Case Conceptualization: 38-year Old Husband with Depression and Anxiety

Case Conceptualization: 38-year Old Husband with Depression and Anxiety
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Depression: Case Conceptualization
Background Amos is a 38 years old husband who presents for a follow-up in the outpatient clinic. He seeks to address what he describes as depression. “Often,” says Amos, “I get moments of anxiety, and it just ruins my day.” Amos lives in Annapolis with his current girlfriend. The girlfriend runs a salon and spa business in Annapolis. They have been together for two years, and they have plans to get married. They have one child, a 1-year-old boy, but Amos is not the biological father. However, Amos is yet to divorce his first wife officially. He has two children with his wife, who lives in North Carolina and works as a State Attorney’s office secretary. Amos has not seen the two children for four years because of a restraining order filed by the wife. Amos also has another child, a 17-year-old girl whose mother died on her birth. Her name was Ana. The daughter lives with her grandparents (Anas’ parents) in Bethesda. The patient has not seen this daughter because he is not on good terms with Ana’s parents, who blame him for their daughter’s death. Amos’ parents passed on in a gruesome road accident when he was in grade 1. After that, he lived in six different foster homes before he turned 18. Amos does not have siblings. However, he is close with his distant cousin. The two are entrepreneurs who run a small chain of laundromats in Annapolis and Baltimore. He says he does not have many friends, even from college. He graduated with bachelor’s degrees in business management and computer science. Since the onset of the Pandemic, Amos’s business has hit rock bottom. With his cousin, he closed down six laundromat stores and let go of 26 employees. There are currently only two stores open, and Amos is worried because they are not showing signs of recovery. Amos says his anxiety comes from persistent worry about the future; his business is collapsing. He feels bad he cannot support his children and may never see them until they are 18 because of the current court orders and his estranged relationship with Ana’s parents. After filing a court order, Ana’s parents took the daughter as her legal guardian. At the time, Amos had been accused of money laundering and drug trafficking later dismissed due to lack of evidence. Amos maintains that he was a victim and not a conspirator of the local crime syndicate. Further, Amos feels like he is losing control of his mind and his future. Recently, he has experienced difficulties in concentration. He is increasingly isolated because he does not fancy other people’s company; he is increasingly losing his temper, as evidenced by the smashing of utensils with minimal irritation. Other anxieties and stress triggers include the desire to see his children, the worry that he is getting broke, and an uncertain future. Additionally, Amos reports experiencing major depressive disorder, which includes feeling sad on some days, poor concentration, feelings of hopelessness and worthlessness/guilt, frequent thoughts of dea...