Anxiety Disorder Case-A 32-year-old Caucasian Male

Anxiety Disorder Case-A 32-year-old Caucasian Male

The presenting case is of a 32-year-old Caucasian male. He presented to the clinic with a knee joint injury that he sustained during work. He reported that he fell off the chair after dozing off. He has been experiencing trouble falling asleep and maintaining sleep for an unknown number of months. His sleeping problem, however, worsened over the past few weeks. He also noted that he often feels “on the edge” and restless. He also mentioned that he worries a lot about his performance, having received an underperformance warning a year ago, his family, and a sibling who studies abroad. He feels fatigued most of the time at work, something he attributes to a lack of sleep. Collaborative history from his father revealed that he had received complaints of him not concentrating during work hours. His family history is positive for anxiety disorders. His mother is currently on antianxiety medications, while his younger brother has been treated twice for general anxiety disorder. He works at a financial institution and is currently in a relationship. He is a binge– alcohol drinker and a smoker. The client seems sweaty and restless but cooperative. He had a GAD-7 score of 16.

Assessment and Diagnosis

Initial assessment of clients with symptoms suggestive of anxiety often starts by evaluating the psychological and somatic manifestations of the disease. Nonspecific somatic complaints such as fatigue, palpitations, and restlessness are prominent in many patients presenting with this disorder (Corcoran & Walsh, 2020). Psychological manifestations of the disorder, such as anxiety and excessive worry, are also suggestive of GAD. The client, in this case, manifested symptoms suggestive of generalized anxiety disorders. These include prolonged excessive worry, constant feeling of being overwhelmed, demonstrated by the client’s verbalization of feeling on the edge, restlessness, and difficulty falling and maintaining sleep. His collaborative history also revealed a lack of concentration while at work. These manifestations point towards the generalized anxiety disorder diagnosis.

Holistic assessment of the client utilizes subjective findings along with findings from various screening tools. The client’s GAD-7 score of 16 is indicative of severe anxiety. GAD-7 is a seven-item screening tool utilized in the screening, diagnosis, and severity assessment of generalized anxiety disorders (Sapra et al., 2020). Scores above 15 are often suggestive of severe anxiety, often warranting aggressive management. Findings from this tool further affirmed the GAD diagnosis.

Comprehensive assessment of generalized anxiety disorders utilizes the Diagnostic and Statistical Manual for Mental Health Disorders (DSM). According to the fifth edition of DSM (DSM-V), a positive diagnosis of GAD is made in the presence of extreme worry or anxiety lasting for six months or more and difficulty controlling the worry, accompanied by three of the symptoms described for GAD. These symptoms include restlessness, fatigue, difficulty concentrating, muscle tension, sleep disturbance, and irritability. Additionally, the anxiety must have resulted in significant impairment in an individual’s social and occupational life and not attributable to any physical cause (Diagnostic and Statistical Manual of Mental Disorders: DSM-5 2013). The client in the case above was extremely worried, had difficulty controlling the worries as suggested by their duration, was easily fatigued, lost concentration while at work, and had difficulty sleeping. Moreover, subjective findings from the client were negative of any physical cause to which his anxiety could be attributed. It was also evident that his anxiety affected his occupational life. These manifestations are aligned with the DSM-V description of GAD and warrant the GAD diagnosis. Other client features that affirmed the diagnosis are restlessness and sweating during physical examination and a positive family history of GAD. As Purves et al. (2019) reports, GAD has a genetic predilection. Persons with close family members with the disorders are up to 25% at risk of developing the disorder. Alcohol and smoking have also been found to worsen anxiety severity. This may be the case with the client. Drug use is a causative factor for disease and suffering and, therefore, not recommended, which is projected in the bible. As evident in the English Standard Version Bible (2009),  Proverbs 20:1 says, “Wine is a mocker, strong drink a brawler, and whoever is led astray by it is not wise.” Therefore, excessive alcohol consumption is not good for the body; hence, the bible condemns it. Additionally, the bible condemns the destruction of the body by any substance as it is the temple of God.

Treatment Plan

Comprehensive management of GAD utilizes psychotherapy and pharmacotherapy. Curtiss et al. (2021) note that adjunctive therapy with psychotherapeutic interventions and pharmacotherapy maintains more effectiveness in managing severe anxiety than either agent used alone. Cognitive behavioral therapy is the psychotherapeutic modality of choice in the management of anxiety. Curtiss et al. (2021) note that CBT is the gold standard for managing anxiety. This modality helps in rectifying dysfunctional thought processes that interplay in anxiety disorders. Subsequently, pharmacotherapy with selective serotonin reuptake inhibitors such as sertraline is the first line in managing severe anxiety. This medication maintains effectiveness in lessening anxiety symptoms. Other pharmacotherapies include benzodiazepines such as diazepam, and buspirone. The patient in the case presented had severe anxiety. He will be started on a selective serotonin reuptake inhibitor and scheduled for a CBT program. In the pursuit of helping the client recover, tapping into his spirituality may be necessary. The spiritual dimension gives insight into the significance of avoiding sinful behaviors such as drunkness and encourages the supernatural belief in healing. As postulated in the book of Isiah 53:5, “But he was pierced for our transgressions; he was crushed for our iniquities; upon him was the chastisement that brought us peace, and with his wounds, we are healed” (English Standard Version Bible, 2009). This may be helpful in the long-term healing of the client.

In summation, GAD remains a health concern. Comprehensive assessment of this disorder utilizes subjective findings from the patients along with other diagnostic and assessment tools such as DSM-V and GAD-7. Following this, the disorder can effectively be managed using psychotherapy and monotherapy.

 References

Corcoran, J., & Walsh, J. (2020). Mental Health in Social Work: A casebook on diagnosis and strengths-based assessment. Pearson Education, Inc.

Curtiss, J. E., Levine, D. S., Ander, I., & Baker, A. W. (2021). Cognitive-behavioral treatments for anxiety and stress-related disorders. FOCUS, 19(2), 184–189. https://doi.org/10.1176/appi.focus.20200045

Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). (2013). . American Psychiatric Association.

Purves, K. L., Coleman, J. R., Meier, S. M., Rayner, C., Davis, K. A., Cheesman, R., Bækvad-Hansen, M., Børglum, A. D., Wan Cho, S., Jürgen Deckert, J., Gaspar, H. A., Bybjerg-Grauholm, J., Hettema, J. M., Hotopf, M., Hougaard, D., Hübel, C., Kan, C., McIntosh, A. M., Mors, O., … Eley, T. C. (2019). A major role for common genetic variation in anxiety disorders. Molecular Psychiatry, 25(12), 3292–3303. https://doi.org/10.1038/s41380-019-0559-1

Sapra, A., Bhandari, P., Sharma, S., Chanpura, T., & Lopp, L. (2020). Using generalized anxiety disorder-2 (GAD-2) and GAD-7 in a primary care setting. Cureus. https://doi.org/10.7759/cureus.8224

The English Standard Version Bible: Containing the Old and New Testaments with Apocrypha. (2009). Oxford University Press.

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Write your Case Study: Bipolar, Depressive, and Anxiety Disorders Assignment in the current APA format. The Case Study: Bipolar, Depressive, and Anxiety Disorders Assignment must include:

Title page

Describe the symptoms that meet the criteria for the chosen mental health diagnosis with the fictional client who would come in for services from you as the social worker.

From what you have learned, prepare at least 2 suggestions for treatment (e.g., referral for medication evaluation, individual or group therapy, assistance at school) for the chosen diagnosis.

Reference page for resources, including both textbooks, the Bible, and at least 1 scholarly reference published within the past 5 years. LU’s library includes many resources to meet your needs. Newspaper articles and blogs do not qualify as professional resources.