This case is about an old widowed Asian American woman called Anna. This case is meant to determine Anna’s issues regarding her biological behavior, psychology, social life, and spirituality. This study is also meant to assess Anna’s psychological fitness and recommend the best treatments considered. This case study will begin with critical issues.
The whole case study seems to be talking about Anna’s psychology. For the better part of her life, Anna has experienced fluctuating anxiety, and the symptoms have increased in recent years. Anna’s anxiety symptoms worsened when she lost her husband to cancer and started caring for her elderly mother.
Anna is suffering from being too anxious in this case study. The medical professional put her under Paxil to try and reduce the effects of anxiety on her. Anna has been on treatment for four weeks, and still, no evident change is seen. For the last 24 months, the physical symptoms of this disorder have been evident. These include increased body tension, severe headaches, and muscle tension. She has also had sleepless nights and prolonged fatigue. In her report, Anna says that she drinks too much wine; this may interfere with her body’s immunity to fight the effects of her disorder.
Anna has worked as an elementary school teacher in various grades and school districts since she was 24. During this period, she made a lot of friends who became so close to her. After her retirement, Anna continued to be in touch with many friends until the last eighteen months, when her level of anxiety increased. She was forced to cut off her friends, and she says her retirement affected her greatly. Her social network was comprised mainly of coworkers, as most of her friends could not contain her increased level of anxiety.
Anna is a Hindu; this is evident in her desire to include Hindu teachings during her counseling. It would be good for the counselors to use her faith in Hinduism to lower her level of anxiety. Even though the counselor considers this a minor issue, it is essential to incorporate the patient’s beliefs into the system they wish to embrace.
The counselor would administer the Beck Anxiety Inventory to Anna as the first assessment. This would prove that she already suffered from intense and chronic anxiousness. The Beck Anxiety Inventory is a simple assessment done within a short period and gives massive data on the patient’s anxiety. The assessment is easy to perform and explains what type of suffering they are going through to the patient. Also, the Beck Anxiety Inventory is suitable for Asian cultures (Oh et al., 2018). Anna is an Asian American woman with a strong cultural belief in family.
Signs and Symptoms
Looking at this report, the symptoms, and the patient’s testimony in terms of behavior, I would most strongly consider that this case is Generalized Anxiety Disorder (ICD-10 code 309.21, F93.0). Some of the key symptoms that prove this are her increased level of anxiety in recent days; she finds it hard to control her worry, fatigue, muscle tension, inability to sleep, irritability, and restlessness. These symptoms can not be related to substance use and cannot explain other mental illnesses.
Other DSM Conditions Considered
Other disorders were initially considered but later discarded due to a lack of enough proof. The disorders include; Separation, Anxiety Disorder (ICD-10 code 309.21, F93.0), and Substance/Medication Induced Anxiety Disorder (291.89, F10.280). The Separation Anxiety was more appealing when Anna lost her husband, and then she decided to focus on the well-being of her family, including her children and grandchildren. However, Anna reported increased anxiety when her husband died, and she most of the time thought of her well-being and finances. She resorted to drinking alcohol which she felt reduced her anxiety.
The amount of wine Anna took every week was a temptation to her counselor diagnostically. The separation anxiety was discarded because the loss of her husband and the symptoms she displayed do not genuinely relate to her habit of taking too much wine. These disorders were discarded in favor of Generalized Anxiety Disorder because Anna did not display panic symptoms that are more common in other anxiety disorders.
Consideration of Theories and Factors
The DSM-V states that women tend to suffer from Generalized Anxiety Disorder more than men. The feelings of anxiety cause discomfort and tend to disrupt everyday life (Wright et al.,2017). Anna’s symptoms negatively affected her life even though she does not display any panic from the effects of her anxiety. Generalized Anxiety Disorder is the most accurate diagnosis for this case.
According to my understanding, the main issue, in this case, is the client’s psychological symptoms. In their order of importance, these issues are learning to cope with her increased level of anxiety, reducing the physical effects caused by her increased level of anxiety, and re-introducing her to a social circle with these tools to give her a more comprehensive support network.
The use of Cognitive Behavioral Therapy (CBT) has been at the forefront to help patients reduce their increased anxiety levels in clinics and health facilities (Bandelow et al., 2017). Using the CBT method would positively impact Anna’s feelings and suppress the physical symptoms seen. Previous studies show that CBT reduces muscle tension and avoids sleep difficulties (Bandelow et al., 2017). Also, the counselor would address the spiritual feelings of the patient and her belief in Hinduism.
The counselor would recommend that Anna stops using alcohol sometimes or reduce her level of alcohol consumption. Anyone would recommend to her that she stops alcohol consumption for some time as it affects her mood. The best section course for her is to suspend alcohol to give Paxil the best chance of work. The medicine cannot perform well in her body when she consumes a massive amount of wine daily.
There are various considerations to make in this case. The role of culture in Anna’s life affects her health condition. She follows their culture to take care of her aging mother as she doesn’t want her to go to a nursing home. In her report, one would feel like she needs to take her elder mother to the nursing home, but she is afraid of how society will view her. She, therefore, resorts to staying with her despite all the stress she is going through. Her level of anxiety affects her relationship with her family member, especially her grandchildren. Therefore, the counselors may need more information from Anna on why she regards culture so much, even though these practices may affect her mentally.
There is evidence of conflict between Anna’s Hinduism belief and the counselor’s Christian faith, this conflict will have to be addressed and ethical common ground established. Anna sees life from a different perspective, separate from the counselor’s view that this life is just one chance we have on this earth. However, Anna believes that life is meaningless while looking at how her level of anxiety rises after the death of her husband. Therefore, the counselor would focus only on guiding the patient and allowing each party to maintain their personal beliefs but focusing on universal truths and commonalities. The role of the counselor, in this case, is not to convert the patient to his faith but to counsel and benefit the client’s state of mind. It would be unethical to convince the client to follow his faith without explicit permission from the client.
Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of Anxiety Disorders. Dialogues in clinical neuroscience, 19(2), 93.
Oh, H., Park, K., Yoon, S., Kim, Y., Lee, S. H., Choi, Y. Y., & Choi, K. H. (2018). Clinical Utility of Beck Anxiety Inventory in Clinical and Nonclinical Korean Samples. Frontiers in psychiatry, 9, 666.
Wright, Z. E., Pahlen, S., & Krueger, R. F. (2017). Genetic and Environmental Influences on Diagnostic and Statistical Manual of Mental Disorders-(DSM–5) Maladaptive Personality Traits and Their Connections with Normative Personality Traits. Journal of abnormal psychology, 126(4), 416.