A 28-year-old woman presents to clinic. She is concerned about frequent headaches, trouble focusing, and disrupted sleep. She lost her home in a hurricane 8 months ago. At that time, she was evacuated and received emergency medical and humanitarian care. Subsequently, she was rehomed to a shelter where she has been living since that time with her two young children, ages 3 and 5. She is a single mother. She has been unable to find permanent housing and a job. Her income consists of public assistance via disaster relief, which also includes food stamps.

Physical exam reveals nothing remarkable. The patient appears tired yet restless and is somewhat unkempt. She confirms that she has lost weight recently but does not know how much. She exhibits a low mood and flattened affect as she answers questions, and she speaks in a low voice. She is unable to recall details about the last year of her life. She denies any substance abuse or suicidal ideation. She has a negative medical history and takes no medications.