Case Studies

These case studies show that appropriate interventions targetting underlying issues are far more effective than simply surpressing symptions with drugs.

  • Post-natal life support the right prescription

    A young mum cradling a newborn baby

    Four-week-old Bobbi had poor weight gain, slept poorly and was irritable, which made her 22-year-old mother Shaniah teary and anxious. Vanessa, a mother-baby nurse visited Shaniah at home in her small, shabby, rented house in a deprived area that was poorly cooled and insulated. 

    Vanessa considered post-natal depression and asked about Shaniah’s supports. Shaniah was estranged from her mother and left home at 16, having been sexually abused by her stepfather. Until her pregnancy, her social interaction had been centred on drug use, connections mostly lost when she stopped using.

    Her boyfriend Jayden lived with her but didn’t like being a father and would get cross when Bobbi cried. Jayden was often out, though he didn’t work, and controlled all the finances. Shaniah was largely housebound. 

    Vanessa asked if Shaniah had anyone she could call on. After some hesitation, Shaniah identified her maternal aunt, Frannie, who was in her early thirties and busy with young children. Shaniah hadn’t wanted to worry her. Encouraged by Vanessa, Shaniah contacted Frannie, who was pleased to offer support. 

    Vanessa also arranged to meet with Shaniah and Jayden to talk through Jayden’s discomfort with being a father. During that meeting it emerged that Jayden’s avoidance was because he felt a failure. 

    They were both being exploited by their landlord and had not fully tapped into available Centrelink support. Vanessa was able to direct them to the appropriate Centrelink office and a community housing service.

  • Dislocated distress; drugs not needed
    A young women sitting in distress

    Amy, 16, attended her school counsellor, Ms Briggs, saying she was ‘depressed’.  She couldn’t sleep for worrying, woke early, was off her food, couldn’t concentrate in class, and said she had thought she would rather be dead. 

    This had been going on for over a month, triggered by her boyfriend, Josiah, breaking up with her. 

    Ms Briggs, trained in Mental Health First Aid (MHFA), recognized Amy’s pattern of distress earned the label of depression.  Many in her place would have referred Amy to her GP or an Emergency Department. In both places, on average, depression would have been accepted and Amy likely started on antidepressant medications. 

    But Ms Briggs probed further, suspecting an extreme reaction to the end of a relationship of only six months. She looked for complications in Amy’s relationship with Josiah or the break-up but found none. 

    Amy’s family situation was more informative. Amy’s parents had always fought a lot. Amy’s relationship with her mother was also strained. Shortly after the relationship with Josiah began, her father disclosed he was having an affair and was moving interstate. 

    Amy displaced her distress at this abandonment by the parent she regarded as being 'on her side' with immersion in a new relationship and busy social, academic and sporting life. Normally she could have dealt with the break-up, but the distress related to her father suddenly flooded back, without Amy recognising why she felt so bad.

    Understanding Amy's distress didn’t make it go away, but it did change how she and Ms Briggs felt about what was needed. Amy needed support to grieve, perhaps some mediation with her mother, and an opportunity to tell her father how he had disappointed her – all things that Ms Briggs could help with. A medical referral, and drugs, were not required.

    Amy wasn't suffering from depression caused by abandonment. Rather, she was suffering from abandonment in a way that fit the pattern of depression. Depression was the manifestation, not the explanation.

  • Not coping, but not depressed
    A man holding his face in his hands in distress

    David, 44, a diesel mechanic and father of two, was referred to an Employment Assistance Program (EAP) by his HR department because his line manager had detected a deterioration in performance. 

    The manager, who had a good relationship with David, attributed his poor work performance to depression, as David had been late to work, looked exhausted and was distractable. David told his EAP counsellor that he was unhappy, sleeping badly, couldn’t concentrate, lacked energy and had had ‘a few panic attacks’. Work normally came easily to him but was no longer finding it engaging. 

    The counsellor asked if there were other pressures on him. David had divorced two years before and initially the co-parenting had been collaborative. However, in the last few months, in the context of falling behind on child support payments, his ex-wife had been uncooperative with his access to the children. The counsellor wondered why he had fallen behind - he had a good income. 

    David became tearful and disclosed a gambling problem. After the separation, he had used his love of sport as a distraction and fallen into a pattern of increasing online sports betting, ultimately leading to multiple unpaid debts for utilities etc. 
    Although he no longer gambled, David’s money worries were a constant preoccupation, causing insomnia and anxiety, and making him feel guilty and a failure. He feared he would lose his house.

    The counsellor put David in touch with a financial counsellor – a free service through a range of NGOs. This helped to unclutter David’s worries by reaching repayment plans for various debts so he could make better use of counselling and grief work regarding his lost marriage and compromised relationship with his children.