Psychiatric Interviews for Teaching: Depression — Transcript

Full transcript

1. 0:14hello Alice and Wells do you want to
2. 0:15come and have a
3. 0:18seat hi I'm Dr Taylor one of the GPS at
4. 0:21this surgery what would you like me to
5. 0:23call you Al will be fine okay okay so
6. 0:27what's brought you here today
7. 0:28Allison
8. 0:31um my sister's noticed I'm just a bit
9. 0:34fed up really right okay my sister said
10. 0:37um I should come right okay has this
11. 0:40been going on for some
12. 0:42time yeah a few months right okay do you
13. 0:46want to tell me a bit more about what's
14. 0:47been going
15. 0:48on
16. 0:50um I just things things seem to be
17. 0:53piling up
18. 0:54right
19. 0:57just I just don't seem to be coping with
20. 1:00things home okay the kids and things
21. 1:03right okay would it be okay Alison for
22. 1:06for me to ask you a few more detailed
23. 1:08questions about how you've been
24. 1:09feeling okay well if we start with
25. 1:12asking you a bit about your mood how
26. 1:14have you been feeling in
27. 1:16yourself um I say a bit Fed Up
28. 1:21m c in the morning it just everything
29. 1:24just seems very black right it's
30. 1:27like it's just like swimming in
31. 1:31in treal really and I just
32. 1:34don't just I think by tea time time the
33. 1:37kids get
34. 1:40home been having a fairly decent
35. 1:43conversation with them but right and and
36. 1:46can I just check Alison when you say
37. 1:47things feel very black do you feel do
38. 1:49you mean you feel very
39. 1:50miserable Fed Up miserable okay and what
40. 1:55about sort of feeling
41. 1:56tearful has that been
42. 1:58happening
43. 2:00I dropped some sugar the other
44. 2:02day and I just burst into tears right
45. 2:10okay so is it the slightest thing that
46. 2:12would make you make you feel tearful
47. 2:14things that perhaps wouldn't ordinarily
48. 2:15bother
49. 2:16you yeah right my sister's noticed as
50. 2:19well right okay so you've been feeling
51. 2:21very low and with episodes of
52. 2:24tearfulness yeah what about other things
53. 2:26what about your energy levels are you
54. 2:27managing to keep up with things
55. 2:30I used to do a lot with the kids we used
56. 2:32to go swiming
57. 2:34playing but now I just just spend the
58. 2:37day on the sofa really I I have to go to
59. 2:39work right and just remind me what is it
60. 2:42you do for your job I work in the
61. 2:43supermarket right so how have you been
62. 2:45managing at
63. 2:47work I'm not I'm not been going in as
64. 2:50much cuz I just feel so
65. 2:53exhausted but I mean we're just
66. 2:56not the the supermarket's been taking
67. 2:59over and they've cut the wages right and
68. 3:03I'm having problems with the bills right
69. 3:06and it's like cataloges just writing me
70. 3:09letters mhm you know the kids they they
71. 3:14want all these new games and stuff it's
72. 3:17just you
73. 3:19know I think things are really difficult
74. 3:21all around okay with all this going on
75. 3:23how are you sleeping
76. 3:25Allison um it's just it takes me ages to
77. 3:29go to sleep MH used to read a book right
78. 3:33and um just drop off but now I just
79. 3:36spend my time looking at the clock goes
80. 3:39round and around so from actually
81. 3:41getting off to bed and getting off to
82. 3:42sleep how how long is that taking couple
83. 3:45of hours proba okay once you're actually
84. 3:47asleep are you waking up much during the
85. 3:51night I wake up
86. 3:53about last night I think it was about
87. 3:554:00 I woke up and can you get back to
88. 3:58sleep from that time no no and then when
89. 4:02when you're actually getting out of bed
90. 4:03in the morning are are you still feeling
91. 4:05tired at that point just exhausted feel
92. 4:07like my brain's not been switched off
93. 4:10right and just exhausted the next day
94. 4:13okay what about eating what's your
95. 4:15appetite been like while you've been
96. 4:16feeling like
97. 4:18this I used to have quite a weight
98. 4:21problem but the last couple of months
99. 4:23I'm in this just a bit looser right um I
100. 4:27just you know how much you've lost no no
101. 4:30the kids come in from school and they
102. 4:32make their own stuff and I just don't
103. 4:35bother really okay okay so your appetite
104. 4:37has gone down as well what about things
105. 4:40like concentrating in your memory both
106. 4:42when you I don't know watching TV at
107. 4:44home or or out when you're out doing
108. 4:45your job how have those things been I'm
109. 4:48been pretty useless with the kids
110. 4:49they've um I've got the swimming money
111. 4:52last week and right PE it and parents
112. 4:56even even right okay I just
113. 5:00start one job
114. 5:02and
115. 5:04like I'm not explaining myself very well
116. 5:06it's like the television I used to like
117. 5:08watching the soapes mhm e Enders or
118. 5:11something and no 10 minutes later just
119. 5:14you know thinking of something else okay
120. 5:17okay and what about things Allison that
121. 5:20you used to enjoy are there things in
122. 5:22life that you still enjoy at the
123. 5:25moment um nothing really as I say
124. 5:30bit useless with the kids used to enjoy
125. 5:33going out right um I used to go out with
126. 5:36my friends pictures and things
127. 5:40right but of course now I just can't be
128. 5:42bothered is it is it you can't bother
129. 5:44you don't feel like it as
130. 5:47well what's the point really okay you
131. 5:50know and I was going to ask how old are
132. 5:52your children now I had a bit later in
133. 5:55life mhm took a long long time for me to
134. 5:58have them
135. 6:00um got a girl and a boy one's 11 one's
136. 6:05nine and I'm I'm looking after children
137. 6:07takes a lot of time and energy how are
138. 6:09you managing to keep up with that
139. 6:10feeling as low as you
140. 6:12do well a bit self-sufficient really the
141. 6:16kids they coming from school get their
142. 6:18own tea
143. 6:20right I should be doing more for them
144. 6:22really but no I'm just bit useless at
145. 6:24that at the moment okay and what about
146. 6:26looking after
147. 6:28yourself well you can see I'm just a
148. 6:31mess Dave used to say that's my
149. 6:33boyfriend right I used to you know not
150. 6:36have much money but I
151. 6:38just take a bit of pride in in what I
152. 6:41was doing you know right okay and my
153. 6:44hair and stuff but I can't can't be
154. 6:47bothered with that now there's no point
155. 6:49really okay okay and you mentioned Dave
156. 6:51that's your your current partner how
157. 6:53long have you and Dave been
158. 6:55together about a year I met him at work
159. 6:57right and how are things because often
160. 6:59when people feel really down it has a
161. 7:00real impact on everything including
162. 7:01their relationships how are things
163. 7:03between you and Dave at the
164. 7:05moment but he's not ringing as much he
165. 7:09used to
166. 7:10text but he's he's going you know he's
167. 7:14getting fed up with with me not wanting
168. 7:16to go out right okay and things that's a
169. 7:21slightly embarrassing thing to ask about
170. 7:22but I guess it's important often when
171. 7:24people are really feeling very low it
172. 7:26affects everything in their relationship
173. 7:27including things like the sex life have
174. 7:29you noted no any changes there for you
175. 7:32he's always trying to pressure me a
176. 7:34little bit stuff but really not into
177. 7:38that at the moment okay you just don't
178. 7:39feel like that at the moment okay so can
179. 7:42I just recap Allison and check I've got
180. 7:44this right for the last few months
181. 7:46you've been feeling really down no
182. 7:48energy problems with your sleeping and
183. 7:50eating problems with concentrating not
184. 7:53really enjoying things and actually
185. 7:54struggling a bit with the kids and
186. 7:56perhaps some difficulties in your
187. 7:58relationship with Dave have I got that
188. 8:00right
189. 8:02okay can I ask Allison in the past have
190. 8:05there ever been episodes when you felt
191. 8:07like
192. 8:08this when when my husband left
193. 8:12mhm
194. 8:14um I was Al I was always crying then for
195. 8:18no particular reason
196. 8:21right um I haven't told anybody this
197. 8:24before but I took some tablets
198. 8:28right so how long ago are we talking
199. 8:30about is this a few years
200. 8:32ago about four years ago about four
201. 8:34years ago okay so so you took some
202. 8:36tablets yeah can you tell me is it all
203. 8:38right tell me a little bit more about
204. 8:41that you know what it's like the kids
205. 8:43are in bed
206. 8:46MH and you're on your own and add a few
207. 8:48glasses of wine
208. 8:50right and I just just took these tablets
209. 8:53right okay can you remember what you
210. 8:56actually took at the time what sort of
211. 8:58tablets there were
212. 9:01they were just in the bathroom cabinet
213. 9:04M paracet right
214. 9:07okay so you took some paracetamol can
215. 9:10you remember sort of roughly how many
216. 9:11you
217. 9:13took about two strips about 12 right
218. 9:17okay and and you'd had a couple of
219. 9:18glasses of wine did you take anything
220. 9:20else any other tablets with it no okay
221. 9:24and was this something Allison that
222. 9:25you'd thought about for a while or was
223. 9:28it something was quite an sort of of the
224. 9:29moment decision that
225. 9:31evening um I've been crying a lot but I
226. 9:36think just whine right okay but you
227. 9:40know okay it's bit of burden to
228. 9:43everybody really
229. 9:45and and was there any other things that
230. 9:48you did around the time sometimes when
231. 9:49people take tabls they leave a note or
232. 9:51do other kind of final acts get their
233. 9:53Affairs in order did you do any of those
234. 9:55things no
235. 9:58just just so you I took the tablets and
236. 10:01go to sleep right okay so did you have
237. 10:04any thoughts about what taking the
238. 10:06tablets would do did
239. 10:09you I just thought I go to sleep and not
240. 10:12wake up but I woke up a couple of hours
241. 10:14later and I just sick everywhere but I
242. 10:17was sick okay so so you actually just
243. 10:20want to check I get this right because
244. 10:21it's important you actually thought they
245. 10:22would kill you at the time I just didn't
246. 10:24want to wake up I just say I'm just a
247. 10:27useless just a useless mom now and I was
248. 10:30then right okay so so you took the T you
249. 10:33you were very sick in the night did did
250. 10:35you seek any medical help at the time no
251. 10:38no okay and then you okay the following
252. 10:43day well yeah just just felt a bit of a
253. 10:47twit really did you feel pleased that
254. 10:49you were still
255. 10:50alive yeah I think you know I realized
256. 10:53it just been silly right okay
257. 10:57okay so that that was a few years ago so
258. 11:00if we just come back to how how you're
259. 11:01feeling at the moment you talked about
260. 11:03feeling very low have there been times
261. 11:06currently when you've thought about
262. 11:07either taking a an overdose or doing
263. 11:09something else to to harm yourself in
264. 11:11any
265. 11:12way you know at night
266. 11:16when when you're watching the clock and
267. 11:19you know you're on your own kids are in
268. 11:23bed I just everything's so hard and yeah
269. 11:26I suppose you know it's see just feels
270. 11:29easy you know right and has that just
271. 11:32been something you've thought about have
272. 11:33you actually made any plans got any
273. 11:35tablets in or done anything else no
274. 11:38no like that okay and I guess that's a
275. 11:42difficult question to ask but one we
276. 11:43would ask everybody in your situation
277. 11:46have things ever been so bad you felt so
278. 11:49low that you not only thought about
279. 11:51harming yourself or or perhaps killing
280. 11:53yourself you've also wondered whether
281. 11:54the best thing might be to take the
282. 11:55children with you no my kids my kids
283. 12:00okay no would hurt them okay no and what
284. 12:05about sort of the side of that things
285. 12:07positive things sort of things to live
286. 12:09for things that you feel good
287. 12:12about not much at the moment I
288. 12:16suppose kids sometimes you
289. 12:19know they they do things that make you
290. 12:22think you know what's good about life
291. 12:25things
292. 12:27but and there other things that help at
293. 12:31the moment I'm thinking about people who
294. 12:32can be
295. 12:34supportive my sister as I say she she
296. 12:38said to get down here and she's always
297. 12:40there she comes down
298. 12:42Rings got a couple of
299. 12:44friends they're quite good right but and
300. 12:47Dave when he's in the mood of course
301. 12:49sure but I don't think he's going to be
302. 12:51around for much longer right and do you
303. 12:55think or do you feel able to keep
304. 12:57yourself safe at the moment from from in
305. 13:02yourself I think so yeah I know I can
306. 13:05come here now You' very good today okay
307. 13:08do you think if that was to change so
308. 13:11that you didn't feel you were able to
309. 13:12keep yourself safe you'd be able to let
310. 13:14anybody
311. 13:15know well I know what happened last time
312. 13:18that was nothing and I know I was silly
313. 13:20then so I know to come here right
314. 13:25okay okay aome well thanks for going
315. 13:27through all that I can appreciate it
316. 13:28must be very painful it does sound to me
317. 13:31like you are suffering from symptoms
318. 13:33that strongly suggest that you're
319. 13:34actually depressed at the moment now I'm
320. 13:36not sure how much you know about
321. 13:38depression not much really not much but
322. 13:41I know I just don't feel don't feel
323. 13:44right at the moment well I guess just
324. 13:46briefly depression can cause a number of
325. 13:48problems for people and traditionally we
326. 13:50think about people feeling very low and
327. 13:52very miserable and often you know
328. 13:54thinking about hurting themselves but it
329. 13:55can also affect all other areas of life
330. 13:57in terms of problems with eating and
331. 13:58sleep sing and the other problems you've
332. 14:00noticed like concentration and perhaps
333. 14:03not really managing as well as normal um
334. 14:06I guess the positive side is that you've
335. 14:08you've done something about it and you
336. 14:09you've come to talk to me about it today
337. 14:12and I think there are almost certainly a
338. 14:13range of things we can put in place to
339. 14:15help you and treatments that are
340. 14:17available so I guess what I'm thinking
341. 14:19was it might be worth as just spending a
342. 14:21few minutes just thinking about some of
343. 14:22those options for you so that we can
344. 14:24start to improve things for you would
345. 14:27that be all right with you
346. 14:30I need I need to do this yes and I think
347. 14:33I think that's sensible yeah
348. 14:43okay