Diagnosis : Depressive Disorder And Depression And Stress Management

31 y/o AA male patient seen today for psychiatric-mental health assessment. He is awake, alert and oriented x4. He is calm, cooperative and follows commands during assessment. The patient reports he is depressed, difficulty sleeping and nightmares at night. The patient explained his depression is as a result of deep thinking from a news he received two days ago from his elder brother that his mother is ill. Stressors identified by the patient include losing his job a week ago before the news about his mother; his wife is 6-months pregnant with their first child, who currently works part-time at her present job; patient relates difficulty paying monthly bills and inability to provide adequately for his family as a man. The patient denies mood swings, suicidal/homicidal thoughts and ideation. Patient reports his spouse is at work at the moment and he does not want to put stress on his wife due to her current condition. Patient denies been hospitalized for depression or psychiatric illness; and denies family history of mental illness. Patient reports he is seeking help because he does not like feeling this way using terms of “helpless and loss of worth from his spouse”. Patient reports he needs help with his depression and nightmares before his current condition get out of hands and ruined his marriage.

This patient is experiencing generalized anxiety disorder. First, let us look at this disorder from

Prior to Mr. Smith’s diagnosis, Mrs. Smith worked outside of the home on a part-time basis. Her income was set aside to fund Junior’s college education. Mrs. Smith concentrated on maintaining harmony within the home and was a calm, stable influence in Mr. Smith and Junior’s lives. Since Mr. Smith’s diagnosis, Mrs. Smith has started working full time. The stress created by Mr. Smith’s diagnosis and care needs, concern over Junior’s well-being, full time employment, and financial concerns have caused Mrs. Smith to experience generalized anxiety disorder with panic attack specifier as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM, 2013).

1. Client demonstrates excessive and sometimes unrealistic worry that has been occurring more days than not for past seven months. Client has been affected by physical issues due to anxiety; such as, nausea, diarrhea, lack of sleep and trouble falling asleep, excessive crying, discourse at home, and hypervigilance.

d. A nurse gives a PRN dose of an antipsychotic drug to a patient to prevent violent acting out because

This is a 52-year-old male with a 9/24/2014 date of injury. A specific mechanism of injury has not been described.

The patient moved from Troy, New York a few months ago after getting married. She is living in Barrington and working in Northwood. They moved because her husband's job. The patient would like to talk about depression. She tells me that she has had anxiety her whole life. She was never evaluated by a physician for this, as her parents reportedly did not believe in any medication. She says that she struggled with her anxiety throughout her teen years and went to counseling in college, but never saw a physician at that time. She is no longer in counseling. In addition to feeling anxious, she feels depressed. She says

Rationale: Jennifer has been presenting with symptoms for unspecified amount of time. Jennifer meets six of the criteria for symptoms being present during the same 2-week period and represents a change from previous functioning. Jennifer is depressed most of the day, nearly every day, has diminished interest in all or almost all activities most of the days, nearly every day, has fatigue or loss of energy nearly every day, feelings of worthlessness, and diminished ability to think or concentrate, is having recurrent thoughts of death, recurrent suicidal ideation without a specific plan. The symptoms have cause clinically significant distress or impairment in social, occupational, and other functioning areas. There is no know substance or medical condition and occurrence is not better explained by Schizophrenia Spectrum or Psychotic Disorders. Jennifer has never had a manic episode or a hypomanic episode. Possible family history of depression - mother.

DOI: 6/29/2010. The patient is a 50-year-old female packager who sustained a work-related injury when she hit her head on machine door after bending over to pick up an item.

This is a 54-year-old male with a 1/17/2012 date of injury. A specific mechanism of injury has not been described.

On 08/19/16, patient was noted to have symptoms of post-traumatic stress disorder which includes decreased nightmares once per week, “SUS” and hypervigilance 4 times/week with diminished intensity,

Molly is a 29-year-old woman unemployed, living with her parents. She presents to the therapist looking sad, stark and exhausted with lethargic movements. She expresses concerns with feeling down for 2 ½ years after a job loss from an exciting IT career. She is unmarried and currently using marijuana regularly and moderate amounts of alcohol to cope with her sadness. She can no longer find pleasure in things, her mood can be described as depressed, and she has poor sleep hygiene, difficulties with concentration, no appetite, and no interest in sex. She also has concerns about feeling irritable and nervous. She has recently unintentionally lost 15lbs. While talking with the therapist she frequently is tearful. This is her first experience with a

She finds herself constantly worrying that there is no reason; such as the status of her home, being late to work despite waking up an hour before departure, any possible accidents which may lead to her death, and various scenarios which lead to unfortunate events. She states that she has been married for about 10 years to her college sweetheart. She has no children due to her worries of complications during childbearing and raising children. She worries that her children whether children will turn out to be normal, pretty, or crazy like their mother. She describes her marriage as ‘hell’ due to her husband’s lack of support. She does not mention any other family member besides her husband when asked about her family. Janine holds s a job in as a tax accountant. She works from 6am to 11pm, and she brings her work home with her. This is due to her anxiousness interfering with her concentration on tasks. Recently work has been overwhelming for her since there is no method for relieving her stress. She states that her husband does not help her with housework, which adds to the stress from work. In fact, she does not see her husband often which prompts her to worry if her husband is having an affair. She is not on medication at the moment; however, she used to take Xanax once every morning for 2 years. As for meals, she states that she only eats quarry, animals hunted for food, and that she

Chief complaint: DM feels anxious; she would like to stay away from Xanax and to decrease her anxiety.

Jessica is a twenty-eight-year-old married female who works at a large hospital. She has high expectations for herself because she has graduated with honors at both college and medical school. For the past few weeks, she has been feeling tired and unhappy. She has had a demanding and high stressful job at a large hospital for two years. She feels that she is unable to perform well at her job and has trouble concentrating at work and at home. She is uninterested in her usual activities and has many negative thoughts that keep her awake at night. Two diagnoses that best fit this case study are Major Depressive Disorder and Generalized Anxiety Disorder.