Case Study: A student from China with Depression
Zhang Nan was a 22-year old boy who was a college student. He lived with his parents and grandparents in their 3-bedroom apartment. Amidst his college routine, he observed some difficulties in his college life. He started complaining that he is finding it difficult to deal with the college life. On the second last year of his college, he had failed in one of the major subjects, due to which he had to give another attempt for the same. He noticed that this failure really affected him and his confidence levels. He also gradually started experiencing increasing levels of anxiety and could not concentrate on his studies. This also led to peer pressure from his parents as his college performance showed poor results. His parents stated that Zhang was once an intelligent student with remarkable qualities and the first one to graduate in his class with distinction, but now they are complaining about his laziness since the day his college life started.
They often feared about their child being a depressed person.
Before assessing the causes and results of depression, it is important to understand the following three aspects of depression:
- Biochemical or clinical assessment (How we work)
- Cognitive assessment (How we think)
- Lifestyle or social assessment (How we live)
Biochemical or clinical assessment:
It is natural for every student to excel in his school/college life. Students even work hard for that. But as they enter the college and demand that they should never fail, they can experience structural and functional changes in the brain functioning. A small failure can lead to a flood of negativities in their minds. This sudden change in their thinking and behaviour can lead to major depression at later stages.
Similar is what happened with Zhang. When he couldn’t achieve his goal of gaining 100% in everything, he started experiencing ‘climatic’ change in his mood. His doctors examined him and noticed all the symptoms of depression such as mood swings, anxiety, fatigue, poor concentrations, sleep difficulties, negative thinking, loss of enjoyment in life, etc. At one point in time, Zhang also thought of giving up his life, but since he had no such intent or plans, it was not clinically significant at that time.
Zhang was experiencing a lot of negative thinking cycle in his mind. Like all other students, even Zhang used to focus on one thing that to be a good student, it is necessary to get A+ in all subjects. This, unfortunately, failed to happen because the more he tried to make things right, he could notice it working wrong. This led to a flood of negative thoughts in his mind and a change in his behaviour pattern. This created an unfair relationship with his parents who mistreated his symptoms of depression as him being lazy.
Like every other depressed victim, Zhang also did not care about his own needs and health. He was not taking care of his health and used to feel easily exhausted due to the peer pressure of studies. He was not mentally active, and this affected his lifestyle a lot.
One of the simplest treatments for depression is empathy. Understanding why, what and how it occurred was been explained to Zhang and his family. This eventually brought a change in his life and relieved a lot of stress and uncertainty. On consulting a therapist, he was given a proper schedule for diet and exercise to keep him distracted and active.
He was told to fast walk for about 20 minutes, twice a day, regularly. Apart from this, he was even told to meditate for at least 15 minutes, whenever possible during the whole day. This not only kept him calm, but it made him realise his self-worth and it also gave him the strength and ability to face the situations ahead.
Diet was changed by including fish in his diet as it is a rich source of omega-3 fatty acids. He was also given vitamin B complex to boost his immunity. Along with this, he was given SSRI antidepressants which take around 14-21 days to work.
As the improvements were noticed in his medications, he was then introduced with low-intensity Cognitive Behaviour Therapy (CBT) to reduce his negative thinking and changed behaviour. Along with him, his parents also were introduced to the same therapy to improve their relationship with Zhang. This changed their attitude towards their son from criticism to understanding and support. As Zhang showed improvements in his therapy, his treatment was gradually reduced.
His mental and physical improvements showed improvements and his confidence levels started rising again. The doctors monitored his progress and the lessons learned during therapy sessions were followed up for few months after the treatment. A deep research of antidepressants suggests that the treatment should be continued for a period of about 6-9 months unless and until the mood stabilisation doesn’t achieve.
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