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Julie is a 32 year old graphic designer


Julie is a 32 year old graphic designer.  In January she started feeling low in mood and was finding it difficult to get motivated to go to work.  For the first couple of weeks, she put this down to ‘post-Christmas blues’.  Over the next few weeks, she began struggling more with motivation and everything seemed like a huge effort.  She began having thoughts like “I am stuck in a rut”, “Everyone else is doing better than me”, “I’m going no-where”. Things she previously really enjoyed doing like swimming and seeing her friends were no longer enjoyable.  Since everything was such an effort to Julie, and when she did make the effort she didn’t enjoy it, she began doing less and less.  Her friends called regularly and invited her out, but she started to refuse these invitations because she no longer enjoyed being out socially and she felt like a burden to her friends.  By the end of February, Julie was no longer going out other than for work, she was struggling to get out of bed in the morning and when she was at work, she found it a huge effort and thought everything she produced was “useless”.  She began to feel hopeless about the future, her mood became lower and she decided to take two weeks off to “try and sort herself out”.  She went to her GP and was prescribed an anti-depressant medication.  Three weeks later, nothing had changed and Julie realised she had to do something or she would risk losing her job and her friends.

When I met Julie for assessment in March, she told me how her problems had developed over the previous three months.  She said she couldn’t understand why she was feeling this way as she has a great life with lots of friends, a close family and a good job.  She said that nothing significant had happened in the past few months to explain the way she is feeling and that she is “just being pathetic”.

Julie completed some questionnaires to assess the severity of her depression and she scored in the moderate range.  Cognitive-behaviour therapy has an extensive evidence-base for the treatment of moderate depression and is recommended by the National Institute of Clinical Excellence (NICE) as the treatment of choice.  I discussed this approach with Julie and we agreed to meet for 6 sessions in the first instance followed by a review.  Julie’s sessions included the following:

1)      Understanding how the problem developed and was being maintained:

2)      Re-establishing previous levels of functioning:

3)      Managing self-critical thoughts:

4)      Review and relapse prevention

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