ABSTRACT
This chapter provides a case of a 15-year-old girl who presents with a 4-month history of feelings of being a failure and hopelessness. She is overwhelmed by feelings of guilt that she is a burden to her family. Sometimes she will force herself to spend time with friends because she feels guilty about letting people down. Depression is more common in girls but it may be that it presents with more aggressive and hostile behaviour in males. An initial assessment which includes a detailed risk assessment is necessary. It would also be useful to get a parental history as they may provide some useful insights into her pre-morbid personality. Once her mood has lifted and she is more amenable, cognitive behaviour therapy (CBT) or interpersonal therapy would be useful to help her manage both her negative feelings and feelings of guilt. Given her age it is also important to engage her parents so that they can provide appropriate support.
