Anxiety case study


Emily is a 23-year-old, white female that presents to the office with a chief complaint of ?My aunt said that I am always on edge, a worry wart, and need some help before I have a heart attack?. She reports that over the last year, her life has become more and more difficult. She states that she worries constantly about her family, her health, school, her future, and other things that are not relevant. She feels helpless and hopeless sometimes. She tends to isolate so people will not bother her because if someone says the wrong thing, it can set her off which will end up with her crying or getting very irritable. She is scared her grades may slip because she is really struggling to stay on task and focus.

Emily was raised in a middle class, suburban home with her little sister by both her parents. Her mom was diagnosed with stage 4 breast cancer when she was 16 years old and passed away 3 weeks before her 18th birthday. Her aunt has since stepped in as a surrogate mother for her sister and herself. She stated that she did struggle in high school academically due to trouble with focus, but she worked with a tutor frequently. She graduated with a 3.2 GPA and received a soccer scholarship to Auburn University, where she played soccer for 4 years and graduated in general studies. She now lives back at home with her dad in Lafayette and is enrolled in the Accelerated nursing program at ULL. She said she just wanted to be home with her family after her soccer scholarship was complete and she always wanted to be a nurse so this program was perfect.

She states that she constantly fears she or her sister have cancer. She said that this thought, as well thinking about her dad dying, tends to keep her up at night frequently. On average, she will sleep 5 hours a night, which has been this was since she left home for college at the age of 18.

She reports that she always feels tired and sometimes feels ?on edge? and she does not know what to do with herself and feels like she is going crazy. She stated that her heart will start pounding, experience shortness of breath, and sometimes feels like the room in closing in on her. She denies auditory or visual hallucinations. She denies any appetite changes. She denies suicidal or homicidal hallucinations. She is not psychotic.

She is hyperverbal and open, appears very well rounded and educated. She is oriented to person, place, time and situation. She is cooperative, makes appropriate eye contact, however is easily distracted.

Vital Signs: BP 130/69, P-88, T-98.4, Height-5?8?, Weight-130, BMI-25

Last PCP visit ? No PCP at the time

Medical History- T&A age 2; septoplasty age 22

Psych History- saw a therapist after her mom died which was provided by the hospice company that cared for her at the end of her life.

Family Medical History:

Mom- breast cancer, died @ 46 years old

Dad- Hypertension, hypothyroidism

Maternal Aunt: breast cancer

Paternal Grandmother- hypothyroidism

Family Psychiatric History:

Maternal Grandmother- Bipolar II

Father- Major Depression Disorder

Sister- ADD

Social History: Not currently sexually active, currently enrolled in college, drinks wine occasionally, denies illicit & licit drug use. Denes tobacco use. No legal issues in the past or present.

Medications: Tylenol or Advil for occasionally headache

Dont use article that is more than 3 yrs old

review stahl book of psychiatry and Saddock and Saddock

that will include a treatment plan for the accurate diagnosis. The treatment plan will include 1)

pharmacological and 2) non-pharmacological interventions, 3) patient/family education,

4) consultation/referral and 5) follow-up. Your treatment approach should be evidence based with citations.

Please use APA to cite references and use appropriate references.

The paper should contain

Ø Pharmacological Treatment Identified: 15 points ( 2-3 article)

Ø Non-Pharmacological Treatment Identified: ( 2-3 article)

Ø Patient/Family Education: ( 2-3 article)

Ø Consultation/Referral: ( 2-3 article)

Ø Follow up: ( 2-3 article)

review stahl book of psychiatry and Saddock and Saddock

must be peer reviewed articles

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