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A 30+ year old woman attorney told a friend that she is upset about breaking up with her boyfriend. They had been going together for 5 years and she thought they were going to get married. The patient blamed herself for the breakup. She explained that the boyfriend complained about constantly needing to reassure her that he still cared for her. Despite her accomplishments she still felt inadequate, especially in relationships with men. The patient admitted that she had been chronically depressed for several years and often felt hopeless about the future. She worked hard and covered up feelings at work but often became irritable and angry because she felt the firm and some of her workers took advantage of her. The patient has no previous history of a Major Depressive episode or a manic episode.
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This solution provides a provisional mental health diagnosis for a woman following a break-up with her boyfriend. This assessment is based on the information provided in the attached case study.
Based on the information provided, it appears that your friend is suffering from a pre-existing mood disorder that has been exacerbated by the recent break-up with her boyfriend. The different types of mood disorders are as follows:
-->Major Depressive (could be recurring or one episode)
-->Mood Disorder due to a general medical condition
-->Substance-Induced Mood Disorder
I will begin with the one that I believe to be the correct diagnosis. Further below I will explain why I eliminated the ones that do not fit this case based on the information that has been provided by you and the DSM-IV requirements for diagnosis.
I believe that your friend is suffering from Dysthymic Disorder.
You stated that she has been chronically depressed for many years and has been burdened by feelings of hopelessness. Her poor self image has manifested itself in her feelings of being inadequate both at work and in her relationships with men. Other symptoms of this disorder include an increase OR decrease in appetite, an increase OR decrease in sleep, fatigue OR low energy and reduced concentration or indecisiveness. Please note that not all of these symptoms need to be present for a diagnosis. From what you have described in your posting, I was able to identify two symptoms (low self-image ...
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