Assignment task:
A 65-year-old woman presents "feeling run down." A history of present illness reveals that for the past 2 months, she is feeling tired, unable to concentrate, and has a decreased appetite. A review of systems is positive for feeling guilty, worthless, and hopeless, and she copes with these feelings by sleeping more than 12 hours a day. She has had 3 such episodes, each occurring during the winter and lasting for about 3 months each time. She reports decreased libido, anhedonia, difficulty concentrating, hypersomnia, and increased appetite. She has no significant past medical history and takes no medications. She does not smoke or drink alcohol. Her family history is positive for major depressive disorder in her father. Her vital signs are blood pressure 130/90 mm Hg, heart rate 72 bpm, respiratory rate 12 breaths/min, and temperature 98.6 °F (37 °C). The findings of her physical examination are unremarkable. Laboratory test results of a CBC and CMP are normal. What is the best management?