Print

Chapter 1 A Case Study: Rachel’s Battle with Depression We begin our exploration of antidepressant medications by considering the case of a young woman who develops gradually worsening depression starting in adolescence. At the current time, Rachel is 21 years old and a junior in col- lege. She has been in therapy and on medication for depression for several months. As we learn about Rachel, we find that she is the eldest of two chil- dren, with a brother, Jake, who is three years younger. Her parents have been divorced since she was 12. Jake was diagnosed with autism spectrum disorder when he was four years old, with a mild-to-moderate level of impairment. Rachel and Jake’s mother has spent excessive amounts of time caring for him. Jake has always attended a regular public school and is currently a high school senior. He plans to attend community college for two years following his graduation. Rachel’s mother, Leslie, works part-time in a medical office billing depart- ment. She has a bachelor’s degree in accounting and worked full-time until Rachel was born. She stopped working to raise her children. When Jake was old enough to go to school, she returned to work part-time. She works about 20 hours per week but has often taken personal time to take Jake to his activ- ities. Rachel’s father, Michael, is a corporate attorney. He excelled in law school and was recruited by a prestigious firm. He worked long hours when his children were young, often putting in 70-hour work weeks, including weekends. He was rewarded with a partnership in the firm when he was 38. It was at that point that he began to pull away from his family. He was making more money than he ever had and wanted to enjoy the life he had been