Major Depressive Disorder

Chapter 4 describes a case of IPT treatment of major depressive disorder with a focus on role transitions, and how social roles are central to our sense of identity, how all individuals may hold numerous roles (partner, child, parent, sibling, neighbor, community member, etc.), besides having vocational roles (colleague, employee, employer, or professional). It looks at how social roles determine the ‘rules of engagement’ (around communication, sharing of responsibilities) and expectations we have of one another, and how a change in one’s social role (losing a job, moving to another city, becoming partnered, ending a spousal or long-term romantic relationship, adjusting to a disabling or disfiguring medical condition, becoming a new parent) can generate a shift in or loss of one’s sense of self. It examines how these role transitions also evoke changes in one’s needs for or access to social supports and how a role change can be stressful enough to provoke an episode of major depression, especially in individuals with limited social support, insecure or disorganized attachment, or a history of or genetic vulnerability to depression.