Case Study - Depression

Doug is in his 70s and lives with his spouse. He went into a decline when his mother died a few years ago. He has been under the local psychiatrist for some time and has been taking a variety of anti-depressants. About a year ago (2009) he underwent 10 Electro Convulsive treatments to try and kick start the dopamine in his brain, to no avail. He had been offered CBT but he declined.

As a last resort I was called in to see if I could change anything. He had just changed over medication once more and when I saw him he was not only suicidal but had the most severe shakes I'd ever seen in a depressed person.

As I took his history it became evident that he had been depressed before when he was in his 40s. I used this as my point of reference, because he had pulled through one bought before. It turned out he felt useless now he was retired, he'd loved sport but couldn't play anymore. When he'd recovered before it was because he'd gone back to work, been around other people and had something to focus on and take his mind off the depression.

We looked at all the things he wasn't doing at the moment - could not watch TV, or listen to the radio because he could not focus and found the noise annoying (common complaints in depression) There was nothing to watch, nothing to do. He'd stopped playing the sports he could do and spent most of the day just worrying about how to kill himself. He shaked so badly the doctors had tested him for Parkinsons.
Doug liked to be an expert in subjects, so I suggested he became an expert on depression.

We had 4 sessions of hypnotherapy together, followed by some solutions focused and cognitive behavioural therapy. By the time I saw him again after the Christmas break the following had occured.

• He was listening to the radio again.
• Watching some TV.
• Reading magazines.
• Sorting out the household chores.
• Going out shopping.
• Visiting Bristol centre.
• Was not talking about suicide.
• Reduced his shaking.

At this point I felt I could suggest reading about CBT and that he might like to reconsider his psychiatrists suggestion to have it under the NHS.

After just a few weeks he'd made a significant change from when I saw him at first, and I believe it was a mix of everything. One problem I see with elderly people is although they may live with a partner, they do not have the mental stimulation of a large crowd, so just talking to outsiders on a regular basis can help tremendously. As I left Doug to it, Help the aged stepped in with getting him out and active.
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Also see > Depression intro / Pathology of depression / symptoms of depression / hypnotherapy / coginitive behavioural therapy / mindfulness/ drugs or anti-depressants / finding a therapist