Case study: Sylvija Blackwood

Name:
Sylvija Blackwood

Date of birth:
1 May 1961

Mental health history:
Diagnosis of depression after the birth of her son and also 10 years ago around the time of her separation from her husband.

Background information

Sylvija was referred to a registered psychologist by her general practitioner (GP) for psychological therapy under a mental health plan. The mental health care plan indicates that Sylvija has been experiencing a lot of stress lately as well as difficulties with her memory and sleeping, low energy levels and feeling generally overwhelmed. The GP recommended an assessment and treatment for possible anxiety disorder and/or depression.

Sylvija provided the following information to the psychologist in their first session.

Sylvija lives in suburban Melbourne with her life partner of 10 years, Magda. She has one son, Peter, aged 38, who is married and has a two-year-old daughter. Peter and his wife moved to Perth a year ago so that they could be close to his wife’s parents and extended family. Sylvija has regular phone contact with her son but misses spending time with her granddaughter in person.

At the end of 2020, Sylvija retired from her job as a team leader of a large administrative team within the Department of Human Services. Sylvija and Magda had plans to travel around Australia and overseas to enjoy their retirement together. However, Magda was diagnosed with breast cancer early in 2022 and has undergone surgery, chemotherapy and radiotherapy. The treatments have left her physically weak and no longer feeling confident enough to travel long distances or be away from her medical team for a significant length of time. This also means that Sylvija has not felt able to take even a short trip to visit Peter and his family since they moved to Perth.

Sylvija was born in what was then known as Yugoslavia and moved to Australia with her parents and three older brothers as refugees in the late 1960s. Sylvija remembers the struggles of starting at her new school knowing limited English but recalled that she made friends with other children from multicultural backgrounds and generally enjoyed school. After completing high school, she went to business college to train as a secretary and married Peter’s father at the age of 21. She said that her family’s cultural expectation was for young women to marry young and have children. There was never any consideration of her pursuing higher education, unlike her brothers. She said that she experienced two miscarriages before giving birth to Peter prematurely at 35 weeks gestation. She recalls that as a new mother, she was extremely worried that something would happen to Peter and was diagnosed with post-natal depression in the first year after his birth.

Sylvija said that she was married to Peter’s father for 30 years. She said he was a “good man”, and they had a solid relationship. However, when she turned 50, she realised that she was no longer in love with him. She fell in love with Magda, who had been a close friend for many years. She said she and Magda have kept the nature of their relationship a secret from their families, but they are out within some parts of their friendship group.

Sylvija said that she and Magda used to enjoy doing a lot of things together, like attending cultural events, doing outdoor activities and looking after their large garden at home. They also had a wide network of friends, but they haven’t been socialising much since Magda’s diagnosis. She said that she no longer has the energy for gardening and finds that she can’t seem to sit still to do other things that she used to enjoy, like reading, seeing shows or watching movies. She said that she often feels restless but can’t seem to work up the initiative to plan things or get things done. Consequently, she feels like she wastes a lot of time, which frustrates her.

Sylvija said that she’s noticed that her memory doesn’t seem to be as good as before, and this is worrying her. She often seems to misplace things at home. Sometimes, she also can’t remember information from the past that she previously would have easily brought to mind, such as the name of a place that she and Magda had been to or the name of the theatre where they’d seen a certain show.

Sylvija’s goals for therapy are to feel like her “old self again”, have the energy to do things, reconnect with her friends and try and get back to doing the things that she hoped to be doing in her retirement.

Assessment information

Based on the problems that Sylvija described, the psychologist decided that it was important to collect further information about her symptoms of anxiety, depression and stress and her memory loss.