Margo is a 49-year-old divorced woman who works as a bank teller. She tells her primary care provider (PCP) that she feels tired all the time and that she is gaining weight because she has no interest in her usual exercise activities, and that she has been overeating, even though she is often not really hungry. She notices that she has difficulty falling asleep at night and awakens around 4 a.m. most mornings, without her alarm, and cannot go back to sleep even though she still feels tired. She finds little joy in her life but cannot pinpoint any particular concern or event causing this problem. The PCP asks Angela to fill out a Beck’s Depression Scale, which indicates she has moderate depression.

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