Gemma, a 39-year-old woman, was referred to me with symptoms of depression, including persistent sadness, low energy, loss of interest in previously enjoyable activities, changes in appetite, and difficulty sleeping. She has been experiencing these symptoms for the past six months, impacting her overall functioning and quality of life.
Neurobiology: Upon assessment, Gemma underwent a comprehensive evaluation, including a neurological examination and a review of her medical history. The neurobiological assessment revealed decreased activity in the prefrontal cortex, which is associated with regulating mood, as well as dysregulation in the serotonin system. Gemma's neurobiology suggests a biological vulnerability to depression, requiring targeted interventions to address these underlying factors.
I began by introducing Gemma to psychotherapy and cognitive-behavioural therapy (CBT). In the initial sessions, we established a strong therapeutic alliance, providing a safe and supportive environment for Gemma to express her emotions and concerns. We went through CBT techniques to help Gemma identify negative thought patterns and develop more adaptive thinking.
CBT Interventions:
Thought Monitoring: Gemma learns to identify and record her negative thoughts and associated emotions. She becomes more aware of cognitive distortions, such as all-or-nothing thinking or overgeneralisation, which contribute to her depressed mood.
Cognitive Restructuring: I guided Gemma in challenging and reframing her negative thoughts. We explore evidence supporting and contradicting these thoughts, helping Gemma develop more balanced and realistic thinking patterns.
Behavioural Activation: Gemma and I collaboratively develop a list of enjoyable activities that she used to engage in before depression. We set achievable goals to gradually reintroduce these activities into her routine, aiming to increase positive reinforcement and improve her mood.
Additional Interventions:
Exercise Routine: Gemma is encouraged to incorporate regular exercise into her daily routine. Exercise has been shown to boost mood and increase the production of endorphins, which can help alleviate depressive symptoms.
Social Support: Gemma is encouraged to maintain and strengthen her social connections. I helped her identify supportive individuals in her life and encourages her to engage in social activities and seek emotional support when needed.
Sleep Hygiene: We discussed the importance of sleep and helped her develop healthy sleep habits using hypnosis. We discussed strategies to improve sleep quality, such as establishing a regular sleep schedule, creating a calming bedtime routine, self-hypnosis and avoiding stimulating activities before bed.
Progress and Follow-Up: Over the course of several months, Gemma shows improvement in her depressive symptoms. She reports increased energy, a more positive outlook, and a regained interest in previously enjoyed activities. Gemma and I continue working together, monitoring her progress and addressing any ongoing challenges or setbacks. Regular check-ins t ensure that her emotional regulation remains effective and appropriate.
This case study highlights an integrated treatment approach for depression, incorporating neurobiology, psychotherapy (specifically CBT), and additional interventions. By addressing the underlying neurobiological factors, modifying negative thought patterns, and utilising a holistic approach, Gemma can experience significant relief from her depressive symptoms and improve her overall well-being.
