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Ms. Z, a 28-year-old assistant store manager who has been depressed since her six-month-long romance with her ex-boyfriend ended one month ago, shows up at your outpatient clinic. She talks about her past with unsuccessful relationships and admits, “I don’t do well with breakups.” Ms. Z claims that even though she has never received psychiatric treatment, her employer pushed her to go to therapy. Ms. Z has frequently been late for work as a result of sleeping in. She complains that it’s difficult to move and feels like her legs weigh a lot when getting out of bed. Despite spending more than 12 hours in bed, she feels exhausted during the day and worries that she might have a significant medical issue. She claims that her hunger and weight have not changed noticeably since these symptoms started.

Ms. Z claims that while not missing any workdays, she struggles to focus and has shed tears in front of clients while fretting over not finding a significant other. She claims that she feels terrible remorse for “not being good enough to get married” and that her close friends are worried since she has been staying in bed on the weekends and not returning their calls. Although Ms. Z seemed tearful throughout your examination, she cheered up when she talked about her baby nephew and her plans to see a college friend next summer. Ms. Z denied having suicidal thoughts.

Major Depressive Disorder, Single Episode, and Moderate would be the primary diagnosis. Adjustment Disorder with Depressed Mood and Dysthymic Disorder would be the differential diagnoses. These diagnoses have the DSM5 codes 296.2x and 309, respectively. These diagnoses have the ICD 10 codes F32.0 and F34.1, respectively.

An antidepressant would certainly be helpful for Ms. Z’s treatment. The most often prescribed class of antidepressants, known as SSRIs, is regarded as the first line of treatment for major depressive illness. The most frequent adverse effects of SSRIs are gastrointestinal distress, headaches, and sexual dysfunction. SSRIs are typically well tolerated. Ms. Z’s exhaustion and difficulties concentrating are consistent with signs of serious depression, and her tears and shame indicate that she might be going through a lot of pain. Major depressive disorder symptoms can be effectively treated with SSRIs, and they may also help Ms. Z feel more rested and energetic.

I would advocate cognitive behavioral therapy as an alternative to medication (CBT). With a history of unsuccessful love relationships, CBT has been demonstrated to be particularly beneficial in treating patients with depression. Moreover, CBT can assist patients in developing good coping mechanisms for breakups.

Educating the patient on the warning signs and symptoms of depression and nudging her into professional care if her symptoms worsen or continue would be a suitable health promotion intervention for this patient. In order to lower the patient’s risk of getting depression, it is also important to encourage the patient to maintain appropriate lifestyle practices, such as a balanced diet and regular exercise.


Lee, M., Lee, H., Kim, Y., Kim, J., Cho, M., Jang, J., & Jang, H. (2018). Mobile app-based health promotion programs: a systematic review of the literature. International journal of environmental research and public health, 15(12), 2838.

Cotterill, S., Knowles, S., Martindale, A. M., Elvey, R., Howard, S., Coupe, N., … & Spence, M. (2018). Getting messier with TIDieR: embracing context and complexity in intervention reporting. BMC medical research methodology, 18(1), 1-10.


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Case Study

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.


Remember to answer these questions from your textbooks and clinical guidelines to create your evidence-based treatment plan. At all times, explain your answers.

  1. Summarize the clinical case including the significant subjective (patient stated data) and objective data (provider assesed data).
  2. Generate a primary and two differential diagnoses.  Use the DSM5 to support the assessment.  Include the DSM5 and ICD 10 codes.
  3. Discuss a pharmacological treatment would you prescribe? Use the clinical guidelines to support the rationale for this treatment.
  4. Discuss non-pharmacological treatment would you prescribe?  Use the clinical guidelines to support the rationale for this treatment.
  5. Describe a health promotion intervention that would be appropriate for this patient.


at least 500 words ( 2 complete pages of content) formatted and cited in current APA style 7 ed  with support from at least 3 academic sources which need to be journal articles or books from 2019 up to now. NO WEBSITES allowed for reference entry. Include doi, page numbers, etc. Plagiarism must be less than 10%.

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