Case Study Report
What diagnosis has been given to this client?
Panic Disorder with Agoraphobia
Background Information
Please outline the major symptoms of this disorder.
According to the DSM, the major symptoms of Panic Disorder with Agoraphobia are, recurrent panic attacks and enduring anxiety about experiencing another panic attack. The individual is also anxious about going places where escape might be difficult or embarrassing, or where they will be unable to receive assistance in case of emergency. The symptoms cannot be better explained by another medical or psychological effect.
Briefly describe the client’s background (age, race, occupation etc).
The client is named Annie, and she is a 24 year-old
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Annie makes it very clear in her interview, that she is afraid of having panic attack in public. She says she is not so much afraid of feeling overcome with anxiety, as she is embarrassed about how her body reacts when undergoing a panic attack. Annie states that most of her panic attacks occur as a result of her imagining how embarrassing it will be if she has a panic attack in public—she loses control of her bladder, she will run out of the situation, and most often hide in the bathroom. Annie states that the Agoraphobia is a result of her overthinking how people view her. Throughout the interview, Annie often demonstrates how she thinks others view her—“why did she just run out” or “she is crazy”. During the interview, it becomes clear that Annie is mainly afraid of judgment by other people. In her interview, Annie mentions that feelings of being trapped also cause her anxiety. She recurs a time when she was invited to a party. Annie explains that while she may want to go to a party, she has to surround herself with people who understand her condition, and will understand if on the way to the party, has to turn around because she may not feel like she will be able to handle talking and socializing with people. Annie further explains, by describing a situation in which, hypothetically, if a person Annie was taking to a party is not okay with turning around, or leaving a party early, then Annie would feel trapped which would then most likely lead to a panic
Persistent concern about having additional attacksb. Worry about the implications of the attack or its consequences(e.g., losing control, having a heart attack, “going crazy”)c. A significant change in behavior related to the attacksB. The presence (or absence) of Agoraphobia.C. The Panic Attacks are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism).D. The Panic Attacks are not better accounted for by another mental disorder, such as Social Phobia (e.g., occurring on exposure to feared social situations), Specific Phobia (e.g., on exposure to a specific phobic situation), Obsessive-Compulsive Disorder (e.g., on exposure to dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder (e.g., in response to stimuli associated with a severe stressor), or Separation Anxiety Disorder (e.g., in response to being away from home or close relatives).(APA, 2000)
For a person diagnosed with agoraphobia, there are a number of restrictions and consequences associated
How is anxiety triggered?- Well, “researchers don't completely understand all the causes, but they do know that anxiety is linked to a number of surprising triggers, from weight-loss supplements to thyroid problems.” There are many anxiety disorders like for example, separation anxiety disorder and social phobia; being in social situations can cause this uncertain and nervous feeling this is called a social anxiety disorder/phobia, this can include worrying about being judged or embarrassed in front of a group of people and/or being concerned about maybe
Answer: Social Anxiety or Social Phobia (King, 2016); social situations are the cause of her anxiety
Panic disorder and agoraphobia are two separate disorders that often go hand in hand with each other. An individual can be diagnosed with panic disorder, but a diagnosis without agoraphobia can often take place as well. Some individuals develop symptoms of agoraphobia, but do not have the classic panic disorder symptoms, hence the reason they are both listed as separate disorders in the DSM-5. Panic disorder can be identified as “recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four or more physical and cognitive characteristics take place (Hooley, J. 2017, pg.188).” When dealing with panic disorder it can often become debilitating, due to the fact that the individual does not know when the onset of an attack will occur. Individuals with panic disorder more commonly develop agoraphobia as a comorbid disorder, and if left untreated, can have a difficult time even leaving their home. Agoraphobia can be defined as “the individual fears or avoids
Social anxiety disorder, which is also called social phobia involves overwhelming worry and self-consciousness about everyday social situations. The worry often centers on a fear of being judged by others, or behaving in a way that might cause embarrassment or lead to ridicule. The fear may be made worse by a lack of social skills or experience in social situations. The anxiety can build into a panic attack. As a result of the fear, the person endures certain social situations in extreme distress or may avoid them altogether. In addition, people with social anxiety disorder often suffer anticipatory anxiety, the fear of a situation before it even happens, for days or weeks before the event. In many cases, the person is aware that the fear is unreasonable, yet is unable to overcome it. (Goldberg)
Panic disorder is something that develops for no apparent reason. It causes repeated and unexpected attacks of intense fear. It can last for a few minutes or even hours. The people that have this disorder usually live in fear of having another attack. They are afraid to be alone, or to be far from medical help. The feelings of intense fear can trigger severe physical reactions. This disorder is very real and treatable.
Several types of anxiety disorders are discussed in this film. General anxiety disorder is described as a constant feeling of worry and fear for at least six months. A person suffering from general anxiety may experience panic attacks, cold sweats, heavy breathing, and may withdraw from social interactions. It is regularly treated with medications and cognitive behavior therapy, which is a psychotherapy that focuses on helping patients understand the feelings they are experiencing and how those feelings may be contributing to their issue. Post-traumatic stress disorder, or PTSD, is another anxiety disorder discussed in this film. People develop PTSD after experiencing an emotional shock or major trauma. Someone with PTSD may have issues sleeping and controlling their anger; they may experience feelings of detachment, numbness, and may have flashbacks of the traumatic experience causing their PTSD. Like general anxiety disorder, PTSD patients are often treated with medication and cognitive behavior therapy. Recently a new therapy, eye movement desensitization and reprocessing therapy, has been used in PTSD patients. This therapy requires the patient to rapidly move their eyes while recalling the traumatic experience. The third type of anxiety disorder discussed in this film is obsessive compulsive disorder, or OCD. OCD is described
Allison has experienced a few panic attacks in her life, but has not had a panic attack in more than two years. But she still carries Xanax with her everywhere she goes, just in case she needs it. Ever since she was 7 years old, she has worried about random issues. Allison remembers walking through her house at 7 years old, checking on all of the appliances to make sure that they were all unplugged before everyone fell asleep in fear that a fire would break out and burn the house down. Allison was also worried as a 3rd grader about her mother dying any day from cancer, since her mother was a smoker. When Allison was 16, she had great difficulty with learning how to drive in fear that she would be involved in a car accident. Indeed, Allison was involved in 2 car accidents, none of which were her fault.
She stated that anxiety started after high school when she felt pressure to go to college. There is no evidence to support that client has learning disabilities. Hannah reported that she thought the change would help improve her life. She stated that she thought moving out on her own would shift her into independence. However, client reports that her anxiety has been worse. Reportedly, she has difficulty spending too much time alone. Hannah recalled her recent experience meeting with friends at a coffee shop and reported that during the entire outing she experienced persistent thoughts of going home. She stated concerns about the possibility of losing her friends due to the anxiety. Hannah reflected on how social life when she lived with her parent and reports her new social difficulties. Client reported that her anxiety is stopping her from making friends. Hannah works as a freelance photographer. Anxiety has been stopping her photography. Hannah reported that she has been receiving less work and took the responsibility for the decline in work. Client reports some of her anxiety symptoms as shaking, hot flashes and sweating. In addition she reports having many flooding thoughts that others may think she is stupid, she can’t do her job, she’s an idiot, weirdo, or everyone is looking at her. She reported that those thoughts make her feel she should give up and she is an idiot. Hannah reports that when anxious while working, she has the tendency to clinch tight onto the camera. Reportedly, her shaking interferes with her taking photos. Client reported that had resorted to wearing black to work and many places to conceal the evidence of her sweating due to her
Panic Disorder is a type of anxiety disorder that consists of feelings of sudden fear, overwhelming fright, and fear of death. Panic disorder can be inherited, but it can also be the result of
People who suffer from a social phobia will worry a lot about making a fool of themselves in front of other people, and will feel very anxious before going into any of the social situations that worry them. They may go through, in great detail, all the embarrassing things that could happen. When they are actually with people, they will feel even more anxious, and may be unable to say, or do, what is intended. In a way, it is a self-fulfilling prophecy. You worry so much about looking worried that you actually do look worried. People experiencing both of these types of social phobia have many of the same physical symptoms. You may get a very dry mouth, sweat a lot, and feel your heart racing. Other people may be able to see some of the signs of this anxiety, such as blushing, stammering, shaking and trembling. Sometimes you may breathe too fast, which can give you feelings of numbness or pins and needles in the fingers and toes. This can make the anxiety even worse. These feelings of fear and bodily symptoms can end in a panic attack. This is a short period, usually lasting only a few minutes, during which people feel overwhelmingly anxious, terrified of losing control, and may feel
Around the age of four Annie would wake up in the middle of the night and begin having abnormal sentiments where she would be alert however have no clue what's going on. During the interview, Annie explained that she grew up in a domestic violence home. She likewise clarified that as a kid the things she witness had an effect on her and, in the long run, began upsetting her state of mind and the way she sees her environment. As Annie got older her panic disorder worsening. She eventually isolated herself from society unless she was accompanied by one of her friends or ask them to do the task for her. If she attended a party with her friends she needed to have an escape plan. Not only did her panic disorder influence her social life negatively
Agoraphobia could be a result of previously repressed emotional problems, such as a death of a loved-one or any type of abuse. The fear of some situations is learned. After feeling uneasy in one situation someone might think they will get the same feeling next time. this is classified on the DSM-IV it is an excessive or unrealistic worry about life circumstances.
Feelings of anxiety are relatively normal especially when a person is under stress. Stress is also quite a normal occurrence in the workplace: strict regulations, difficult bosses, tough deadlines, continuous overtime, and overloading. It is not surprising that some employees develop anxiety and anxiety disorders. Stress and anxiety may be further exacerbated if the job requires handling of customers in settings like call centers. Ironically, it has been noticed that most employees who suffer from panic and anxiety disorder (PAD) are perfectionists, model employees in the company. Usually, these types of people pay strong attention to details, show extraordinary commitment to their jobs, and manifest a high degree of selflessness. An employee having sudden attacks of anxiety would display the following symptoms: difficulty in breathing, trembling, sweating, rapid heartbeat, nausea, and numbness. A common complaint during an attack is verbalized fear of having an impending heart attack. Sometimes, an employee escapes to a place where he feels safe whenever feelings of panic overwhelm him. The root of the problem is said to be the employee 's feelings of distrust. Therefore, education about the condition and communication in good faith are both needed to resolve the problem. Lack of faith on either side might harm the business relationship. Luckily, PAD can be treated using a variety of methods. An immediate solution to anxiety and panic attacks is the relaxation techniques.