A 27-year-old woman with a first-lifetime major depressive episode seeks care. Her depression began 3 months ago and has grown more severe, to the point that she is currently struggling to concentrate at work in her sales job, and she frequently cries in the break room. She notes a mild decrease in appetite, but her weight has remained fairly stable at 92 kg (BMI = 32.6) and is a source of considerable concern and guilt.
Sleep has been non-restorative, but she has not struggled to initiate sleep and wakes up appropriately once in the night for about 20 min. She has thought that she would be better off dead—or more specifically that her children would be better off without her—but she does not plan to kill herself, citing religious prohibitions and a desire to feel better. In addition to a referral to cognitive behavioral therapy and considering body weight parameter, what is the…
