DH Case Study: Successful Middle-Aged Woman – Depression with Substance Abuse
Client was a middle-aged successful businesswoman, an active mother to her children, and a wife to her husband. She presented to treatment to address areas such as mood instability, anxiety, trauma, and substance use disorder. Client reported the day before entering treatment, she was severely depressed, and informed her mother and husband that she did not want to wake up anymore. This is reported to be the breaking point for her to seek treatment. Client also struggles with co-dependency issues with her mother that was caused by her toxic relationship with her husband, as she would constantly turn to her mother for help and support.
When she first arrived at the residential level of care, she was highly anxious and emotional. Client made the decision after just a few short days to leave the residential environment against clinical advice and contacted her husband to rescue her from what she called “prison.” She would continue treatment at the PHP level of care while living at home locally with her husband and children. She reported during the first week of the transition that she was feeling much less anxious due to living at home; however, this was short lived due to the high stress of living at home and decided to return back to treatment in our structured living facility. Therapy, in the beginning of her stay was focused primarily on family dynamics and several interventions to help her breakthrough walls, as she was highly resistant, and unsure of proper decision making regarding remaining in treatment or being with her family. Therapist and Clinical Director worked closely to ensure client’s safety and ongoing recovery. Client eventually surrendered to the program, was extremely forthcoming with issues regarding her past taking responsibility for her role, as well as opening up about her toxic relationships with mother and father. She struggled for quite a while with admitting that she has an addiction to substances due to not “wanting to be labeled a drug addict.”
Client addressed her transition back into the work environment where she has experienced several manic episodes. However, at those times she was un-medicated, and abusing alcohol. Since being back to work, she has reported that her perception has completely changed, along with her self-confidence due to therapy, and being compliant with the right medications. She has adhered to the clinical recommendations of returning back to work slowly, part-time until completing Intensive Outpatient Programming. Through client’s course of treatment, she has been able to recognize the need of remaining compliant with medications, self-care and gaining a support group. This was executed by utilizing Motivational Interviewing, Cognitive Behavioral Therapy, and psychoeducation regarding mental health along with addiction. She was able to complete a detailed timeline to help assist in recognizing patterns of behavior, along with the root cause of her mental health.