Psychiatry · Model history

Low mood and loss of interest: a model mental health history

Setting
Outpatient mental health clinic
Patient
Mrs. Clark, 45, has felt persistently low and unlike herself for three months.
Listen
5 min

After listening

Say the next question

Read the patient’s answer, say your next question aloud, then reveal the model.

Patient
“Yes. Sometimes I wish I just wouldn't wake up.”

Use calm, direct language to ask the most important immediate safety follow-up.

Model interview

Full transcript

  1. Doctor

    Mrs. Clark, I'm Dr. Rivera. We have privacy here, and we can take this at your pace. What has been happening?

  2. Patient

    For about three months I've felt very low. Everything feels heavy, and I don't feel like myself anymore.

  3. Doctor

    What does a difficult day look like for you?

  4. Patient

    I force myself to go to work at the library, but I move slowly and can't concentrate. At home I just sit on the couch.

  5. Doctor

    What has happened to the things you usually enjoy?

  6. Patient

    I stopped playing the piano and reading. I used to love both, but now I feel nothing.

  7. Doctor

    How has your sleep been?

  8. Patient

    I fall asleep, but I wake around three every morning and can't get back to sleep.

  9. Doctor

    How are your appetite, energy, and concentration?

  10. Patient

    I eat because I know I should. I have almost no energy, and I keep losing my place at work.

  11. Doctor

    Have you been blaming yourself or feeling that you are letting people down?

  12. Patient

    All the time. I feel like a failure as a mother and an employee, even over small mistakes from years ago.

  13. Doctor

    Have you ever heard or seen things other people couldn't, or felt that someone was trying to harm you?

  14. Patient

    No.

  15. Doctor

    Have you ever had a period when you felt unusually energized or confident, needed very little sleep, talked much more than usual, or acted impulsively?

  16. Patient

    No, I've never had anything like that.

  17. Doctor

    Have you been drinking more alcohol or using any drugs or medicines to cope?

  18. Patient

    No drugs. I might have one glass of wine on the weekend, but not more than before.

  19. Doctor

    You said everything feels heavy. In the past few weeks, have you wished you were dead or wished you could go to sleep and not wake up?

  20. Patient

    Yes. Sometimes I wish I just wouldn't wake up.

  21. Doctor

    Thank you for telling me. Are you having thoughts of killing yourself right now?

  22. Patient

    No. I don't want to kill myself. I just want this pain to stop.

  23. Doctor

    Have you thought about how you might kill yourself, made a plan, or taken any steps toward one?

  24. Patient

    No. I haven't made a plan or done anything.

  25. Doctor

    Do you have access to a gun or a large supply of medicines at home?

  26. Patient

    There are no guns. We have normal household medicines, nothing I've been collecting.

  27. Doctor

    Have you ever tried to kill yourself or deliberately hurt yourself in the past?

  28. Patient

    No, never.

  29. Doctor

    What has helped you stay safe when those thoughts appear? Who could you contact today?

  30. Patient

    I think about my daughter. My sister knows I've been struggling, and she would come if I called.

  31. Doctor

    Do you feel able to stay safe today, and would you tell your sister or contact urgent help if the thoughts became active or you started making a plan?

  32. Patient

    Yes. I can call my sister, and I can tell someone if it gets worse.

  33. Doctor

    You had one similar episode eight years ago. What treatment did you receive then?

  34. Patient

    I took sertraline and saw a therapist. Both helped, and I eventually felt like myself again.

  35. Doctor

    What are you hoping we can help you with now?

  36. Patient

    I want to sleep and feel some joy again. I'm frightened that I'll always feel this way.

  37. Doctor

    Let me summarize. For three months you have had persistent low mood, loss of interest, early waking, low energy, poor concentration, and strong guilt that are affecting work and home. You sometimes wish you would not wake up, but you deny current suicidal thoughts, a plan, or past attempts. Your daughter and sister are important supports, and treatment helped before. Is that accurate?

  38. Patient

    Yes.

  39. Doctor

    Our first priority is your safety. Before you leave, we will complete a fuller safety assessment and make a written plan with your sister's contact and crisis support. Then we can discuss treatment and close follow-up together.

  40. Patient

    Okay. I'm relieved I told you.

Flow at a glance

The route through the history

  1. Create privacy and pace
  2. Explore mood, pleasure, and function
  3. Ask about biological and cognitive symptoms
  4. Screen for mania, psychosis, and substances
  5. Ask directly about suicide
  6. Assess plan, means, history, and supports
  7. Close with a concrete safety process

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Editorial record

Tied to one reviewed case

This model uses a fictional Bedside English case as its source. The page and pre-generated WAV audio are checked against the same transcript and source-case fingerprints.

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