The Role of Sexual and Gender Identity in Long-Term Psychodynamic Therapy for Comorbid Social Anxiety and Depression in an Adolescent Female

Adolescence is a time of significant change with social, cognitive, and emotional alternations, and growth of autonomy and identity. This is a single clinical case study that uses long-term psychodynamic psychotherapy with an adolescent female diagnosed with comorbid social anxiety and persistent depression. The treatment initially focused on addressing the patient’s self-esteem, perfectionism, and self-criticism. During the treatment it was revealed that the patient’s sexual and gender identity contributed to social anxiety and depressive symptoms, and the therapy conceptualized the role of these identities as contributing to social discomfort which perpetuated her depressive symptoms. Through accepting her budding sexual and gender identity, the patient successfully became more comfortable in social settings which ultimately alleviated her depressive symptoms. This treatment highlights the unique nature of working with an adolescent apart of the sexual and gender minority, and how these identities contributed to her experience of social anxiety and depression.