Read the following vignette:

Christina is a 25-year-old Mexican American woman who has been working as an elementary school teacher since she graduated from college three years ago. Although she does well at her job, she has been feeling low ever since she left college. When she took this teaching position, she had to relocate to a city over four hours away from her family and the house she grew up in. Even though she has made some new friends, Christina still feels disconnected and lonely. She is also concerned about her mother, who has been diagnosed with a serious health condition.

For the past month, Christina has felt much worse. She reports feeling very sad and tired most of the time and is having difficulty concentrating at work. She says that she does not have enough energy to accomplish the things she would like to do. She admits to overeating and drinking every evening to "unwind" after school, and is concerned she is sleeping too much on the weekends. She also has very low self-esteem, despite being well-liked at her school and receiving good performance evaluations.

Christina describes her life as "heading nowhere" and says that lately she has felt extremely hopeless. She wonders if she will ever feel as happy as she did when she was in college. She does not have a history of ever feeling worse than this, and is in good health.
Based on the information presented, address the following questions in your discussion post:

1. What depressive disorder diagnosis would you consider giving to Christina? Describe the process you used for making this decision.

2. Knowing that substance use disorders can mimic and co-exist with other disorders, and that depressive disorders frequently co-occur with other disorders, including anxiety disorders, substance-related disorders, and eating disorders, what other information would you gather, or what other assessment instruments might you use, to help you make an accurate diagnosis for Christina?

3. What V and Z codes would you consider for Christina? How would including these systemic considerations help you in understanding Christina's presenting symptoms and thinking about your treatment approach?

4. What social, cultural, and systemic factors would be important for you to consider when assessing and diagnosing Christina? How is the separation from her mother, family, and home impacting her? What multigenerational issues might be affecting Christina at this time?