| Summary: | Nathan presents with a flat affect and describes a sense of numbness that has been occurring over the several months. Upon further reflection, these several month episodes have been occurring for the last four or five years coinciding with the summer. Five years ago, Nathan’s sister, six years old at the time, drowned in his parents' backyard pool when he was supposed to be watching her. The tragedy subsequently broke apart his family. The numb feelings begin at the beginning of May and begin to recede as the holiday season begins. During these down months, Nathan describes pronounced changes: his productivity at work suffers, difficulty concentrating, a lack of engagement and feeling of pointlessness, and no interest in activities. At home, his relationship with his girlfriend suffers because of her worrying about his condition. Arguments that arise between him and his girlfriend remain unresolved, helped only by the change in seasons. More generally he finds a lack of motivation and loses pleasure in eating or eats more unhealthy foods. He has currently lost weight because of a lack of appetite. Further, Nathan ruminates on the guilt over allowing his sister to drown and that he deserves to die. Suicidal thoughts are frequent for Nathan, as he believes the world would be better without him. He currently has a way has decided he would commit but doesn’t possess the motivation to carry it out. The interview ends with Nathan expressing a desire to have these feelings stop.
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