Vivian: Hello, William, how are you doing?

William: Well, I don't know. I'm still feeling down a lot. I just didn't really feel happy around my kids, which isn't like me at all. I'm usually out there playing ball with them. What's really bad is that I snapped at them the other day for no reason.

Vivian: Have you been tearful?

William: Once or twice...a little.

Vivian: How are things at work and with your wife?

William: Fine. I can still concentrate on work, and things with my wife are fine. The support group has been very helpful. I can bounce things off of other people who are going through the same thing, which helps, but I am worried about why the medication hasn't helped. I'm not feeling better...actually things have been getting worse since I've been on the medication.

Vivian: Well, your BDI score was originally 9, but has recently been rising to 15 and 16, so I can certainly see that you are getting more depressed. On question 9, you indicated that you have not had thoughts about ending your life. Is that right?

William: No, things aren't that bad. I am still managing...I'm just sad and irritable sometimes.