1. After successfully diagnosing your case study Lamanda (chronic Depressions disorder)

(see case study below), discuss the following:

• What makes this unipolar depression different from major depressive disorder?
• What cultural relevance needs to be considered when diagnosing this disorder?
• How would the cognitive perspective in dimension two of the multipath model explain the causation of unipolar depression?
• What treatments other than medication are recommended?

CASE HISTORY Lamanda is a 22 year old woman who has recently graduated from Ohio State University with a psychology degree. She is currently working as a waitress at a popular restaurant near campus, and says she has always planned to attend law school. Lamanda was born in Detroit, Michigan. Her mother is an African American who is an assistant manager at a grocery store. Her father is Caucasian and works at a department store. Lamanda reports that she was a shy, unattractive child, but that in general her early childhood was "pretty happy." Lamanda says that during elementary school, she was constantly harassed by classmates about being of mixed race. Still, she says that she felt very close to her family during this period. She says she feels especially close to her mother, though she typically approaches her father "when I have a big problem." When Lamanda was 14, her family moved to Royal Oak, a working class suburb outside of Detroit. At about this time, Lamanda began to blossom intellectually. Her grades were consistently very good, and she was a member of the National Honor Society. She says she remembers this as the happiest period of her life. Lamanda also bloomed physically. She became popular with boys, although she reports frequent anxiety when she was unsure of how to deal with their advances. Lamanda was especially distressed by some strong sexual advances from her 47 year old softball coach during her sophomore year of high school. Lamanda insists, however, that this "incident" is in the past and that she has not thought about it for years. Throughout high school, Lamanda concealed her mixed heritage from her classmates by not inviting friends over to her home. She admits that she is embarrassed by this, and she suspects that her parents realized what she was doing. She now insists that "I am not black or white, I am me." During her junior year of high school, Lamanda had her first serious boyfriend, Morris Silverstein, who was a high school classmate. She describes the relationship as warm and supportive and they became sexually active during her senior year of high school. She describes the sex as "good, considering our age." Morris was accepting of Lamanda's ethnic heritage, and became good friends with Lamanda's father. Like many young people, Lamanda seldom discussed sexual or romantic issues with her parents, preferring to keep her parents out of her personal life. Morris broke up with Lamanda during her freshman year of college explaining that he wanted to be able to date other people. Lamanda says she coped with the break up "pretty well" and she and Morris have remained good friends. In college, Lamanda has dated sporadically and she acknowledges some bisexual experimentation. Lamanda says that she prefers heterosexual relationships, however. She has been dating Brett for more than a year, but she says that he seems to be less committed to the relationship than he used to be. Although he seems to be making an effort to be supportive, Lamanda reports that he tries to be positive but always ends up criticizing her. Although Lamanda appears to be a natural athlete, she leads a relatively sedentary lifestyle. She was the star pitcher for her high school softball team, although she quit abruptly during her junior year. Last year, she

joined a recreational softball league, but she quit after only a few weeks, explaining that she was just not enjoying herself. Lamanda does not like her job at the restaurant, but seems unwilling to look for other employment. She says that she feels "very jittery" whenever she gets ready for work, and she uses any excuse to take days off. She also refuses to associate with fellow employees, and reports getting very anxious when she was given a surprise birthday party. Lamanda works the evening shift, and she often does not get home until 3am. In turn, she routinely sleeps in until 1 or 2 in the afternoon. Recently, she has lost interest in cleaning her house and seldom cooks for herself. She also attends less to her personal grooming. She now avoids seeing both Morris and her parents, fearing that that they will disapprove of her. She also says she has lost interest in further education. About two months ago, Lamanda became friends with a social worker who frequents the restaurant. After a protracted conversation, he recommended that she seek professional assistance.