Buddy King

BUDDY KING

At the time of his referral to a psychiatrist working in the outpatient program of

A private psychiatric hospital, Buddy King was a 28-year-old married African-American man with two daughters (ages 18 months and 4 years) who worked as a manager in a family food business (he had obtained a degree in business administration at the age of 24). Buddy was referred by his family doctor after his wife had called the doctor to express concern over her observations that her husband was becoming increasingly depressed. Over the prior 2 to 3 months, Buddy’s symptoms of depression had indeed escalated. These symptoms included sustained depressed mood and lack of energy, difficulties concentrating, decreased interest and withdrawal from the activities he usually enjoyed, pessimistic views and rumination about the future, and sleep disturbance (i.e., awakening in the morning several hours before he intended). More recently, Buddy had experienced a decrease in his interest in sexual relations with his wife, and occasionally he had thoughts about committing suicide.

Despite these escalations in his symptoms of depression, Buddy was hesitant to see a psychiatrist due to his fear of being revealed as “mentally ill” or “weak.” However, these symptoms were beginning to interfere with his work, social life, and marriage. Buddy had previously been very energetic and devoted to his work. He now found it difficult to get up in the morning to go to the office. Furthermore, he had been an avid athlete, but recently he had discontinued nearly all of his athletic activities. Based on these factors, Buddy reluctantly agreed to set up an initial appointment with the psychiatrist.

Clinical History

Buddy’s decision to agree to make this appointment was also influenced by his experiences in college When Buddy was in his senior year at a prestigious university in the Midwest; he had also experienced symptoms of depression. During this time, Buddy was under a great deal of...