UNIVERSITY OF NUEVA CACERES

J. Hernandez Street Naga City

S/Y 2019-2020

Case Study
about
Depression

Submitted to:
Mr. Jerome Daz
( Professor)

Submitted by:
Kristine Anne P. San Juan
Rusciel M. Evangelista
2nd year/BEED
(students)
 Introduction

In clinical practice there is frequently occurring problem, namely who has the
competence to treat stuttering. Speech therapists often think that – because of the
emotional background of stuttering – it is better to refer children who stutter to
psychotherapy. This paper presents the diagnostic process of a 15-year old boy who
stutters and suffers from depression in order to outline the competence of a speech
therapist in the treatment of people who stutter.

Depression

Depression affects people of all ages, including children and young people.
Depression among school-aged children is becoming increasingly commonplace.
Children and adolescents with major depressive disorder are much more likely to
commit suicide. Depression in school-aged children is real and it is serious problem that
all too often goes unnoticed. The most common symptoms of depression are feeling
worthless, anxious, empty, irritated, hopeless, loss of interest in activities, hobbies, or
relationship, reduced pleasure in daily activities, inability to enjoy activities which used
to be the sources of pleasure, change in appetite, persistent difficulty in falling asleep or
staying asleep, difficulty in concentrating or making decisions. Sigmund Freud suggests
that depression also involves guilt and self-criticism, which can be related to loss during
childhood. Anger and hostility may be directed at parents if they don’t give the child the
love and care that they needed during their development. However, these destructive
feelings are turned inwards and the child blames itself for the loss, which leads to guilt
and self-criticism.

Case Study

A 15-year old boy was referred to speech therapy because of his stuttering. He
started to stutter when he was 5 years old. In the early period during his diagnostic
process it turned out that he had serious emotional problems. He was often moody and
sad without any reason. Sometimes he became irritable and never socialize with other
children. At that time he lost his interest in school and was thinking about committing
suicide. During the first interview it was all about getting the basic information about his
problem. The boy is tall and thin. He was moody and sad and he seems older than his
age. He speaks very low. The mother looks like in the mid 30’s. She says that the
teacher complains about her son, who has behavioral problems in school. He is not able
to control his strong emotions. He is often angry because his classmate teases and
bullied him. The second interview was all about obtaining the data of his child
development. From the history the following details are very important. The mother was
young when she became pregnant. During the course of pregnancy and birth, it was all
normal. It was all normal that the mother did not notice his speech development. He did
not fit in nursery school but later he managed to adapt it. He was lonely in the school
and did not have any friends. He began to stutter at 5 years old and he had bed wetting
problem. He has 3 more siblings. When his brother was born, he was only 3 years old
and the birth of his brother was a shock for him. When his brother was born, everything
changed. His mother and father were always busy with their work and they were left in
to their grandparents. He changed very much.

Drawings

During the diagnostic session. he was asked to draw some different things. The first
drawing is a person. He draws the figure of the person with a suitable size and he
placed it in a center of the page. The lines are entangled. He draws the shape of the
figure especially the head with more than one line. It is not looking for eye contact. It
seems that the figure makes a vague step with his left foot. The second drawing was a
house. The house is schematic and the lines are also entangled and assymmetrical.
The drawing of the tree is also schematic. The proportion of the branches and trunk is
suitable but the branch seems more dominant than the trunk. The roots, which
symbolizes the past, are not visible. but this is all normal for kids because they are
concerned about the present. The lines of the branches, which symbolize the relation to
people are entangled. Next was family drawing. The drawing of the family gives
interesting information about the relationship in the family. They represent the
unconscious desires and fantasies of the person who draws them. He draws himself on
the picture at the last one but his shape is the largest one. The Fantasy family drawing.
The task is to transform his family into anything he wishes. In his “fantasy family” his
father is a house. The house is a home. The house symbolizes a feeling of safety. His
mother has become a heart and the heart symbolizes affection. His other siblings
become a pinball machine which symbolizes a winner, and a mouse that means less
brave. He becomes a TV box because he like watching TV. The last drawing was
mother and child. This drawing points out the characteristic of the relationship between
mother and her child. In his figure, they reach for each other but they are not attained
each other.

Exploration of suicidal thoughts

There were different questions that were asked to the boy.

1. Since when did he have thoughts about suicide and would he commit it?
His answer was he started the suicide thoughts on the middle of February and it was
because of his troubles in school. He was seriously jumping out of the window because
the others pestered him all the time.
2. What would your classmates have believed if you had done it?
They would thought he was stupid.
3. What would your teacher have believed if you have done it?
The teacher would have been very sad but she would not have been surprised because
the teacher knew that he was sad because the others had teased him.
4. What would your mother have believed?
He says that his mother would have thought that he committed suicide because he was
sad. She would have thought that she did not care about him and did not pay attention
to him. She would have put herself it in 2 to 3 months.
5. What would your father have believed?
He thinks that his father probably would get through it more easily or he could become
more introverted and would start to think of committing suicide himself.
6. What would your grandparents have believed?
His grandpa considers suicide as a taboo. He never expresses emotions but his
granddad would mourned for months.
7. What would your brothers have believed?
He said that his younger brother would not understand it but later on he would miss him.
8. Who would go to your funeral?
He said that hid dad would surely go to his funeral and he’s not sure if his mother and
his siblings would do so.
9. Was there anybody who committed suicide in your family?
He believed that his great grandfather had suicidal thoughts because he died when he
was young and drank a lot.
 Conclusion of the diagnostic process

The boy was separated from his mother when his sibling was born. The next
separation from his mother was very difficult for him. He did not fit in nursery school. He
was 5 years old when he began to stutter and had bed wetting problems. These
symptoms are signals of his anxiety. His stuttering could be seen as a reaction to his
early separation. Fitting in into the community always go slowly for him. He also has
integration difficulties in school. He was lonely and his classmates tease and always
exclude him which makes him angry. Not much later he started being concerned about
his depressed symptoms and suicidal thoughts.
During his diagnostic process, his problems are deeper than speech therapy could
help him. After the analysis of the result, he should be refer to a psychotherapy before
he would start speech therapy.