. Chloe’s father explained the complicated relationship that she has with her daughter, admitting that the parents often feel frustrated by their daughter’s behavior. Chloe agrees being feeling more comfortable when she is alone in her room, and not when she is around her parents. She says she is not close to either of her fathers. From her parent’s report, there is a family history of substance abuse, bipolar disorder, depression and attentional difficulties.
Educational/Social History
Currently, Chloe is a freshman in high school. In her first shear, she has recorded a GPA of 2.9. According to Chloe, her grades started declining when she entered the 8th grade. She, however, says that she was able to maintain a GPA averaging 3.0 until this current school year where it has since dropped to 2.9. Her parents explained that Chloe’s grades have declined due to difficulties in school. This, according to her parents, does not seem to worry her as she does not appear to care. When she records a high grade or receives an A in a test, Chloe is observed to be happy. This happiness, however, does not last long. Chloe then says that she has never skipped school. She denies any history of skipping school, but admits that she has been thinking about it lately. According to her, everyone in the school hates her. For this reason, Chloe thinks that it is better for her to stay at home alone in her room where she finds more comfort.
It seems that Chloe has not had any friends since she was in the 7th grade. She says that when she was in 6th grade, she used to have friends whom she used to enjoy going out with. She says that they used to go to the movies, to the beach among other places, and she used to enjoy it. Her parents report that Chloe has not seen any of her friends for a very long time, and when asked whom she spends time with in school, she does not mention any friends. It seems like Chloe does not have any friends, and she lives in total isolation.
History of Psychological Treatment
Her parents report that they noticed changes in Chloe’s attitude about one and a half years ago. They say that they saw that Chloe had been feeling sad. After noticing this, they arranged for her to be meeting the school counselor at least once a week. All this time, Chloe was insisting that she is fine and that she did not need the counselor. After several sessions with the school counselor, Chloe terminated her appointments. The parents did not pursue any further treatment or therapy after this.
Mental status examination
On appearance, Chloe looks to be mentally and physically stable. Chloe appeared well groomed and was appropriately dressed. Chloe denies having experienced hallucinations. There was no evidence of thought disorders as she seems to be up to date with the person, place, time and situation around her. On evaluation, her current and long-term memory seems to be intact. She, however had an agitated mood. At the beginning of the interview, Chloe seemed disengaged. This was exhibited by the lack of eye contact and crossed arms. As the session progressed, she seemed more comfortable and willing to open up to certain subjects. She began to cooperate with the interviewer. Chloe also denied any history of sexual, emotional or physical abuse. She also insists that she has no suicidal or homicidal plans or intends.
Treatment plans.
Following the examination Chloe’s case, a treatment plan is recommended for her. The goal of the treatment is to ensure that Chloe gets back her social life as well as improve her academic performances. After the treatment, it is anticipated that Chloe will go back to the life that she was living before 6th grade and that she will develop emotional attachments towards her family and friends.
Mr. and Mrs. Belle are advised always to keep a keen on the Chloe. Chloe’s lack of social life is the reason she is undergoing all these problems. It has been noted that Chloe’s interest in social life has declined sharply. The fact that she has no one to share with is another noted problem. Mr. and Mrs. Chloe are therefore advised always to be there for Chloe.
In addition, Chloe’s parents and teachers in school should keep a close eye on Chloe and identify the things that makes her happy and engage her in them a lot more often. An example is visiting the zoo that her parents admitted made her happy. Chloe should also not be let to stay in isolation. There is always that open person who she feels a little bit comfortable being around.
Chloe should also be handled with care. Instead of being criticized for the things she has done, those around her should always try to advise her and show her the way forward. Her parents should carefully watch her actions both at home and school. She should be taken out a lot often.
Evaluation of treatment progress
To observe her progress, her academic performances should be evaluated. She should have a one on one interaction with her teachers who will help her improve her performance. She should also visit the school counselor at least twice a week who will monitor her progress. In addition, she should also attend the clinic. Mental examinations should be carried out on her occasionally to ensure that she is mentally stable.

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