The Case of Victoria: Generalized Anxiety Disorder
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Generalized Anxiety Disorder
When assessing a patient with GAD, professionals look for signs of worry and anxiety about various topics. In this case, Victoria worried excessively about performing her roles poorly. She worries about other things, like how she looks and what people think about her. The other criteria assess whether the patient can control her worry (Bennett & Walkup, 2019). In this case, Victoria cannot control her worry and would rather stay home instead of interacting with others. The other criteria determine if the worry is linked to at least three of the following six symptoms. That is tension in the muscles, inability to sleep, difficulties concentrating, restlessness, fatigue quickly, and irritability. In this case, Victoria has sleep disturbances; she is restless and has difficulty concentrating. The other criteria are assessed to confirm that the condition is not triggered by other underlying conditions (Bennett & Walkup, 2019). In this case, she is tested for other conditions, and the primary care provider is contacted. It is found that she has no other condition. All these criteria confirm that Victoria is suffering from a Generalized Anxiety Disorder.
GAD is a comparatively common condition affecting approximately 3.1 % of Americans. The frequency of GAD in children and teenagers varies from 2.9 to 4.6 percent (Leonte et al., 2018). GAD has comorbidity proportions comparable to or higher than other anxiety conditions, and it is one of the most prevalent comorbid conditions with other abnormalities. Owing to the same manifestations of these diseases, the most prevalent comorbidity of GAD are substance abuse disorders, major depression, and bipolar (Leonte et al., 2018). As a result, it is paramount for Victoria to be assessed for other conditions such as bipolar.
The differential diagnosis for this case is Obsessive-compulsive disorder (OCD). OCD is a mental disease in which persons have persistent, unwelcome emotions, ideas, or feelings referred to as obsessions. This makes them feel compelled to do something repeatedly, referred to as compulsions (Bennett & Walkup, 2019). Washing hands, inspecting objects, and cleaning, for example, might considerably conflict with a patient’s everyday activities and social connections. The rationale for OCD is that it manifests similarly to GAD (Leonte et al., 2018). For instance, when she says she thinks her clothes are wrinkled, she has symptoms of ordering whereby the patient wants things to be perfect. The other symptom is an obsession with worry, similar to GAD.
It was okay for several family relatives to accompany Victoria to the health clinic. This means that her family was concerned and ready to support her in accessing quality care. Family members play a crucial role in helping the patient make decisions concerning managing a condition (Bennett & Walkup, 2019). As an NP, I would accept her being accompanied by her relatives to the office. This is to respect the patient’s autonomy regarding her own decisions.
Before the family health provider is contacted, the community mental health provider must assess the patient following the patient's chief concern and subjective data. This data is essential since it represents the status of the condition from the perspective of the patient. It will give them a clue about the patient's issue. The NP should know that Buspirone medication is used to treat anxiety by altering the neurotransmitters in the brain. The patient should get educated that the medication is taken orally 2 -3 times daily (Bennett & Walkup, 2019). Also, the patient should take the medication with or without food. However, she must stick to one way so that the same amount of drugs can constantly be absorbed by the body.
In treating GAD, antidepressant medications should get used. First-line pharmacological therapies include antidepressants, including drugs in the selective serotonin reuptake inhibitor (SSRI) and serotonin and norepinephrine reuptake inhibitor (SNRI) families (Leonte et al., 2018). Among the majorly used drugs in this category are Lexapro, Cymbalta, and venlafaxine. The other medication is Benzodiazepines which should be used in limited situations to relieve acute symptoms since they can be habit-forming. Other alternative interventions include engaging in physical exercise to reduce stress. Also, the patient should eat healthily (Bennett & Walkup, 2019). The patient should adopt techniques for relaxation. Techniques such as yoga and meditation reduce anxiety. Also, the patient should make sleep mandatory by following healthy sleep patterns. This will ensure that the mind rests without wandering and eliminates the symptoms with time.
To determine if the patient has made any progress, the NP should ask how often she has been bothered by feeling anxious, nervous, or on edge. She should also be asked whether she is unable to control her worry or stop worrying (Bennett & Walkup, 2019). Also, she should ask whether she has trouble relaxing and if she is getting annoyed and irritable quickly. Also, the patient should be asked whether she has been worrying that something terrible might happen and if she has worried about different things in the past two weeks.
I would educate the patient and the family about GAD to inform them that it is not associated with an evil spirit and is just a condition like any other. In addition, I would educate them about the benefits of using contemporary medicine since they have been verified through trials (Leonte et al., 2018). I would allow them to use herbal medicines for the patient's autonomy. Some herbal medicines effectively cure GAD (Bennett & Walkup, 2019). That includes medication like Kava. Kava is well-known for producing pleasant sensations and having a soothing, calming impact on those users (Bennett & Walkup, 2019). As a result of its relaxing properties, Kava has gained interest, especially in the medical profession, as a potential therapy for GAD.
References
Bennett, S., & Walkup, J. T. (2019). Anxiety disorders in children and adolescents: Assessment and diagnosis. Recovered from: https://www. up-to-date. com/contents/anxiety-disorders-inchildren-and-adolescents-assessment-and-diagnosis.
Leonte, K. G., Puliafico, A., Na, P., & Rynn, M. A. (2018). Pharmacotherapy for anxiety disorders in children and adolescents. Waltham, MA. (Accessed on March 21, 2018: UpToDate.