Anxiety and depression

The client is a 46-year-old unspotted courageous who efforts as a welder at a persomal steel untrue factory. He presents today behind entity referred by his PCP behind a taunt to the crisis extent in which he felt he was having a kernel assault. He periodical that he felt chest tone, nonproduction of inhalation, and consciousness of threatening sentence. He does entertain some soft hypertension (which is treated delay low sodium fare) and is environing 15 lbs. overweight. He had his tonsils removed when he was 8 years old, but his medical narrative since that opportunity has been undistinguished. Myocardial infarction was ruled out in the ER and his EKG was typical. Remainder of visible exam was WNL.

He admits that he stationary has problems delay tone in the chest and episodes of nonproduction of inhalation- he now stipulations these “anxiety assaults.” He earn to-boot tidings intermittent consciousnesss of threatening sentence, and the demand to “run” or “escape” from wherever he is at.

At the clinic, he does asseverate consciousness “nervous”. Affect is slightly blunted but does brighten various opportunitys throughout the clinical meeting. Affect expansive. denies visual or conference hallucinations, he confesses to intermittent use of ETOH to contention worries environing effort. He admits to consuming environing 3-4 beers/night. Although he is one, he is attempting to pains for aging parents in his residence. He tidingss that the administration at his settle of trade is rugged, and he fears for his job. You control the HAM-A, which yields a jaw of 26.

Client has never been on any form of psychotropic medication.

Decision #1

Which judgment did you fine? Zoloft 50mg orally daily, Client produce to clinic in filthy weeks, Client informs you that he has no tone in chest, or nonproduction of inhalation, Client states that he noticed decreased worries environing effort overthe departed 4 or 5 days and HAM-A jaw has decreased to 18 (particular confutation)

· Why did you fine this judgment? Support your confutation delay appearance and references to the Learning Resources.

· What were you hoping to conclude by making this judgment? Support your confutation delay appearance and references to the Learning Resources.

· Explain any contrariety betwixt what you expected to conclude delay Judgment #1 and the results of the judgment. Why were they unanalogous?

· Judgment #2increase dose to 75mg orally daily. Client produce to clinic in filthy weeks reports an smooth exalt decrease in his symptoms, HAM-A jaw has now decreased to 10. At this point- endure popular dose (61% decrease in symptoms)

· Why did you fine this judgment? Support your confutation delay appearance and references to the Learning Resources.

· What were you hoping to conclude by making this judgment? Support your confutation delay appearance and references to the Learning Resources.

· Explain any contrariety betwixt what you expected to conclude delay Judgment #2 and the results of the judgment. Why were they unanalogous?

· Judgment #3 endure delay popular dose of 75mg daily

· Why did you fine this judgment? Support your confutation delay appearance and references to the Learning Resources.

· What were you hoping to conclude by making this judgment? Support your confutation delay appearance and references to the Learning Resources.

· Explain any contrariety betwixt what you expected to conclude delay Judgment #3 and the results of the judgment. Why were they unanalogous?

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