Mary is a 41 year old woman who lives with her husband and three children aged 17, 14 and 10 years. Mary holds down a responsible position in a large organisation and loves the work she does. Her...

Mary is a 41 year old woman who lives with her husband and three children aged 17, 14 and 10 years. Mary holds down a responsible position in a large organisation and loves the work she does. Her husband is supportive and they have been married for 18 years.
Mary describes moments of despair where she is tearful and has little or no energy to move from her bed. She believes she is a burden to her family. At these times, she lacks motivation to complete simple activities such as eating and dressing. In the past, Mary has always looked smart and ensured she showered on a daily basis yet over the last month Mary’s family have noticed that she sits in her dressing gown for long periods of time and her personal hygiene has deteriorated. She is currently on sick leave from work.
Mary’s husband reports that Mary often talks of feeling worthless and hopeless and has made comments in the past that she can’t see how she will manage to get through another day. These appear to be occurring more frequently. The husband also reports that Mary is having difficulty sleeping and is often found awake staring at the window in the early hours of the morning.
The family is very concerned about Mary’s health because she has had a previous admission to hospital for depression. However, they are reluctant to have her admitted to hospital against her wishes as she says there is nothing wrong with her and she doesn’t want to trouble anyone for help.