Are You Blue? What Do You Do?

A Case Study on Treatment Options for Depression

by
Robert Grossman, Psychology Department, Kalamazoo College
Amy Pettigrew, College of Nursing, University of Cincinnati
Linda Walsh, Psychology Department, University of Northern Iowa
Kathleen Boje, School of Pharmacy, University at Buffalo

"You know Peggy, don't you? She's been so down lately," Brenda said as she, Christy, Bob, Jim, and Jean dropped into chairs at a table in the Student Union. "She hasn't been at volleyball lately! We've missed her killer serve! I just saw her. She was mumbling and had tears in her eyes. She said she had gotten a couple of D's on her mid-terms and was worried about losing her scholarship. Seems she hasn't been able to concentrate on classes the past two or three weeks. But what really upset me was she said she doesn't enjoy much of anything any more, not even volleyball!"

"Yes, she did," replied Brenda. "She said she's exhausted but can't seem to get a good night's sleep. Today she woke up at 4:00 AM and couldn't get back to sleep. She told me she felt so depressed she could hardly get up. I asked her if anything was going on that might be related to this and she told me her ex-husband is calling almost every night and often threatening suicide."

"Yeah, I know," continued Brenda. "She's got two years to finish her degree before the divorce settlement and health insurance expires. I know that she's also worried about her parents' health problems."

"I saw Peggy the other day," Christy interjected. "She was telling me how overwhelmed she feels trying to taking care of herself and her son. She said she can manage to get his dinner on the table—just barely—but doesn't have the energy or the appetite to make anything for herself. She said she thought she may have frightened Joey the other day. He came back in from playing after dinner and found her sitting in the dark. That shook her up. She said it reminded her of when her mother would stay in her room for hours on end."

"Well," said Brenda, "just now when I saw her she told me she had gone to her family physician, who told her she should see someone about diagnosis and treatment for depression. Her doctor suggested there might be resources on campus that would be more affordable than his referral sources. She told me she felt worthless as a mom and a student, and then ran into the ladies room in tears! I checked to make sure she was OK and then came here. I don't know what she can do. I'm so worried about her! I know I would feel better if I knew what kinds of treatments are available for depression. Do you guys know?"

"We can't diagnose her or recommend treatments, but we could help you pull together information on the kinds of treatments available and the kinds of professionals Peggy might get help from," offered Bob. "My RA told me that the campus health center can diagnose and prescribe medication for depression. Someone on our dorm floor had recently gotten help through the health center. This was for an antidepressant medication, which the health center can write prescriptions for. I'd be willing to follow-up on that and try to get some information on tricyclic medications (Expert Group A)."

"Come to think of it," said Brenda, "we just learned about Prozac and the other selective serotonin reuptake inhibitors (Expert Group B) in my physiological psychology class. I have a friend who saw a psychiatrist at the campus health center and was given a prescription for that. I can go check my notes on these meds. Christy, you're in that class, didn't we hear about something called MAO inhibitors (Expert Group C)? Could you look up info on those?"

"Some people feel hesitant about taking medication," said Jim. "I know I do! And drugs usually have side effects that make you feel worse, don't they? I'll check out something more natural, like St. John's wort (Expert Group D). They can hardly keep it in stock down at Herbal Health."

"Some people are against taking anything," said Jean. "I think you can get a diagnosis at the campus counseling center and they offer cognitive psychotherapy (Expert Group E). I've heard that it's as effective as medication and has almost no side effects. I'll check it out."

"Great!" said Brenda. "I know I would feel so much better if I knew the pros and cons of each of these and who one can turn to for help. Let's research these and compare our notes on them back here later today, OK?"

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