Ms. Z is a 28-year-old assistant store manager who arrives

Ms. Z is a 28-year-old assistant store manager who arrives at your outpatient clinic complaining of sadness after her boyfriend of 6 months ended their relationship 1 month ago. She describes a history of failed romantic relationships, and says, “I don’t do well with breakups.” Ms. Z reports that, although she has no prior psychiatric treatment, she was urged by her employer to seek therapy. Ms. Z has arrived late to work on several occasions because of oversleeping. She also has difficulty in getting out of bed stating, “It’s difficult to walk; it’s like my legs weigh a ton.” She feels fatigued during the day despite spending over 12 hours in bed and is concerned that she might be suffering from a serious medical condition. She denies any significant changes in appetite or weight since these symptoms began. Ms. Z reports that, although she has not missed workdays, she has difficulty concentrating and has become tearful in front of clients while worrying about not finding a significant other. She feels tremendous guilt over “not being good enough to get married,” and says that her close friends are concerned because she has been spending her weekends in bed and not answering their calls. Although during your evaluation Ms. Z appeared tearful, she brightened up when talking about her newborn nephew and her plans of visiting a college friend next summer. Ms. Z denied suicidal ideation.

Based on the information provided, it appears that Ms. Z is experiencing symptoms of depression. Her sadness and difficulty coping with breakups, along with her oversleeping, fatigue, and difficulty concentrating, are consistent with depression. Her feelings of guilt and worthlessness, as well as her withdrawal from social activities, also suggest depression. However, it is important to rule out any medical conditions that could be contributing to her symptoms.

It is also notable that Ms. Z denies any significant changes in appetite or weight, which are common symptoms of depression. However, it is still possible for her to be experiencing depression without these symptoms.

Given her symptoms and history of failed relationships, it may be helpful for Ms. Z to engage in therapy to address her underlying emotional issues and learn coping strategies for dealing with breakups. Additionally, medication may be recommended if her symptoms are severe or do not improve with therapy alone.

It is important to continue monitoring Ms. Z’s symptoms and ensuring that she has a support system in place, including close friends and family who can provide emotional support. If she experiences any suicidal ideation or other concerning symptoms, it is important to seek immediate medical attention.