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Case Study: Anna

Anna, 68 years old, is the first member of her family born in Asia. She just lost her spouse. She claims she had a wonderful relationship with her spouse for 34 years, until he passed away. Anna tries her best to care for her mother, who lives with her and is 90 years old. She has three adult children and several adorable grandkids. Anna taught for 41 years until she was forced to retire due to her advanced age.

Biological Key Issues

Anna claims that the stress she has experienced over the last year and a half has made it difficult for her to sleep. She also suffers from frequent headaches and neck and shoulder discomfort. Anna states that she constantly feels as if she's ready to "leap out of her skin," which makes it difficult for her to sit still.

Psychological Key Issues

Anna's friends and relatives have described her as "high strung," and her eldest kid has remarked that her mother seems a little anxious. Anna reports that her mother used to be quite anxious, but that she has significantly calmed down after through menopause 30 years ago. Since one and a half years ago, she has never stopped worrying, and her lack of interest in anything else is quite annoying. Anna said that she had raged at her daughter when her two older children have asked her to stop phoning them daily. Social Anna's persistent anxiety and concern about things she knows to be false are straining her relationships with her children and friends. Anna wants to return to school, visit her friends, and have a sense of purpose in her life. Due to her anxiety, her grandchildren are not as close to her as they once were. Anna said, "I'm terrified no one will ever want to be around me again, and I'll die alone on the street, forgotten by my friends and family."

Spiritual

Anna is a devout Hindu who wants to include her spirituality into her counseling job.

Assessments

I would administer the Mental Status Exam to Anna to get a complete picture of her physical and mental health (MSE). I will still have her complete the Generalized Anxiety Disorder (GAD) Screening Tool, despite the fact that she has previously provided responses to all of the questions. I would also want to assess Anna's thyroid levels, serum glucose, blood urea nitrogen, creatinine clearance, and urinalysis when she returns to the doctor (Lee, 2020).

Diagnostic Impressions

Initial thoughts based on the diagnosis I believe Anna has ICD-10 F41.1 generalized anxiety disorder based on my observations. Anna has expressed regret that her concern has created difficulties with her children, that she sobbed every day for a year after her husband's death, and that she is too exhausted to perform much more than the absolute minimum. These symptoms do not match the criteria for a diagnosis of ICD-10F32.9, which is an undescribed form of depression.

Signs and Symptoms

Other DSM Conditions Considered

Anna has expressed regret for straining her relationships with her kids and grandkids because of her worry, and she did grieve for her husband and cry every day for a year. However, I do not think these symptoms warrant a diagnosis of unspecified depressive disorder ICD-10F32.9 because, if Anna is able to control her anxiety, her relationships with her kids and grandkids will be restored, and she will have more energy and motivation to do more than the bare minimum.

Treatment Recommendations

Key Issues

Anna's primary issues stem from the fact that she was born with an anxiety disorder, that she just lost a loved one and a job she enjoyed, and that she no longer believes she has the autonomy to make choices about her own life. Individual and group cognitive behavioral therapy is the first recommendation I have (CBT). As a result, she will be able to interrupt her worrisome thoughts when they arise. Second, I would attempt reconciliation with her children and successors. Thirdly, I would assist her in finding an activity outside the home that restores her feeling of meaning and purpose. If it were a feasible, I would advise Anna to gradually discontinue using her anxiety medication (Cooper, 2018).

Recommendations for Individual Counseling

The first stage in Anna's recovery is cognitive behavioral therapy (CBT). Psychoeducational is the first phase in CBT treatment. Using a cognitive behavioral model of GAD, I would demonstrate to Anna how a worry episode is constructed from the bottom up (situation, thoughts, emotions, and behaviors). Anna may have a better understanding of how to utilize CBT to stop worrying if she first learns about the stages of concern. Anna should begin maintaining a diary as a tool for self-monitoring so she can determine what causes her anxiety and keep note of how it affects her inner and outside worlds (Carl, 2019).. Once we determine what causes Anna's anxiety, we may discuss potential solutions. "Exercises" refers to "applied relaxation," "mindfulness," "cognitive reappraisal," "behavioral experiments," "imaginative exposure," and "response prevention" (Carl, 2019).

Specific Considerations

Anna's parents are Hindu, and they immigrated to the United States at a period when a large number of Filipinos were making the same journey. This implies that Anna is of Asian ancestry, but does not specify which Asian nation. After the passage of the Philippine Independence Act in 1934, only 50 foreigners were permitted to enter the nation annually. Anna's parents may have been the only members of their family to immigrate to the United States as a result of the conflict between the United States and Japan. Filipinos are individuals that prioritize their family above their personal prosperity (Borza, 2022). It's a huge thing to uproot your life and relocate 9,000 miles away from relatives and friends you'll never see to a new nation.

References.

Borza, L. (2022). Cognitive-behavioral therapy for generalized anxiety. Dialogues in clinical neuroscience.

Carl, J. R., Miller, C. B., Henry, A. L., Davis, M. L., Stott, R., Smits, J. A., ... & Espie, C. A. (2020). Efficacy of digital cognitive behavioral therapy for moderate‐to‐severe symptoms of generalized anxiety disorder: A randomized controlled trial. Depression and anxiety, 37(12), 1168-1178.

Cooper, R. (2018). Diagnostic and statistical manual of mental disorders (DSM). KO KNOWLEDGE ORGANIZATION, 44(8), 668-676.

Lee, E. (2020). America first, immigrants last: American xenophobia then and now. The Journal of the Gilded Age and Progressive Era, 19(1), 3-18.