CASE DEPRESSION

Mrs N is a 60-year-old divorced woman with 2 married daughters aged 38 and 32 years. She has a
brother and had a twin sister who died at 4-days old from pneumonia. She has known about her twin
sister for most of her life but none of her family ever talked to Mrs N about her. Mrs N had been
suffering from periods of depression or low mood since 1979 when her husband left her for an older
woman. Her mother died at the end of 1998 and she has been suffering from depression since then.
She had always had a difficult relationship with her mother but the relationship had been worse over
the last few years when her mother became physically and mentally dependant and had to go into a
nursing home. Mrs N had been feeling guilty because of this. Mrs N also felt that her mood was worse
after Christmas each year when there was less daylight.

Case history

Mrs N first suffered from depression in 1979 and at that time she felt that she was in a deep pit that
she just couldn't get out of. She pushed family and friends away even when they tried to help. The
only person who was of any help was her younger daughter who ignored the fact that she seemed ill
and just treated her as normal which she very much appreciated.
Mrs N visited her GP who referred her to the psychiatric department of the nearby general hospital
where she saw a psychiatrist. He diagnosed her as having manic depression and prescribed Lithium
which is a mood stabilising drug. However she only took it for 5 days as she describes that it made her
feel like a "zombie". She went back to see the psychiatrist after 2 weeks who told her to go away and
get better on her own as she obviously wasn't manic depressive. She gradually felt better over time but
since then Mrs N has visited her GP several times with depression and was prescribed various
antidepressants.