Generalized Anxiety Disorder Case Study

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.

The patient, a thirty-three year old female singer, is having difficulty sleeping, simple activities like getting groceries tire the patient easy, complains of neck pain, and cannot concentrate. The patient experiences worry and anxiety. However, when asked about what specifically, many things were brought up but none were more important than the other.

This experience was educational and I was able to learn how to tailor questions that follow specific presentation complaints during the history intake process. Upon initial presentation, and discussion of her symptoms, it became evident that the questions needed to be more specifically related to the frequency of her disturbance, her diet, mood, social history, and activity level. At this same time, an evaluation of the severity needed to be explored with consideration the co-existence of anxiety and depression. Confirming the absence or presence of an acute life stressor was important to uncover during the history portion of the exam. This encounter was exciting to diagnosis because the diagnosis came from the clinical findings from the exam. The historical flow was intuitive and helped differentiate the diagnosis. Lab tests were not necessarily helpful to diagnose, although important to rule out other potential differentials. Both anxiety and depression were found to be present

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).

Caroline Collins is a 38-year-old white female of average height and weight, appearing her stated age, who referred herself for a mental health assessment through the recommendation of her husband to go for counseling regarding her situation. Caroline wore a blue hospital scrubs and she appears exhausted. The client has been married for 15 years to her husband Alex. She has two children, a girl named Josephine, age 14, and a boy, Carter, age 12. Caroline works a rotating shift at the hospital on the surgical floor. She begins the sessions by explaining that she has trouble with certain fears such as, driving, dark places, and standing in line also stressed and worried. She feels

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.

Psaras reported no family history of psychiatric or substance issues in biologically related family members. She indicated that she meets with a mental health professional once a week. The stated that she began treatment because she felt overwhelmed living with her husband. Ms. Paras reported that she has never been placed on medication. The mother stated that she has never felt significantly depressed. She indicated that there have not been times when she has been anxious. The mother reported that she has never had a panic attack. She indicated that she does not have trouble sleeping. Ms. Psaras stated that her weight has always been consistent, she has never tried to hurt herself or others and has never thought of it. The mother reported that she has never had any unusual thoughts or experience, she has never done any dangerous things. The mother denies any symptoms of

Looking at the symptoms such as anxiety attacks, overeating, fear of accomplishment, fear of abandonment, and so forth—can be interpreted as outward manifestations of unconscious conflicts that have their origins in childhood experiences and defensive reaction to these experiences that are necessary to her as a child.

Generalized Anxiety Disorder affects millions of Americans each year. Typically, those who struggle with anxiety on such a regular basis struggle with fatigue and poor concentration. Although the effects of anxiety are easier to define, the causes, unfortunately, are not. Often, figuring out the exact causes for anxiety proves difficult, as it varies from person to person. There are, however, some major commonalities between individuals with anxiety, such as workload, social situations, or other disorders. In today’s hectic society, people’s schedules are busier than ever. Adults are expected to balance multiple areas of their lives, including work, school, and family. If an individual becomes sick, he or she may fall behind in one area, which

Smith has been presenting with depression and anxiety along with chest pains, stomachaches, and headaches. The depression and anxiety symptoms appeared about 3 months ago when Mrs. Smith changed jobs. She also reported having trouble keeping details straight at work and felt that she was not as “sharp as she previously had been. Mrs. Smith expressed that she had relational problems with her children and also found that her daughter was abusing narcotics. Mrs. Smith also reported symptoms of being tearful, fatigued, with reduced appetite, feeling easily overwhelmed, and ruminating thoughts. Mrs. Smith reported that 6 months ago she also started to become overly emotional in stressful

The Sarah self-referred for assessment at am outpatient clinic. She subsequently requested a referral to a psychologist in Chicago, IL. Sarah is a 24-year-old adult Caucasian female who identified as a lesbian. She reported a history of depressive symptoms that have worsened in the last few months. She is seeking treatment for these intensified depressive symptoms. She described having “depression” many years ago, but became evasive when asked to clarify. In addition, she noted a concern with experiencing anger and hostility towards others; she stated that these emotions are “uncomfortable” for her. She clarified that in the past three months she has perceived herself as “grumpier than usual.” She reported having experienced anhedonia, fatigue, and insomnia.

Due to the extreme changes in Vanessa’s life, the therapist has chosen to administer the Beck’s Depression Inventory (BDI-II), as well as Beck’s Anxiety Inventory Tests (BAI). Both tests will determine if the client’s feelings in the past week to two weeks are symptoms of either depression or anxiety. Depending on her score on the BDI-II, she could be experiencing minimal, mild, moderate, to severe depression. The BAI will indicate whether the client is experiencing minimal, mild, moderate, to severe anxiety. These tests should help the therapist in providing the best treatment plan for the

It should be noted however that little background information was provided along with the referral request and thus in order to carry out a comprehensive assessment of Ms. Coldwell 's psychological health additional information will need to be gathered pertaining to her current symptoms, pertinent medical history (including psychiatric), family histories (both medical and psychological), work and educational history, and any other relational or social histories which may

296.32 (F33.1) Major Depressive Disorder, recurrent episode, moderate severity, with anxious distress. Ms. Client meets eight of the nine diagnostic criteria for Major Depressive Disorder (MDD). Specifically, during several periods of time she experienced depressed mood, diminished interest in things she enjoyed to do, hypersomnia, psychomotor agitation, fatigue, feelings of worthlessness, decreased concentration, and suicidal thoughts without intent. Additionally, as Ms. Client expressed, these symptoms are source of continuing distress and interfere with her academics and social functioning. Also, her symptoms started four years prior to the psychological assessment and persisted intermittently since then, lasting for several weeks to several months, with the most recent period of extended length (enduring two weeks) approximately one year ago. Since the last episode she has experienced these symptoms for two to three days at a time. Although the last episode that met the criterion of two weeks duration occurred approximately a year ago, the symptoms have not disappeared, but they occur periodically since then and when they do, they cause considerable distress and impairment in functioning. Thus, the disorder cannot be coded as ‘in partial or full remission’. The specifier ‘with anxious distress’ was given, because Ms. Client reports feelings of difficulty in concentration because of worry and restlessness.

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.