We’ll start with the case study of Anthony Soprano, Jr. (referred to as A.J.) from The Sopranos (a HBO television series, 1999–2005). A.J. started a new job working construction and was getting more stable in his life following dropping out of community college. He met a girl named Blanca at the construction site and they started dating.

Figure 1. A.J. became sad and irritable following his failed engagement.

The two became really close, and A. J. eventually proposed to Blanca. After some reconsideration, she decided that A.J. was not right for her and broke up with him. Following the breakup, A.J. is sad and lethargic. A.J. continued to work at the construction site for some time, but the sight of Blanca talking to other men becomes too much for him, so he eventually quits. After the breakup with Blanca, A.J. started sleeping all the time and would not come out of his room. He had a decreased appetite and anhedonia. He seemed to lack energy for quite some time. There were no suicidal ideations initially. Though his symptoms seemed to be improving slightly, after an incident with another student, he again confined himself to his room. He attempted to kill himself by jumping into a pool with a cinderblock around his leg while his parents were out of the house. Luckily, his father came home and saved him prior to there being any significant damage. A.J. was admitted to an inpatient psychiatric facility and received the therapy he needed.

Treatment

Proper treatment of A.J.’s diagnosis would, given his severe symptom levels, include beginning with antidepressant medication. Psychotherapy, specifically CBT (which has shown great success with a combination of antidepressant medication), DBT, CT-SP, or BCBT, may also prove helpful.

Case Study: Eeyore from Winnie the Pooh

Background Information

Figure 2. Eeyore.

Eeyore is an older gray donkey. There are no documents indicating the exact age. Eeyore does not have an occupation. One main difficulty Eeyore has elaborated on is his detachable tail, which seems to cause him several problems. He has indicated that his goals are to remain strong for his friends despite his lack of self-confidence, and as a result, he often feels lonely without support from others that he is close to. Some forms of coping mechanisms include trying to feel useful in the presence of others and also trying his best to find pleasure in life.

Description of the Problem

Eeyore constantly insists that his tail falls off rather frequently. Eeyore’s posture typically involves a slumped head and droopy eyes, and he commonly says, “thanks for noticing me.” Sluggish movement is also apparent, without any physical cause for movement delay. He seems to step on his tail often and fall down. Eeyore indicates that sometimes it seems that even his close friends do not need him. Around friends, he typically makes comments about his relative unimportance and travels near the back of the pack. He also stated that although he tries to force a smile, a real smile has not existed in a long time, even though others try to cheer him up. He often feels empty even when accompanied by friends. Eeyore also seems to experience a loss of energy throughout the day, although sleeping habits are not explicitly expressed.

Diagnosis

Eeyore met criteria including depressed mood most of the day, markedly diminished interest or pleasure in activities, fatigue or loss of energy nearly every day, feelings of worthlessness, and diminished ability to think or concentrate.

Case Study: Ashlynn

Ashlynn is a 21-year-old college student and political science major who has struggled with depression on and off since beginning college. She was picked up by campus police after being caught vandalizing a man’s apartment and was recommended to a psychiatrist after exhibiting erratic behavior. She explained that she was only at the man’s apartment because he was a classmate and she wanted to prove to him how much she liked him. She spoke about how that, even though he didn’t know it yet, they were destined to be together and that they would someday run for office together and be the first-ever married president and vice president. She was irritable and argumentative, and defensive about her behavior. She indicated that she didn’t care about her finals anymore (though she had consistently good grades in the past), she had been pulling all-nighters to research politicians, and had been experimenting with illicit drugs.