Reply to one of the following prompts.
In the subject line of your posts, please identify which prompt you are responding to, for example, prompt #2.
1. Jennifer is a 25-year-old female who has the complaint of worrying excessively, feeling restless, difficulty concentrating and feeling fatigued for the last 6 months. She is under considerable stress trying to juggle work, taking college classes, and raising her 2 young children. After running some lab tests including a TSH (which were all normal), you diagnose her with generalized anxiety disorder. What pharmacological and non-pharmacological interventions could you recommend to help treat her anxiety? Are there any medications that you would avoid for this patient? Are there any tools that can help you screen your patients for anxiety in case they don’t feel comfortable admitting to you that they are anxious? How would you follow up with this patient?
2. Emily is a 44-year-old woman who presents with a 6-week history of initial insomnia and a 10-pound weight loss. She admits to feeling sad almost every day since she lost her job 6 weeks ago. She has no interest in engaging in previously enjoyable activities. She denies suicidality (ideation or plan). She has never been treated for depression. Her physical examination is negative, vital signs and blood work including a thyroid profile is all within normal limits, and her body mass index is 22. Her mother has a history of depression, and she was treated successfully with Sertraline. What medication should be considered for Emily and why? Does her age and childbearing potential influence your treatment decision? Is medication therapy enough? Please include medication education in your discussion.
3. James is a 51-year-old male truck driver with a long history of diabetes and hypertension. His current medication regimen is Lisinopril 20mg QD, metformin 1000mg QD, Lipitor 40mg QHS, and ASA 81mg QD. His A1C is 7, BP is 144/80, total cholesterol is 266, HDL 44, LDL 177, and Trig 199. What other information should you know about this patient to feel confident that his care is well optimized? What parameters would you like to see improved? To what clinical guidelines should you adhere when managing this patient? Are there any changes to treatment you should consider? Support your decisions with evidence. Jennifer Case Study
Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas. In your peer replies, please reply to at least one peer who chose a different topic.
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Jennifer’s Case Study
Cognitive-behavioral therapy (CBT) is a non-pharmacological intervention that is a first-line treatment for the majority of people who suffer from anxiety disorders. In care settings, CBT for anxiety is mostly brief and emphasizes psychoeducation, exercise programs, and psychological counseling (Servant, 2019). The term “psychoeducation” refers to the process of acquiring knowledge on the psychophysiology of anxiety behaviors and the rationale behind different treatment approaches. A medical professional may recommend to patients that they practice breathing exercises, exposure, and cognitive therapy as part of a self-help approach. Jennifer Case Study
Medications used in managing GAD include antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), which are often used for the treatment and prevention of anxiety disorders. According to the recommendations of the physician, these medications are to be taken regularly, regardless of whether or not the patient is experiencing symptoms of anxiety on any given day (Horenstein & Heimberg, 2020). Furthermore, antihistamines and beta-blockers could be helpful for those who suffer from mild anxiety. These medications, in comparison to antidepressants, are taken just when anxiety is evident or immediately before an experience that is likely to cause anxiety.
There are various tools for screening for anxiety that are used by specialists in the mental health sector. Some diagnostic procedures, such as those utilized in the assessment of generalized anxiety disorder, are more adapted than others to the detection of particular disorders. Empirical testing for reliability and validity has been done on these instruments to ensure their accuracy. The Generalized Anxiety Disorder scale (GAD-7) and the Beck Anxiety Inventory (BAI) are two of the self-report indicators of anxiety that have seen the most widespread use (Dulka, 2021).
Patients who exhibit symptoms of anxiety should schedule a follow-up consultation not later than two weeks after their first visit (Horenstein & Heimberg, 2020). The majority of primary care physicians recommend prompt treatment and continuous monitoring for individuals exhibiting symptoms of GAD. It is more challenging for physicians to overcome obstacles than it is for patients when it comes to treating individuals with common mental conditions with appropriate treatment.
Dulka, B. (2021). Screening for Anxiety Disorders. Retrieved from https://www.therecoveryvillage.com/mental-health/anxiety/related/anxietyscreening-tools/
Horenstein, A., & Heimberg, R. G. (2020). Anxiety disorders and healthcare utilization: A systematic review. Clinical psychology review, 81, 101894.
Servant, D. (2019). Non-Pharmacological Treatment for Anxiety Disorders. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32237617/