DBT for Depression: Diagnostic Formulation

Dennis-Hannon

Center for Psychological Growth and Resilience, LLC

Key Points

  1. Diagnostic assessment revealed that Jackie was in a depressive episode, as indicated by depressed and irritable mood, anhedonia, avolition, hypersomnia, decreased concentration, diminished sexual libido, and feelings of guilt, worthlessness, and hopelessness.
  2. Jackie’s depression had been building for at least the previous six months, and caused functional impairment including disengagement from relationships, procrastination, and reduction in self-care habits.
  3. Jackie’s diagnosis was major depressive disorder.
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Presenting Complaint

Jackie was referred to therapy by her primary care physician after an annual physical wellness check. She reported feeling that she was in a depressive episode, but was unsure of the cause. She considered the effects of physical ailments on her mental health, yet was unclear about the connection. She also seemed unaware of how her mother’s ailing health and the pressures of interacting with and caring for her affected her own mental health.

Once in therapy, Jackie was able to piece together how these phenomena resulted in reduced self-care and increased avoidance behaviors. Also, how exercising and moving less due to knee pain affected her, when activity had been so important for stress management.

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