Marisol is a 29-year-old graduate student who comes to couns…
Marisol is a 29-year-old graduate student who comes to counseling at the encouragement of her older sister. Over the past five months, Marisol has experienced a steady decline in her mood and functioning following a series of cumulative stressors. Earlier this year, she was laid off from her part-time job, struggled academically, and went through a difficult breakup after a four-year relationship. Since then, she reports feeling “empty and exhausted most days” and says she has lost interest in activities she previously enjoyed, including cooking, exercising, and spending time with friends. Marisol describes persistent low mood nearly every day, along with frequent tearfulness, low energy, and difficulty concentrating on her coursework. She has been sleeping up to 10–12 hours a day but still feels fatigued, and on some days she struggles to get out of bed. Her appetite has decreased, and she has unintentionally lost about 12 pounds over the past three months. She reports feeling like a “burden” to others and frequently ruminates about being a failure. Marisol has begun skipping classes, has fallen behind on assignments, and has withdrawn socially because she “doesn’t have the energy to pretend to be okay.” She reports that these symptoms have been present most days for over four months and are significantly interfering with her academic, social, and occupational functioning.