Case Study- Depression and anxiety in midlife

The first day I met Dawn she was very pleasant but with worry written all over her face. I asked her to tell me her story.

Dawn is 55 years old with 2 grown and married children. She has worked part time in the past and has dealt with depression and anxiety throughout her life.

Dawn came to me having spent months in a slow downward spiral already. She had just resigned from her job and was considering leaving her husband. Her children were independent and had moved due to their careers. She had many friends but was unable to reply to messages or summon the energy to see them.

She said she had tried medication in the past but did not want to walk that path again at this time. She was self medicating with excessive alcohol consumption and increased cigarette smoking. Eating was inconsistent either binging for comfort or skipping meals due to anxiety and loss of appetite. Sleeping was problematic with insomnia a regular occurrence.

She said she spent many days in bed or unable to leave the house. She felt overwhelmed, exhausted and short tempered over the smallest of actions and people. She often lost track of time and days with her mental self-talk playing a negative loop non-stop. She had no feelings of hope regarding any aspect of her life.

In our first session I gave her a blank journal and asked her to write her feelings and thoughts into this daily, even if it was one sentence or word, and bring it to our sessions.

In the preceding sessions I mostly listened to Dawn. But we also began working together to “hijack” or replace the negative self-talk, set a new regular daily routine to begin with, and write down small goals for the week ahead. She needed to bring hope back into her mind. As well as take better care of herself, so her body and mind were working healthy and clear as could be rather than sabotaging that. She began taking small steps to change some daily habits.

With further talking it surfaced that Dawn had lost her sense of “mother” identity now her children were gone and also her work had become very unsatisfying and she felt she’d lost her purpose in life.

We agreed she was in a depressed state and it was most likely situational depression but also past family dramas not explored. 

Dawn then shared her childhood with me. There was a very dominating father that had impacted her self worth and caused dependency traits, which was being reflected in her marriage.

Session Progress: At session six: (3 months into therapy)

We agreed the journal had been a good outlet for her expressing deeper emotions and distracting her mind from the negative self-talk.

Most days Dawn carried out her new routine and introduced more healthy habits, including mindfulness and anxiety reducing techniques.

There were setbacks around session four with her resuming destructive habits for about 10 days.

She is starting to see herself as an independent, much stronger woman, a different person and reborn from her childhood full of fear.

It is easier for her to leave the house and has seen most friends.

She is focusing more on what she does have in her life versus what is missing.

At this point she set some future career goals and is looking forward to returning to study and retrain in a more desired field.

Took a break from our sessions after session 6.

On her healing path.