Case Study 13-1: A Woman With Depressed Mood

Abstract

Alula Tarif's daughter, Leila, had called the community mental health clinic to request an evaluation for her mother. She said that she and her older brother live with her mother and that - though her brother does not think that there is anything wrong with their mother - she has become very worried about her mother's increasing complaints of fatigue, lack of energy, and loss of interest in life. She had bought her mother some multi-purpose vitamins, but when she did not seem to improve, she had taken her mother to the primary care physician, who recommended that she be evaluated at the community mental health clinic. When Leila called for an appointment, she said that it was very important that her mother be seen by a woman doctor. An appointment was arranged with a female psychiatric nurse practitioner. Alula Tarif enters the examining room hesitantly, holding the arm of her daughter, Leila. She is dressed in a black long skirt and long-sleeved loosely fitting tunic top and is wearing a headscarf that covers her hair and forehead. She appears much older than her stated age of 43 years. Her face is lined and there are dark circles under her eyes. She does not make eye contact and appears very anxious. She responds to the nurse's greeting with a nod. Leila explains that her mother speaks Kurdish, and although she understands a little English, she does not speak much English. The nurse asks Mrs. Tarif if she would like to have her arrange for an outside interpreter. When Leila translates the question, Mrs. Tarif becomes very agitated and prepares to leave unless Leila can stay and interpret for her.