Cognitive Behavioral Therapy for Major Depression

Vanessa, a client experiencing symptoms of major depression. Vanessa has been

experiencing loss of interest or pleasure in your activities, weight loss or gain, trouble getting to
sleep, being tired and without energy and feeling worthless or guilty.This five symptoms that she’s
been experiencing for 2 months is diagnosed by her psychologist.

C: hello vanessa ikinagagalak kong makilala ka.

V: Hi
C: so ni refer ka sa akin ng iyong general physician because you've been feeling quite down
recently.
V: opo, i've been feeling quite bad for quite a while so naisip ko po na makipag kita sa isang
psychologist dahil gusto ko na pong mawala yung pakiramdam na ganito.
C: ok so tell me how things are at the moment?
V: It's kinda hard kasi po there will always come a time when I just feel a bit low and worry about
things pero hindi ko po alam kung ano po yung reason and i just can't really be bothered to do
anything at all. and i find it hard to get motivated for things that i want to do. I really want to be better
pero po I just can't reach it po. kaya po gusto ko po na gumawa ng paraan tungkol dito.
C: ok so sinabi mo na you are feeling really down and really sad
V: opo
C: and you haven't got any motivation but it sounds like you put quite a lot of pressure on yourself
para subukan na maging better.
V: opo pero para sa akin ang hirap nito dahil wala naman po akong kahit sino na pwedeng
makausap tungkol dito and i just kind of stay on my own. ayaw ko po sanang isipin ito pero hindi ko
po mapigilan.
C: so sinabi mo na you are quite isolated and there's not many people around you?
V: opo wala po ako ano pag sabihin nito at sa tingin ko naman po hindi din nila ako maintindihan.
C: ok so i'm just going to try and find out a little bit more about you. So ikaw ay isang english student
sa isang university and you live away from home with some friends tama ba?
V: opo
C: ok so you live with your friends but you don't feel like talking to them?
V: opo mabait naman po sila and i really get on well with them pero hindi ko po alam nitong mga
nakaraang buwan po kapag nag aakit sila na gumala or pumunta sa mall parang ayaw ko po na
sumama sa kanila kasi parang hindi naman po nila naiintindihan yung pinagdadaanan ko nitong mga
nakaraang buwan po. hindi naman po nila ako pinag kakatuwaan pero hindi lang po talaga nila ako
maintindihan.
C: ok so it sounds like you try to hide the way you're feeling from them?
V: i guess po. ibig ko pong sabihin mas madali para sa akin na itago nararamdaman ko sa kanila
kaysa po subukan na explain sa kanila nararamdaman ko.
C: ok when did all of this start? you said it's been going on for quite a few months?
V: Opo. sa tingin ko po nagsimula ito noong nagrereview po ako for my exams and i guess the
stress i put a lot on myself. pakiramdam ko po kasi gusto ng mga magulang ko na maging mas
magaling ako at ma ace ko po yung mga exams ko. it's kinda hard because my parents was going to
a little trouble that time so ayon po and I can't seem to fall asleep every night. Feeling ko din po lagi
akong pagod o walang lakas para gumawa ng mga bagay bagay at napansin din po ng mga
roommate ko ang pag baba ng weight ko.
C: ok so nangyari ito last december right?
V: yes po
C: ok so it happened two month ago and you still feel down and sad, you cannot seem to fall
asleep,you feel tired and get some weight loss . it sounds like a lot was happening so you had a lot
of pressure on and you said that your parents were having marital problems ok so it sounds like this
was a real shock to you?
V: opo i guess it was hard as well because i wasn't doing well at my university and i guess i just felt
guilty, alam ko nakakatawang pakinggan pero nararamdaman ko po na kung naging mas magaling
lang po sana ako siguro po maatim ko yong expectation nila at baka hindi pa sila mag-aaway kahit
na hindi naman po ako yung dahilan kung bakit nagkaroon sila ng problema.
C: ok so it sounds like you were trying hard para maging mas successful dahil naisip mo na
mapapasaya mo sila at maayos mo yung problema nila kapag nangyari iyon?
V: opo i wanted to make them feel better but it's just kind of tough.
C: how did it backfire?
V: well it just ended up with them getting worse at simula po noon mas lalo ko po naramdaman ang
pagiging down sa ka malungkot.
C: ok so nong exam period niyo na . how did it go?
V: it ended up not very well. I failed 6 of my subject po
C: sa nakikita ko there's an awful lot of pressure that you put on yourself.
V: it's just annoying because alam ko po na may mas best pa akong magagawa pero hindi pa
ganoon ang kinalabasan. i guess i've put myself a lot of pressure.
C: So you said that if you have done better things would have been like this? I mean hearing it from
my perspective I'm thinking it sounds like you had an awful lot going on at that time. It is absolutely
understandable that you wouldn't do as well as normal. I suppose well I'm just wondering if you have
very high standards for yourself?
V: sa tingin ko din po it may be more than other people. my parents has taught me to do my best but
also get the best in a loving way maybe at nasang ayon po ako sa kanila sa paningin ko po yung po
yung tamang gawin pero kapag hindi ko po yan ginagawa hindi ko po alam naiinis po ako sa sarili ko
at nag-aalala po ako na baka dahil hindi ko nagawa ang best ko baka magalit pa sila.
C: so nararamdaman mo na kailangan lagi mong gawin yung best mo at base sa mga sinabi mo I
conclude na you are already used to it being on pressure to do your best. but is there any kind of
exceptions for that?
V: No
C: ok so i can see then that was a really difficult time for you and that was when your mood started
to get lower and things became more quite bad? Now I mean what's the situation with your parents
at the moment?
V: hindi gaanong ok dahil hindi naman ko po sila madalas makausap. ayaw ko po na kausapin sila
tungkol dito dahil mas nararamdaman ko po kung gaano ako ka walang kwenta bilang isang anak.
C: ok, so do you go home to your parents this christmas vacation?
V: sandali lang po siguro mga 2-3 days
C: kumusta naman?
V: I didn't have fun, no. I was quiet then all the time, kapag kasama ko po sila. and it stresses me out
more than to supposedly relax me in the christmas vacation.
C: ok so it sounds like quite a lot has been happening, you are feeling very low, you are under
pressure and you’ve had problems with your parents marriage and you can't reach out to anyone
that is close to you because you think they can't understand you the same as you parents. Right now
you can't really be confined to your friends and so I suppose I'm just wondering if you can tell me a
bit more about how you've been feeling this past week?
V: i'm really not good po sa totoo lang po iniisip ko po na huwag na lang gumawa ng kahit ano para
maiiwasan ko po iyong pag labas labas ng bahay at hindi ko naman din po mahanap yung
motivation para doon sa mga bagay na dati kong ginagawa o dati kong gustong gawin katulad ng
dati mahilig po ako sa sports or going out with my friends at ngayon po mas gusto ko na po na
mahiga na lang kay sa gumawa ng kahit ano. dahil po doon i miss my lectures sa school at
malungkot ako pero hindi ko talaga makuha yung motibasyon ko sa mga bagay.
C: So base sa nalaman ko at base din sa mga sagot mo. I conclude that you are currently suffering
from depression. Depression can be caused by a family problem, putting on a lot of pressure on
oneself like what you’ve been experiencing this past few months. So depression it rains your energy,
hope and drive making it difficult to take the steps that will help you to feel better so sometimes just
thinking about the things you should do to feel better like na sinabi mo na pagkahilig mo sa sports or
spending time with your friends can seem exhausting or impossible to put into action. sinabi mo na
ayaw mo mag open up sa kahit sino but reaching out and staying connected to those people na may
malaking part sa buhay mo is makakatulong para maka cope up ka sa pinag dadaanan mo. So in
order to overcome depression you may do things that you really want but since you lost interest in
those things you can try new things that seem interesting to your liking. Things that can make you
feel relaxed and energized like it may include a healthy lifestyle, learning how to better manage
stress, setting limits on what you're able to do and scheduling fun activities into your day. It is also
important to try to get 8 hours of sleep. It can make you feel a little better tomorrow and you may
include practice relaxation techniques. It may also help to get some pets. If you can't open to a
person then maybe you can open up into your pet. Also, listening to music, reading a good book,
spending some time in nature and watching tv shows that you like can make you feel relaxed and
make your day meaningful.
V: Thankyou Dra. I will try to do those things po to help myself feel better.

2nd meeting

C: Hello Vanessa it was nice seeing you again, how are you these past few weeks?
V: Hi, Dra. I think I am a little bit nice today.
C: That's great, so kamusta naman ang pakiramdam mo nitong mga nakaraang araw?
V: I still feel sad and down po minsan kapag naiisip ko yong mga bagay na hindi napagtagumpayan
gawin pero katulad po nung sinabi niyo last meeting nag try po ako na mag alaga ng aso and I think
it’s good po lalo na po kapag wala akong makausap o pakiramdam ko mag isa ako.
C: that was good to hear vanessa, I am glad na tinulungan mo ang sarili mo para maka cope up sa
sitwasyon mo. How about your parents, nagkita ba o nag ka usap kayo sa phone?
V: I think they are good but still not in really good shape. I try to call them last night but I still can’t
talk or open up to them so I just sent them a message of how they are.
C: Ok that was a good start, So how about your friends? Nakausap mo na ba sila o sumasama kana
ba sa kanila?
V: hindi po. Hindi ko pa po maramdaman na makipag usap o mag open up sa kanila at saka po sa
ngayon hinahayaan ko po muna ang sarili ko na onti onting lumabas.
C: ok, so bukod sa pag aalaga ng aso ano pa ang pinagkakaabalahan mo nitong mga nakaraang
araw?
V: Nag try po ako na mag basa sa may campsite at maglakad lakad sa dalampasigan kahit po wala
akong kasama medyo gumagaan po ang pakiramdam ko kapag naririnig ang hampas ng alon sa
bato.
C: I agree, nature is really relaxing and beautiful, so I am happy to hear and see na nag tatry kang
gumawa ng mga bagong bagay para matulungan ang sarili mo at ngayong punta mo dito is I can
say na may improvements na sayo lalo na sa pag labas at pag aalaga mo ng pet. Ipagpatuloy mo
lang tulungan ang sarili mo at gawin ang mga bagay na sa tingin mo malilibang ka para maiwasan
mong isipin ang mga bagay na nakakapag palungkot sayo. In that way hindi mo napapansin pero
onti onti ng malelessen ang pagiging feeling down mo. Also did you get hours of sleep everyday?
V: not everyday pero pinipilit ko pong makakuha ng sapat na tulog para maging magaan ang
pakiramdam ko kinabukasan.
C: Yes that's good, so about your problem with your lectures, are you attending your classes?
V: yes dra, I now attend my classes I still feel motivated hearing lectures and doing my things.
C: Ok, if you don't feel motivated dont force yourself to do what you don't like to do at the moment
because it can cause another pressure to yourself. As of now just continue to do the things that you
want and if you feel like trying to talk with your friends or parents and if you feel a little bit motivated
by sports or your lectures dont overthink and pressure yourself to do more. Follow your own pace of
coping up if that’s what can lessen your pressure on yourself.
V: Thankyou Dra.
C: Ok, I hope to see you again next week for our next session.