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My patient was in her early 40s and had had several bouts of severe depression in the past. She had a good job, though a very busy one, and her family was very supportive, especially her husband. On this occasion, she came to see me with inability to cope with anything, boiling down to sheer exhaustion. Work had been putting the last straw of load on the unfortunate camel's back.
When I asked if this experience was something she recognised from previous episodes of depression she strongly denied it: “It's nothing like it. In the past if I were unwell and my husband suggested a weekend in Paris, I would sigh and could think only of the packing needed. Now I would jump at the chance if he offered.”
Should this approach be tested among a large number of patients—randomised, controlled, and double blinded, of course—and then implemented with the next change of policy regarding diagnosing depression?
Interesting research opportunities, possibly funded by Eurostar, spring to mind. I personally could offer to be a guinea pig until we know more. I love Paris, but wouldn't mind Venice either, if it's a problem.
Later, I heard that my patient's workload had been spread among four people; she recovered, and no antidepressants were required.
I think she went to Paris, because I heard no more from her.