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Stress is arguably the most common mental disorder with a significant impact on an individual’s well-being. Its extreme levels contribute to depression leading to loneliness and anxiety. L’s case resonates with complete withdrawal from the social cycle, which drives her into high levels of stress. The failure to reconcile with her inner self implies ensuing emotional turmoil. In light of this, the paper delves into analyzing the case study involving L, the client. It will probe client’s background information, description of the problem, diagnosis, interventions, and conclusive remarks. Pertinently, the paper will dwell on the theoretical framework postulated by Sigmund Freud. In essence, the proper diagnosis, strategies, and solutions to L’s stress disorder can be best captured by his theories in the broader field of psychology because they offer a direct path to the client’s recovery based on the psychotherapy approach.

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Background Information

The client is a 24-year-old female with zero family history of drug and alcohol abuse. L’s depression involves a combination of socio-cultural and economic factors coupled with her inability to reconcile with them for a better perspective on life. However, there is a glimmer of hope given that she does not use drugs and does not have a family history of drug addiction. The ensuing conflict between external and internal factors hinders her personal and professional growth. For instance, Sigmund Freud established that unstable interpersonal relationships are a key factor in diagnosing depression, stress, and related disorders (Horney, 2013). The breakdown of communication between L and her mother has ignited stress. Strained family relations, majorly pronounced in parental absenteeism, complicate stress and depression as outlined in the case study. The lack of a strong bond between L and her father has propelled her into emotional turmoil. Such a case is reminiscent of Freud’s subconscious and conscious conflict, whereby individual’s desires are not actualized entirely (Lacan, 2008). Apparently, the lack of a parental figure in L’s life has raised her stress levels. The client has zero history of depression. However, the lack of togetherness, peace, and harmony hints that the disorder cannot be entirely overruled. Furthermore, the client’s health status is not particularly impressive given the level of over-indulgence in alcohol.

Anxiety is revealed through over-expectations. Despite lacking experience in particular aspects in life, people are generally positive that their concerns will be solved. Therefore, the client’s resolution to train as an ambulance medic drives her into more stress once she has been told that she lacks life experience. Apparently, the client attempt to trust herself and people around her further has amplified her mental breakdown, stress, and depression. Affection is a major factor due to absent parents. Career difficulties equally underline her mental struggles. Such scenarios underscore Sigmund Freud’s conceptualization of stress as a perpetual sense that one is not good enough (as cited in Lacan, 2008). L’s life struggles allude to her lack of self-acceptance because finding oneself according to Freud takes self-belief, repression of anger, positive thought process, and features of being considerate and driven by self-worth.

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Description of the Presenting Problem

L has been undergoing extreme stress levels driving her into depression. Therefore, scores of physical, emotional, and sensory symptoms connected to stress and depression are apparently clear. Firstly, since the client is isolated and bored, it has taken a toll on her social skills as well. Furthermore, she does not even enjoy art, her only love. Secondly, covering school buildings with graffiti establishes her road to self-discovery, but is still symptomatic of stress and depression she has been going through. Thirdly, the client drinks heavily as a false coping approach to high stress levels coupled with anxiety. Since she cannot find anything constructive to work on, the decision to drink has appeared naturally. Fourthly, the client lacks self-worth as exemplified by her discharge from the army. Freud viewed self-worth as the reconciliation of individual’s inner struggles to an extent that one’s outward appearance matches their inner world (Horney, 2013). Such a case cannot be observed from the client but rather a continuous wave of personal struggles through stress, anxiety, boredom, isolation, alcoholism, and the lack of family bonds.


The client is suffering from extreme levels of stress equating to depression. Over-indulgence in alcohol is a key symptom of this condition, whereby the victim identifies it as a strategy to cope with high levels of stress and anxiety. Horney (2013) asserts that alcohol abuse is one of the commonest symptoms of depression. In this case, it is coupled with delusions. For instance, the client views alcohol as a solution to anxiety. Sigmund Freud stated that an interpersonal conflict further heightens the case of depression (as cited in Horney, 2013). However, it is revealed in terms of strained relationships with the parents. L experiences a huge gap in her life since she does not enjoy closeness with either parent. Importantly, isolation and boredom indicate depression as well because the client is struggling to find identity given her unending challenges.

Depression is also indicated by the client’s loss of excitement in doing what she has always found pleasure in doing. For example, she loves art only. While fighting with alcoholism, the client feels detached from the rest people, being an indicator of depression. According to DSM-5: Diagnostic and Statistical Manual of Mental Disorders, L’s mental disorder can be categorized with respect to the following codes: 291.3 Alcohol-Induced, Induced Psychotic Disorder Coupled with Hallucinations, 291.89 Alcohol Induced Anxiety Disorder, 300.00 Anxiety Disorder NOS, 301.7 Antisocial Personality Disorder, and 303.90 Alcohol Dependence Disorder (Hacking, 2013). Anxiety disorders have complicated L’s mental, emotional, and physical condition.

As previously outlined, all conditions presented in L’s diagnostic analysis fundamentally highlight interpersonal conflicts, which massively affect her ability to understand them and develop appropriate solutions. However, the diagnosis has been set through examining client’s attempts to solve problems she has encountered, for instance, fighting with anxiety through heavy alcohol drinking. It eventually led to alcohol dependence as portrayed in DSM-5 (Hacking, 2013). Secondly, poor performance creating boredom at school has led to isolation.

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The treatment of the stress and depression disorder revealed in the case study will involve the adoption of the Freudian psychoanalysis approach to depression and other mental issues. Sigmund Freud outlined the significance of attaining the balance between conscious and unconscious mental processes that guide actions, thoughts, and feelings (as cited in Horney, 2013). Intervention criteria are fundamentally dependent on these three aspects.

Psychoanalysis Approach

Psychoanalysis is a type of psychotherapy, which is dependent on understanding entire unconscious mental processes determining individual’s feelings, thoughts, and actions. The concept postulated by Freud underlines the significance of undertaking psychotherapy. Therefore, according to Sigmund Freud, the latter is vital in identifying and relating unconscious processes to a person and an array of physical and psychological issues the one may experience (Newman et al., 2011). In the case study, L displays isolation, stress, anxiety, and the lack of self-worth among others, which are treatable under the psychoanalysis approach.

Alternative treatment approaches to psychotherapy include undertaking intensive interpersonal or cognitive-behavioral therapies. The decision can be made on either of the approaches the counselor deems appropriate. Sigmund Freud strongly referred to cognitive-behavioral therapy as the most appropriate results-based treatment because it seeks to explore person’s behaviors and how they are connected to the environment (as cited in Horney, 2013). L’s depression issues stem from a negative perspective on the environment along with delusions. Therefore, the selection of the cognitive-behavioral approach is founded on its role in eliminating negative thoughts.

The psychoanalyst works with people being unaware of factors driving them into certain patterns of thought. Hence, through a therapy talk, such thoughts, feelings, and reactions are deeply explored. It can be arranged for a 45-minute session for five days a week. The client’s response to the unconscious once brought forward for discussion indicates a positive effect of therapy (Vahia, 2013). In other words, it will be observed when one can better control one’s emotions and behaviors. The effectiveness of treatment involves the restoration of interpersonal skills, better decision-making, and increased socialization among others.

Psychotherapy will take a minimum of three months and a maximum of five months. However, as previously alluded, it demands timely reviews of client progress. Therefore, the duration will entirely depend on the client’s response to treatment. Importantly, I will use the first five sessions to dwell into the client’s history and such key stressors as family problems, alcoholism, school, and job issues. Exploring them will form a platform that I will use to tackle isolation, boredom, and self-blame and to build interpersonal skills.

As a therapist, my role is to guide the client in making a connection with positive aspects of her life, for instance, through withdrawing from extreme alcoholism and building a strong rapport with her parents. I understand that it can be impossible, but an effort must be made within the shortest time possible. Furthermore, I will assist the client in defining her goals and objectives through highlighting areas that need improvement, particularly eliminating repeated negativities, which cloud proper reasoning. As roadmaps to assist the client define her goals and objectives, I will adopt the following steps: building a strong professional relationship with her, gaining her trust by using my own example where appropriate, and checking on her daily routine because it is the best way in which she can open up. Sigmund Freud observes that the counselor’s role in setting client goals is to identify a sequence of negativities impeding the way to recovery and developing appropriate techniques of handling them (as cited in Horney, 2013). The therapist will determine every course of action.


In essence, depression is a common mental disorder with a significant impact on a person’s feelings, actions, and behaviors in general. In the case study, L’s symptoms, including isolation, stress, heavy drinking, lack of self-worth, and interpersonal conflicts, indicate that the client is experiencing depression. Its diagnosis according to Sigmund Freud follows a pattern portrayed by the conflict between conscious and unconscious components. Psychotherapy is the best approach to treat the client because it explores her inner self, fears, insecurities, negativities, and concerns in life. The counselor’s role is pivotal in building trust, seeking alternative treatment, and making referrals among others.

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