Juan Ubarri Case

Marla is a 42-year-old Hispanic female who comes to the mental health clinic complaining of having trouble sleeping, feeling "jumpy all the time", and experiencing an inability to concentrate. These symptoms are causing problems for her at work, where she is an accountant (University of Phoenix, 2011).

During the interview I proceed to ask questions pertaining to the symptoms she has been feeling. I asked Marla how long she has been experiencing these problems; Marla explains that she has been feeling like this for a long time, at least as long as she can remember but the symptoms have been more intense for the last four months.

Because she has felt these symptoms for as long as she can remember, I asked her to be more specific and she then said since she was in her twenties. She stated she has never felt fully happy and it is as if there is always something. I asked her to tell me about the specific problems and asked her to describe what she feels.

She told me she has problems falling asleep and claims that most nights she wakes and has a hard time falling back to sleep, she also stated this happens for no apparent reason. She then went on to say she feels like she is easily startled by any noise and that she feels shaky, again she said this was for no apparent reason and this happens all the time even when she is alone.

At work she feels she is easily distracted; she cannot concentrate and if trying to multitask she is forgetting to complete work she had started and failed to complete normal tasks. She told me she has been doing the same type of work for over 10 years and feels comfortable with her job duties; although they have new management and they have been implementing changes.

She feels as if she cannot complete all of her work and does not have the desire to. Marla feels like everything is piling and stated she is doing the minimum to keep her job. She overheard other coworkers complaining that she is not a team player and does the bare minimum required.

I asked Marla if she has seen her primary physician and she told me that coming to see me was his idea. I asked her to tell me about her family history and she proceeded to tell me they are healthy and no real issues, although she has never met her father and knows very little about his side of the family. She said there is no depression on her mother's side or her siblings, but she feels she might suffer from it.

When asked about her childhood Marla explained she is originally from Mexico and she arrived to the United States when she was 22. She said she had a normal childhood with her mother, stepfather, and three siblings. Marla continued to tell me they are a very close family and they are very supportive of her and they try constantly to talk positive and make her feel good.

Marla also told me she has been married for 10 years and a year after she married have seven and nine year old boys. She told me she has been busy with the children and their busy schedule, she has to pick them up from school and take them to sport practice twice per week. Her husband drops them off in the morning and takes them to practice on the weekend.

She told me she has a good marriage and a supportive husband but she has never felt completely happy. Marla stated they have not been having an active sexual life and stated that they have two to three sexual encounters per month. Marla stated they were more active a year ago, but does not know why this changed, but honestly does not care.

She told me she has recently been forced to adjust her schedule since they have new management their work schedules have been adjusted and she is not able to drop the children off in the morning. She was a little upset that her schedule is changed almost weekly and she feels she has to juggle her time. She said she is getting home later now and barely has time to make dinner.

Marla also talked about not wanting to do anything around the house. She stated that she feels tired and that she barely keeps up with herself. She stated her husband has recently complained about her personal appearance and hygiene, although she feels