She is a 28 year-old married female. She has a very demanding, high stress job as a second year medical resident in a large hospital. She has always been a high achiever. She graduated with top grades in both college and medical school. She has very high standards for herself and can be very self-critical when she fails to meet them. Lately, she has struggled with significant feelings of worthlessness and shame due to her inability to perform as well as she always has in the past.
For the past few weeks she has felt unusually fatigued and found it increasingly difficult to concentrate at work. Her coworkers have noticed that she is often irritable and withdrawn, which is quite different from her typically upbeat and friendly disposition. On some days she stays in bed all day, watching TV or sleeping. At home, her husband has noticed changes as well. She’s shown little interest in sex and has had difficulties falling asleep at night.
She was under therapy for a months time. She started showing remarkable changes with her behavior. Her insomnia has reduced, now she can sleep properly without keeping awake and tossing. She has found herself increasingly satisfied with her life. The frequent thoughts of wishing that she was dead have reduced. She does not get frustrated with herself anymore.