Read the following case study:
Marco is a 31-year-old male who is a marketing executive for a large fortune 500 marketing firm. His job allows him the flexibility to work from home, but he also has the option of working with his team, in person, when he can. Marco started feeling sad about seven months ago. Along with a persistent
feeling of what he calls “blah.. everything seems dull and uninteresting,” he finds himself as frequently irritable (at even the smallest things) and sensitive to bright colors and loud noises.
Marco reports negative thoughts about himself, including the idea that he “isn’t smart enough” for this company and other people are going to realize that he is an “imposter.” He feels great guilt over taking such a large paycheck, especially because he does not feel entitled to work there. He has started second-guessing his previous work and cannot believe that others would be fooled by such “amateur ideas.” A recurrent thought is that his boss is going to finally realize that they made a mistake in hiring him and will instantly get rid of him. Because of these thoughts and feelings of constant fatigue, Marco complains that he no longer has the motivation to do the things that he used to
like to do and finds difficulty sustaining motivation through his work tasks. Marco complains that the “days are too long” as he has no trouble falling asleep but awakens hours before he has to get up, oftentimes complaining that he cannot “turn off” his thoughts when he awakens. Instead of work, he plays video games most of the day to block out the negative monologue in his head, and even that is becoming “boring” to him. To add insult to injury, playing video games all the time makes him feel “like a loser.” He reports his appetite as “OK”, though he also
laments the fact that his clothes don’t fit because he has lost 10lbs over the past month.
Marco smokes half a pack of cigarettes a day and does not exercise. He has friends but has taken to the habit of turning down his friends’ requests that he go out with them. In this, he has become quite isolated over the past seven months. He does not even take walks, an activity that used to bring him joy. He
has become quite isolated.
Marco has a history of thyroid disorder. He also reports a family history of psychological disturbance- specifically two aunts who suffered from bipolar disorder many years ago. One of them, he reports, committed suicide.
Answer the following questions in 5-7 pages:
• What are your thoughts regarding the best diagnosis to give Marco?
• What symptoms and aspects of his thoughts, feelings, and behaviors do you
focus on to illustrate the logic of your diagnosis (be very specific)?
• Discuss some biopsychosocial and sociocultural considerations (at least one
from each category) that might be important for understanding Marco.
• Recommend a treatment that you believe would be most effective in helping him
through this difficult time. Would your chosen treatment be to address the
biological, psychological or social/sociocultural (or some combination of these
elements)? Explain.
• Find and read at least one peer-reviewed scholarly article that discusses
effectiveness in treating this type of problem. Discuss how this treatment might
help Marco.

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