on include depressed mood, lack of pleasure or interest, sleep disturbances, weight loss and loss of energy, agitation or retardation, feelings of worthlessness or guilt, diminished concentration or indecisiveness, and frequent thoughts of death or suicide. The National Institute of Mental Health (NIMH) (2000) noted that in a given one-year period, about 95. percent of the population, or about 18 million American adults, suffer from a depressive illness. Women, according to NIMH (2000) and Bhatta and Bhatta (1999), are at a significantly higher risk of this disorder that men; women are twice as likely as men to experience depression, a phenomena associated with various hormonal factors such as menstrual cycle changes, pregnancy, miscarriage, postpartum period, pre-menopause and menopause.
Ms. Jones stated in the initial assessment interview that she was experiencing many of the symptoms listed above, including increasingly frequent thoughts of suicide. She complained that the medication prescribed by her physician, Elavil, had caused excessive weight gain (leading to arguments with her partner), and that she wanted to "go off" the medicine to lose weight. Epperson (1999) reported that weight gain was often associated with Elavil intake, along with constipation, dry mouth, and other side effects.
Ms. Jones also stated that she felt that her life was effectively over and that all she did was "take care of crying babies" while receiving virtually no assistance from her partner or her family members. Her affective presentation was that of a sad, frustrated, unhappy woman who felt overly isolated and burdened, lacking in support systems or resources, and confronted with a future that was largely devoid of pleasure. When questioned about the probably causes of her depression, Ms. Jones clearly stated that she "had too many children, too fast" and that she was afraid that she might become pregnant again in the near future; she ...