My name is Terry and I am a 62-year old investment banker. Four months ago, I lost my partner of 30 years, Frank, to a battle with cancer. Since Frank’s passing, I have been extremely lonely. I sporadically cry uncontrollably, particularly when I return to our now empty San Francisco flat. Frank and I used to have a zest for life, spending every weekend in the wine country, playing golf, or having dinner with friends. Now I stay at home on weekends and sleep as much as possible. I occasionally meet a friend for coffee, which puts me in a better mood. But sometimes when I commit to an outing, I forget, and I am starting to get frustrated with my memory lapses. People have told me I have a great talent for sculpture, and sometimes I show my work at amateur exhibits. But I have not created anything new in months. I just don’t think anybody would be interested in my work. Recent muscle aches have reminded me that my own health is not so good. I struggle with high blood pressure, and take Lopressor to control it. In times of stress my blood pressure tends to rise even more so taking the medication regularly has become especially important. I returned to work a couple of weeks after Frank died and I have been performing relatively well at my job. Although I sometimes lack the energy to go to work in the morning, my boss tells me my attendance has been commendable and my clients have not noticed any change in my quality of work. Terry’s Symptoms
□ Crying: Terry sporadically cries uncontrollably. □ Change in sleep habits: Terry now sleeps as much as possible on the
□ Loss of interest in pleasurable activities: Terry has lost interest in
□ Memory Problems: Terry often forgets about commitments with friends,
□ Lack of self-confidence: Terry doesn't believe his art is good enough for
public viewing, which indicates a lack of self-confidence.
□ Muscle aches: Terry has recently noticed muscle aches.
2005 The Permanente Medical Group, Inc. All rights reserved. Regional Health Education.
□ Stressful Life Event and/or Personal Loss: The death of Terry's partner
Frank is both a stressful life event and a personal loss.
□ Medication side-effect: The drug that Terry is taking for his high blood
pressure has a side effect of depression.
□ Brain chemistry: For a clinical depression such as this one, brain
chemistry cannot be ruled out completely as a contributing factor.
Treatment Options Medication Although Terry is very sad, he is experiencing an appropriate reaction to the loss of his partner. If his symptoms became more severe – for example frequent isolation or thoughts of suicide – antidepressant medication would be a good treatment plan. Individual Therapy Individual therapy is best for people with moderate to severe depression. Since Terry is still functioning well – meeting up with friends, doing well at work – he might not need individual therapy just yet. If his symptoms were to get worse, however, individual therapy would be a good way to help change negative thinking and create a more positive outlook. Education & Classes A depression class would help Terry understand the difference between an appropriate grief reaction and a worrisome one that can lead to the more severe Major Depression. He would also learn about what contributes to a low mood and self-care skills to help deal with symptoms. Group Therapy By participating in group therapy, particularly a bereavement group, Terry would realize that there are others like him going through the same thing. He would also feel more validated knowing that his symptoms are a normal for a major loss. Being around others would make Terry feel less alone and he might also learn some practical coping skills from the group.
2005 The Permanente Medical Group, Inc. All rights reserved. Regional Health Education.
Correspondence Infant mortality (per thousand livebirths) group on HIV in women and children. Mortality among infected and uninfectedAfrica: a pooled analysis. Lancet 2004; 364: Abrams EJ, Wiener J, Carter R, et al. Maternalhealth factors and early pediatric antiretroviraltherapy influence the rate of perinatal HIV-Idisease progression in children. AIDS , 2003; Table: Infant m
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