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He slowly started getting comfortable when he ignited a cigarette and he communicated to me about his life. He derived from a family of five, but had not seen his mother or siblings for over ten years. His wife asked for a divorce from him seven years ago and left him with his three children and he has not seen them since then. The only friend he has is his dog Bruno, who he seemed to value very much. He hardly has friends as they all think he is a strange man and the only thing that he does for fun is going out alone to have a drink or purchasing alcohol and drinking it at the comfort of his home while watching television. He confessed that ten years ago he used to love going to social events and attend to basketball games with friends, but now he hardly does any of those activities. In fact he seemed not to like the idea of being in public as he felt like everybody would be judging him for whom he has now become.

It was clear that he was experiencing clinical depression. According to beach et al 2006, he has most of the indications of a depressed man. This is because he hardly has any social life. He in fact confesses that he feels that his siblings, wife and children are better off far away from him. He sees himself as a failure, this is evident from the story he tells of how when he was young he used to think he would have achieved far better results for his life than what he currently accomplished. He barely cares about his hygiene or even physical appearance and has not had close or personal relationships with anybody for the last seven years or so. During the conversations there are instances when he drifts off, and talks about how happy he as when he first got married and how grateful he was when he became a father, but he completes the sentence by saying that he ruined it all and there is now no going back, it’s too late.

When I asked him about his eating habits he hardly seemed to be interested, he can easily remember the last time he had a good bottle of vodka, but not a good meal, he likes take out, cooking is too overwhelming for him. He talks about Velma, his ex-wife and how he loved her cooking. All these are clear indications of a depressed man who blames himself for all the misfortunes he has experienced and has lost touch with his reality and mostly with his social life.

He confesses that a few years back, he was diagnosed with acute hypertension and was told to start living a healthier life style in order to reduce chances of it becoming worse. He has hardly stuck to that as his lifestyle is getting worse. When I asked him about the lifestyle changes, he said what is the need for living healthy when there is really nothing to live for? He confesses that he smokes and drinks alcohol in order to calm himself down and not to think about life in general; reason being is if he thinks too much his blood pressure will rise steeply. He avoids thinking about his life and chooses to live everyday as it comes. When I asked about the last time he had a proper medical checkup he could hardly seem to remember. He gives an approximation, but says he has an appointment the next week and is planning to attend it.

Milton has undertaken intense changes in his life. He talks about how he loved playing basketball while in high school and how sports helped him gain a full ride scholarship to college. However, after playing a few games in college he injured his right knee (ACL) and he can no longer perform at a Division one level. As he says this he touches his knee and to him it seems like something that had just transpired yesterday. This was enough to end his scholarship and this placed him in the city searching for job opportunities. After this life altering event his life took a completely different turn this time for the better. When he met his wife he became better, he studied at a community college and got an exceptionally good job in the insurance industry, but he was fired years later when the firm downsized and this made his life very difficult. His marriage took a downward spiral and his family and friends according to him were always against him. He used to love going to church, but he has not attended service in well over five years. He sometimes in the most recent years tried to reach out to his ex-wife, but she did not want anything to do with him, in fact she took a restraining order against him and moved and now he is unable to locate his former spouse. He hears from people that his two daughters are now married and his son is doing well but to him the ship of being a father has already sailed.

For a person of his age and given that during the conversation he was smoking heavily, Milton has a good memory of things, especially what previously mattered to him. He has a GFA of 35; this is in accordance with the Widiger (2000), analysis of a person’s behavior, responses and social relationships. He has severe social problems as he hardly talks to his neighbors or even personnel at work, he prefers to have lunch at work alone. He never goes out, in fact he cannot remember the last time he went out to have a sociable dinner. He feels like his dog Bruno is his only real and true friend because he would never leave him. He has economic problems as he says he is unable to cater for some of his needs and lives in a small apartment downtown but he has already accepted that his life will never reach any level higher than his status quo.

In order to accurately determine his state, I gave Milton a depression inventory as a test. This was inclusive of a BDI test and an MMSE analysis. He scored 15 in the MMSE. In the BDI he seemed not to answer questions that required some form of calculation and did not even bother to attempt them. He has a mean score of .78. This clearly indicates that he has impaired cognitive ability and he requires immediate treatment (Narrow, 2009). Milton is tired of the turn that his life has taken and wants out, but he feels desperate because he does not know how to undo what has happened in his life. He wants to reach out to his mother and siblings and more so to his daughters, but has no idea how to accomplish this feat. He feels that they will reject him all together.

Milton is experiencing depression as a result of the many unfortunate events that have occurred in his life. His social life is non-existent and this pushes him to become an alcoholic. His cognitive ability is also impaired due to the MMSE and BDI tests. He also has health problems as he hardly visits the doctor’s office for regular check-ups of his blood pressure.