For just two months the lady has been calm, without energy and having difficulty with her schoolwork. Could she end up being depressed? Case scenario I’ve asked my individual Mrs Smith to take her 16-year-old daughter to see a psychiatrist. For just two months the girl has been tranquil, without energy and having an unusual amount of problems with her schoolwork. There are no significant problems in her family members. I can find no physical trigger and I question if she actually is depressed.. A 16-year-old lady with depression A woman brings in her teenage girl for evaluation.Invisalign case shipments for Q1 10 were an archive 63.6 thousand, in comparison to 61.1 thousand in Q4 09 and in comparison to 50.1 thousand in Q1 09. Gross margin for Q1 10 was a record 77.4 percent, in comparison to 73.7 percent in Q4 09 and 75.2 percent in Q1 09. The increase in Q1 gross margin mainly reflects the making efficiencies connected with higher case volumes. Historically, apart from initial teaching classes , continuing education costs and fees for educational programs were charged to sales and advertising expense.