Domestic Violence Manifesting as Depression

Piyali Misquitta, MA Clinical Psychology

The psychological impact of domestic violence, and response to intervention is illustrated by this case. Targetting inaccuarate and unhelpful thoughts through CBT helps clients manage their emotions better and encourage problem-solving behaviours.

A 30-year-old married woman, TN approached Pathfinder Clinic alone with concerns of tearfulness, sadness, guilt, and anxiety. She was especially worried that her thoughts and mood were interfering in her work, and that she would be asked to leave. Further enquiry revealed a history of physical violence by her husband. This information helped provide a context for the distress she was experiencing: she felt sad and guilty about the deterioration of her marriage, and often blamed herself for the situation she was in. When she considered the options for her future, she felt anxious and unable to take a decision. She also reported that she had suicidal thoughts, especially when she was distressed.

Psychological assessments revealed severe depression and anxiety, and also that TN was very concerned with what others people thought of her. This concern was then addressed during consequent sessions of cognitive behavior therapy (CBT), which helped her make an independent decision about what was best for her future. She learned how to deal with conflict with her husband, and put her own requests forward in an assertive way. CBT also helped her re-evaluate the guilt she was experiencing, and reduce self-blame. With regular sessions of CBT and medication, TN reported doing much better at work, and felt confident about her decision to leave her husband. She was also able to identify old hobbies that she used to enjoy, and incorporate them into her schedule.