Psychopathology and Pathophysiology of Depression

CASE VIGNETTE Mrs J has been working as an executive assistant for the CEO (Mr X) of a major corporation for 13 years. Mrs J and Mr X have developed a good working relationship—he is generally very nice but is known for this temper. As is often the case in such long-term working relationships, they have developed certain rituals over time. One of those rituals is the Monday morning coffee that she prepares for him, to his taste. This Monday morning, she prepares the coffee in the usual way: nothing out of the ordinary there. However, his reaction is extraordinary. He begins to shout that the coffee tastes bad and that she cannot make a decent cup of coffee. She is surprised and puzzled, although she knows that Mr X has recently been having both private and professional trouble. Three days later, she is hospitalized for the third time with a severe episode of depression.