ABSTRACT
This chapter presents a case of a 69-year-old woman who complains of feeling constantly tired and not enjoying anything including her grandchildren. She sleeps for 8 hours or more but still never feels rested. She finds herself getting increasingly irritable and snappy with her 37-year-old daughter who is now living with her following the breakdown of her marriage. She is obese and her dress is rather erratic. She has lots of layers of clothing and seems unaware that she has come in her slippers. She looks tired. Her speech is slow, flat and monosyllabic. She states she feels okay but she looks and sounds low. Liver function tests, blood sugar and urea and electrolytes would exclude systemic illnesses that may affect mood and coping. These are numerous and include, for example, neoplasia, diabetes, renal problems and liver problems. If this woman's diagnosis is depression, she would benefit from antidepressant treatment and perhaps cognitive behaviour therapy (CBT).
