Gilner's Mental Health in the Film It's Kind Of A Funny Story

This case conceptualization is based on the film It’s Kind of a Funny Story. The protagonist of the film, Craig Gilner, is the client presenting with a psychological disorder.

Client Background

Craig is a 16-year-old male that resides in Brooklyn, New York. He attends Executive Pre-Professional High School, one of the most competitive and prestigious public schools in New York. His home life is relatively normal, and his family consists of a mother, father, and younger sister. He describes his mother as too fragile and his sister as a genius while his father works too much but states that his parents are not to blame for his psychological problems and they have been very supportive through this process.

Presenting Problem

Craig has been depressed for approximately a year and has been more anxious and stressed lately due to an application to a prestigious summer school he believes he must attend in order to get into a good college. He states he is also nervous about a girl he likes. Since the onset of the depression he has been experiencing thoughts of death and suicide and he also has trouble sleeping. Has trouble organizing thoughts either trailing off midsentence or gets caught in a cycle of thinking of the worst possible outcome. In addition, he has been experiencing fatigue and a lack of motivation often lying in bed for hours before he gets up. He also has eating problems, most of the time when he eats he cannot stomach it and end ends up vomiting.

Clinical History

Approximately a year ago Craig started receiving treatment for depression by a psychopharmacologist that prescribed him Zoloft. He has also been referred to many different therapists. After taking the Zoloft he felt better and stopped taking it for three weeks. After discontinuing his medication, he was unable to combat the suicidal thoughts and he reached out to the suicide hotline to receive help. Subsequently he was willingly admitted to an inpatient psychiatric facility where he continued seeing a therapist individually, was prescribed medication, and attended group therapy.

Diagnosis

I would diagnose Craig with major depressive disorder because his symptoms match the criteria listed in the DSM-5. He remains in a depressed mood most days and has lost interest in things he used to do like hanging out with his friends. This change in behavior has also been observed by his friends. His appetite has decreased and when he manages to eat he cannot keep anything down. As mentioned he also has trouble concentrating and has thoughts of suicide. While he meets the criteria for this disorder it is unknown if it as recurrent because we do not know if he has experienced another depressive episode after treatment. This diagnosis was also difficult to make because some of his symptoms overlap with those in generalized anxiety disorder.

Alternate Diagnoses

AnxietyIn addition to major depressive disorder Craig also meets the criteria for generalized anxiety disorder. He experiences a lot of anxiety and worry about school and other aspects of his life even things out of his control such as wars and the state of the economy. He often compares himself to his friends that attend Executive Pre-Professional worrying that he is not smart enough to keep with them and other students. When he starts worrying about these things he finds it difficult to stop. In these situations, he is often seen on edge and breaking out in a cold sweat. As stated he also has difficulty concentrating. Ruminating on these thoughts also keeps him from getting adequate sleep.

Persistent Depression

There is a chance that Craig could be suffering from persistent depressive disorder as opposed to major depressive disorder. The depressed mood must continue for at least two years and his symptoms have been present for a year. We do not see how long he remains symptom free after being discharged from the inpatient psychiatric facility but if he does so for less than two months and the symptoms persist he would meet the criteria for this disorder.