Question

Case Study #37

Sasha is a 60 year old woman who has recently retired form a career in teaching. Working for many years in a secondary school environment, Sasha was confident, motivated and dedicated to her work, but at the same time looking fowards to retiring so she and her husband could travel and spend more time with their adult children who live nearby.

However upon finishing her work, Sasha found herself experiencing severe anxiety, particulary when around other people, and began not wanting to leave the house or invite people into the house. She also experienced bouts of crying when attempting to complete tasks such as housework and using the sewing machine. Sasha found her symptoms eased when she and her husband went on camping trips in natoinal parks where they often did not see other people for days.

1. Identify specific diagnonsis? using DSM-5. provide ratoinal

2. 1-7 severity scale, more than one diagnosis possible

3. suggest one possible treatment that you would reccomned based on the diagnosis

Answer 1

1) Lets begin with putting sasha's symptoms under one umbrella term i.e. Anxiety Disorders which is experiencing of a chronic and intense feeling of anxiety and dreadfulness about what might happen to you in future. Alongside people with anxiety also experience fear which is simply an emotional response to any real or perceived threat. Based on the above explaination if we look upon what sasha is going through is medically termed as "Social Anxiety Disorder" wherein an individual do not only have anxiety in social scenarios but the anxiety eventually seeps into persons everyday living as pointed above that she would have difficulties managing household chores as well as her emotions. Social Anxiety Disorder based on a scientific definition is charaterized by maked or intense fear of anxiety of "social  situations" where they feel they would be scruinized by others" DSM introduced this is as new diagnostic term but still includes social phobia to link it to previous diagnosis.

2) Yes, more than one diagnosis is very much possible. GAD - Generalized Anxiety Disorder. Based on sashas symptoms and experiences there is a very high likelihood of the presence of another disorder under the umbrella of anxiety disorders i.e the GAD a disorder characterized by anxiety and worry that is not associated with a particular situation or event but eventually becomes a constant feature of a persons day-to-day existence. Such people feel anxious and worry most of the times and do not know why do they feel or experience it. The symptoms as pointed above that sasha would very easily start crying while doing simple activities which any one else without anxiety would carry out very easily is only one out of many symptoms like general relentlessness, sleep disturbance, easily fatigued and constant irritability.

3) Based on the diagnosis, in order to treat Social Anxiety Disorder both medicine and therapy works wherein the most effective of are SSRIs and SNRIs however they carry drawbacks hence from a Cognitive Behavioral Perspective the clinician make attempts to change the client/patients thoughts in combination with invivo or invitro exposure. However if the person does not respond to medication or therapy alternates such as motivational interviewing ; acceptance and commitment therapy and meditation. Alongside the CBT may also be administered for thr treatment of G.A.D

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