case study on anxiety disorder slideshare

Module 4: Anxiety Disorders

Case studies: examining anxiety, learning objectives.

• Identify anxiety disorders in case studies

Case Study: Jameela

Jameela was a successful lawyer in her 40s who visited a psychiatrist, explaining that for almost a year she had been feeling anxious. She specifically mentioned having a hard time sleeping and concentrating and increased feelings of irritability, fatigue, and even physical symptoms like nausea and diarrhea. She was always worried about forgetting about one of her clients or getting diagnosed with cancer, and in recent months, her anxiety forced her to cut back hours at work. She has no other remarkable medical history or trauma.

For a patient like Jameela, a combination of CBT and medications is often suggested. At first, Jameela was prescribed the benzodiazepine diazepam, but she did not like the side effect of feeling dull. Next, she was prescribed the serotonin-norepinephrine reuptake inhibitor venlafaxine, but first in mild dosages as to monitor side effects. After two weeks, dosages increased from 75 mg/day to 225 mg/day for six months. Jameela’s symptoms resolved after three months, but she continued to take medication for three more months, then slowly reduced the medication amount. She showed no significant anxiety symptoms after one year. [1]

Case Study: Jane

Jane was a three-year-old girl, the youngest of three children of married parents. When Jane was born, she had a congenital heart defect that required multiple surgeries, and she continues to undergo regular follow-up procedures and tests. During her early life, Jane’s parents, especially her mother, was very worried that she would die and spent every minute with Jane. Jane’s mother was her primary caregiver as her father worked full time to support the family and the family needed flexibility to address medical issues for Jane. Jane survived the surgeries and lived a functional life where she was delayed, but met all her motor, communication, and cognitive developmental milestones.

Jane was very attached to her mother. Jane was able to attend daycare and sports classes, like gymnastics without her mother present, but Jane showed great distress if apart from her mother at home. If her mother left her sight (e.g., to use the bathroom), Jane would sob, cry, and try desperately to open the door. If her mother went out and left her with a family member, Jane would fuss, cry, and try to come along, and would continually ask to video-call her, so her mother would have to cut her outings short. Jane also was afraid of doctors’ visits, riding in the car seat, and of walking independently up and down a staircase at home. She would approach new children only with assistance from her mother, and she was too afraid to take part in her gymnastics performances.

Jane also had some mood symptoms possibly related to her medical issues. She would intermittently have days when she was much more clingy, had uncharacteristically low energy, would want to be held, and would say “ow, ow” if put down to stand. She also had difficulty staying asleep and would periodically wake up with respiratory difficulties. [2]

• Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in clinical neuroscience, 19(2), 93–107. ↵
• Hirshfeld-Becker DR, Henin A, Rapoport SJ, et alVery early family-based intervention for anxiety: two case studies with toddlersGeneral Psychiatry 2019;32:e100156. doi: 10.1136/gpsych-2019-100156 ↵
• Modification, adaptation, and original content. Authored by : Margaret Krone for Lumen Learning. Provided by : Lumen Learning. License : CC BY: Attribution
• Treatment of anxiety disorders. Authored by : Borwin Bandelow, Sophie Michaelis, Dirk Wedekind. Provided by : Dialogues in Clinical Neuroscience. Located at : http://Treatment%20of%20anxiety%20disorders . License : CC BY: Attribution

Powerful PowerPoint Presentation on Anxiety Disorders: A Comprehensive Guide

Imagine feeling an overwhelming sense of fear and worry, consuming your every thought and impeding your ability to function. This is the reality for millions of individuals with anxiety disorders. These disorders, although invisible, can have a profound impact on the lives of those affected, as well as on society as a whole.

But how can we educate and raise awareness about anxiety disorders in an effective and engaging way? The answer lies in the power of PowerPoint presentations. By harnessing the visual and auditory capabilities of this widely used software, we can create impactful presentations that not only inform, but also inspire action.

In this comprehensive guide, we will explore the art of crafting powerful PowerPoint presentations on anxiety disorders. From choosing the right design to effectively delivering your message, we will delve into the key elements that make a presentation engaging and informative. We will also discuss the importance of incorporating relevant statistics and research data to provide credibility to your content.

But creating an engaging presentation is just the beginning. Structuring your content in a logical and impactful manner is equally crucial. We will guide you through the process of introducing anxiety disorders, exploring different types, highlighting symptoms, and discussing the effects on daily life. Additionally, we will address the various treatment options and support resources available to individuals facing these challenges.

Furthermore, we will delve into the art of public speaking and how to master the skills necessary to captivate an audience. By incorporating storytelling and personal experiences, you can create an emotional connection that enhances understanding and empathy. We will also explore the use of audio and video elements to further engage your audience and solidify your message.

In the final sections, we will provide additional resources and references, sharing links to online platforms that offer further information and citing credible sources and studies.

This guide aims to demonstrate the power of PowerPoint presentations in spreading awareness about anxiety disorders. By educating individuals and communities, we can empower them to take action and create a supportive environment for those affected by these debilitating conditions. So, let us embark on this journey together, and unlock the potential of a powerful presentation that can make a difference.

Creating an Engaging PowerPoint Presentation

When it comes to creating an engaging PowerPoint presentation on anxiety disorders, choosing the right design and layout is crucial. The design should not only be visually appealing but also complement the content and message you want to convey. Here are some tips to help you in this process:

1. Choosing the Right Design and Layout

Select a design template that aligns with the tone and purpose of your presentation. Use professional and clean designs that enhance readability. Consider the audience you will be presenting to and ensure your design is appropriate for them.

Organize your slides in a logical and coherent manner. Make use of headings, subheadings, and bullet points to create a clear structure. This will help your audience follow the flow of your presentation and easily grasp the information presented.

2. Utilizing Engaging Visuals and Graphics

Visuals play a crucial role in capturing and maintaining audience attention. Incorporate relevant images, photographs, and illustrations to reinforce your message and create a visual impact. Avoid cluttering your slides with too many visuals, as this can be distracting. Instead, choose high-quality images that support your content effectively.

Consider using charts, graphs, and infographics to present data and statistics in a visually appealing and easily understandable way. These visual representations can make complex information more digestible and memorable for your audience.

3. Incorporating Relevant Statistics and Research Data

Anxiety disorders are heavily influenced by research and data. Including relevant statistics and research findings in your presentation helps add credibility and strengthen your message. Ensure that you source your data from reputable and reliable sources.

Use visuals, such as charts or graphs, to present statistics in a clear and concise manner. This not only enhances comprehension but also makes it easier for your audience to remember the information presented.

Remember to provide context and explain the significance of the statistics and research data you include. This helps your audience understand the relevance and impact of anxiety disorders in society.

By paying attention to design, visuals, and data, you can create a PowerPoint presentation that not only captivates your audience but also effectively communicates your message about anxiety disorders. A well-designed presentation with engaging visuals and relevant statistics can leave a lasting impression on your audience, increasing their understanding and empathy towards individuals facing these challenges.

Structuring your Presentation for Maximum Impact

To create a PowerPoint presentation on anxiety disorders that leaves a lasting impact, it is essential to structure your content effectively. By organizing your presentation in a logical and cohesive manner, you can ensure that your message is clear and easily understood. Here are some key elements to consider when structuring your presentation:

1. Introducing the Topic and Defining Anxiety Disorders

Begin your presentation by providing an overview of anxiety disorders and their prevalence. Define anxiety disorders and explain how they differ from normal feelings of anxiety. Use relatable examples and anecdotes to help your audience grasp the concept more effectively.

2. Exploring Different Types of Anxiety Disorders

Anxiety disorders encompass various subtypes, including generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobias. Dedicate a section of your presentation to exploring these different types, highlighting the unique characteristics and symptoms associated with each. Incorporate visuals and case studies to enhance understanding and engagement.

3. Highlighting Symptoms and Diagnostic Criteria

An important aspect of educating your audience about anxiety disorders is helping them recognize the signs and symptoms. Present a comprehensive list of common symptoms and the diagnostic criteria used by healthcare professionals. Include both physical and psychological symptoms, such as excessive worry, restlessness, sleep disturbances, and difficulty concentrating. Emphasize the importance of seeking professional help for accurate diagnosis and treatment.

4. Discussing the Effects of Anxiety Disorders on Daily Life

Anxiety disorders can significantly impair an individual’s daily functioning and quality of life. Address the impact of anxiety disorders on various aspects, such as personal relationships, work or academic performance, and overall well-being. Share real-life examples or personal testimonials to illustrate the challenges faced by individuals with anxiety disorders. This helps foster empathy and understanding among your audience.

5. Addressing Treatment Options and Support Resources

Provide an overview of the treatment options available for individuals with anxiety disorders. Discuss evidence-based therapies, such as cognitive-behavioral therapy (CBT) and medication management. Explain the importance of a multidisciplinary approach and the role of healthcare professionals in providing support.

Additionally, highlight the importance of support resources, such as support groups, helplines, and online communities. Share information about local and national organizations that offer assistance, such as mental health clinics and advocacy groups. Including this information equips your audience with the knowledge and resources necessary to help themselves or others who may be struggling with anxiety disorders.

By structuring your presentation around these key elements, you create a comprehensive and informative overview of anxiety disorders. This structure ensures that your audience gains a deeper understanding of the topic, the varying types of anxiety disorders, their symptoms, and the impact they have on daily life. It also empowers them with knowledge about available treatment options and support resources, ultimately encouraging a more informed and supportive community.

Delivering an Effective Presentation

Creating an engaging PowerPoint presentation on anxiety disorders is only half the battle. The way you deliver your presentation plays a crucial role in capturing your audience’s attention and effectively conveying your message. Here are some key strategies to help you deliver an impactful presentation:

1. Mastering Public Speaking Skills

Public speaking can be intimidating, but with practice and preparation, you can become a confident and effective presenter. Start by rehearsing your presentation multiple times, focusing on your delivery, pace, and tone. Pay attention to your body language, maintaining eye contact with your audience and using appropriate gestures to enhance your message. Practice speaking clearly and projecting your voice to ensure everyone in the room can hear you.

Consider joining a public speaking club or taking communication courses to enhance your skills. These resources can provide valuable feedback and guidance on improving your delivery and connecting with your audience.

2. Engaging the Audience through Storytelling and Personal Experiences

To make your presentation more relatable and memorable, incorporate storytelling and personal experiences. Share anecdotes or real-life examples that illustrate the challenges faced by individuals with anxiety disorders. These personal stories can help create an emotional connection with your audience and generate empathy and understanding.

When sharing personal experiences, be mindful of confidentiality and respect for others’ privacy. Focus on the general aspects of the experience rather than specific details that may compromise anonymity.

3. Using Audio and Video Elements to Enhance Engagement

Audio and video elements can significantly enhance audience engagement during your presentation. Consider including short video clips that provide insights into the daily struggles faced by individuals with anxiety disorders or highlight success stories of individuals who have overcome their challenges.

Incorporate relevant audio clips, such as calming music or guided relaxation exercises, to create a soothing and immersive environment. These elements can help evoke emotions and create a more impactful experience for your audience.

However, it’s important to use audio and video elements sparingly and strategically. Too many distractions can detract from your message or overwhelm your audience. Ensure that these elements enhance your content rather than overshadowing it.

Remember, an effective presentation is not only about delivering information but also about engaging your audience and leaving a lasting impact. The mastery of public speaking skills, the use of storytelling and personal experiences, and the strategic incorporation of audio and video elements all contribute to creating a presentation that resonates with your audience. By connecting on an emotional level and providing a memorable experience, you increase the likelihood of creating awareness and inspiring action regarding anxiety disorders.

Providing Additional Resources and References

To further support the information presented in your PowerPoint presentation on anxiety disorders, it is important to provide additional resources and references. This allows your audience to explore the topic in more depth and access credible information for further learning. Here are some key aspects to consider when providing additional resources:

1. Sharing Links to Online Resources for Further Information

In today’s digital age, online resources are readily available and accessible. Include a slide or section in your presentation that lists relevant websites, blogs, and online platforms that offer comprehensive information about anxiety disorders. These resources may include reputable mental health organizations, educational websites, and professional associations.

Ensure that the websites you recommend provide accurate and up-to-date information backed by experts in the field. Revisit these links periodically to ensure they are still active and relevant.

2. Citing Credible Sources and Studies

Throughout your presentation, referencing credible sources and studies adds credibility and strengthens the validity of your information. In a separate slide or section, provide a list of the sources you utilized during your research. This may include academic articles, books, research studies, and official publications.

Ensure that the sources you cite are from reputable sources, such as peer-reviewed journals or well-established publications in the field of psychology or psychiatry. This helps establish the credibility of the information you have presented and allows your audience to explore the topic further.

When citing sources, follow a consistent citation style, such as APA or MLA, to maintain professionalism and facilitate further reading for those interested.

Remember to mention that individuals should consult a healthcare professional or mental health expert for personalized advice and guidance.

By providing additional resources and references, you equip your audience with the tools to continue their learning journey beyond your presentation. This empowers them to delve deeper into the topic of anxiety disorders and gain a more comprehensive understanding. Additionally, by citing credible sources, you ensure that your audience has access to accurate and reliable information, promoting an evidence-based approach to learning about anxiety disorders.

The power of PowerPoint presentations in spreading awareness about anxiety disorders cannot be underestimated. By creating engaging and informative presentations, you have the ability to educate individuals and communities, empowering them to take action and create a supportive environment for those affected by anxiety disorders. Remember to utilize the right design and layout, incorporate visuals and relevant statistics, and structure your presentation effectively. Deliver your presentation with confidence, using storytelling and personal experiences to engage your audience. Finally, provide additional resources and references to encourage further learning and support. Together, let us harness the power of PowerPoint to make a difference in raising awareness and understanding of anxiety disorders.

The Power of PowerPoint Presentations in Spreading Awareness about Anxiety Disorders

PowerPoint presentations have proven to be a valuable tool in spreading awareness about anxiety disorders. By combining informative content with engaging visuals and effective delivery, these presentations can have a profound impact on individuals and communities. Here are some key reasons why PowerPoint presentations are powerful in raising awareness about anxiety disorders:

1. Visual Appeal for Enhanced Understanding

Anxiety disorders can be complex and challenging to comprehend. The visual nature of PowerPoint allows for the effective presentation of information using images, charts, and graphs. Visuals simplify complex concepts and help the audience grasp the information more easily. By using visuals, you can bridge the gap between technical knowledge and everyday understanding, making the information more relatable and accessible.

2. Memorable and Engaging Content

PowerPoint presentations enable the use of storytelling, personal anecdotes, and engaging visuals to create memorable content. Emotionally resonant stories and personal experiences help the audience connect with the topic of anxiety disorders on a deeper level. By incorporating relatable content, you can elicit empathy and understanding, leaving a lasting impact on your audience.

3. Effective Communication of Statistics and Research Data

Statistics and research data are essential to support the information presented in a PowerPoint presentation. By incorporating relevant data into charts, graphs, and infographics, you can efficiently communicate the prevalence and impact of anxiety disorders. This data-driven approach adds credibility to your message and helps the audience recognize the seriousness of these disorders.

4. Accessibility and Reach

PowerPoint presentations can be easily shared and disseminated to a wide audience. With advancements in technology, they can be uploaded to online platforms, shared via email, or presented in person. This accessibility not only allows for wider dissemination of information but also enables individuals to access the presentation at their own convenience, increasing engagement and awareness.

Empowering Individuals and Communities to Take Action

The ultimate goal of a PowerPoint presentation on anxiety disorders is to empower individuals and communities to take action. By raising awareness and understanding, these presentations motivate individuals to seek help, support those affected by anxiety disorders, and advocate for mental health initiatives. By providing additional resources and references, you equip your audience with the tools and knowledge to make a positive difference in their own lives and the lives of others.

In conclusion, PowerPoint presentations are a powerful medium for spreading awareness about anxiety disorders. Through engaging visuals, impactful storytelling, and the effective communication of statistics, these presentations captivate audiences and leave a lasting impression. By sharing informative content, raising empathy, and providing resources, PowerPoint presentations empower individuals and communities to take action and create a supportive environment for those living with anxiety disorders. Let us harness the power of PowerPoint to educate, inspire, and make a real difference in the lives of those affected by anxiety disorders.The comprehensive guide to creating a powerful PowerPoint presentation on anxiety disorders has revealed the importance of this medium in spreading awareness and understanding. By following the strategies outlined in this guide, individuals and organizations can effectively educate and engage their audience, making a significant impact on communities and individuals affected by anxiety disorders.

PowerPoint presentations offer the advantage of visual appeal, simplifying complex concepts and aiding comprehension. By utilizing engaging visuals, storytelling, personal experiences, and incorporating relevant statistics and research data, presenters can create memorable and relatable content that resonates with their audience. Such presentations empower individuals to recognize the signs and symptoms of anxiety disorders, fostering empathy and understanding for those affected.

Moreover, PowerPoint presentations enable the sharing of resources and references, both online and offline. By providing links to credible online resources, organizations, and support groups, presenters guide their audience towards further information and support. This level of accessibility ensures that individuals can continue their learning journey beyond the presentation and seek help or assistance as needed.

The true power of PowerPoint presentations lies in their ability to motivate individuals and communities to take action. By raising awareness, breaking down stigmas, and encouraging dialogue, these presentations empower individuals to seek professional help, support those living with anxiety disorders, and advocate for mental health initiatives.

In essence, PowerPoint presentations have the potential to create a ripple effect of change. They have the ability to break through barriers and create understanding, compassion, and acceptance. Through compelling narratives, captivating visuals, and the sharing of credible information, these presentations can truly make a difference in spreading awareness about anxiety disorders and empowering individuals and communities to address this significant mental health issue.

So, let us harness the power of PowerPoint presentations, armed with knowledge and creativity, to create meaningful connections and bring about positive change for individuals facing the challenges of anxiety disorders. Together, we can build a more inclusive and supportive world for everyone impacted by anxiety disorders.

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Generalized Anxiety Disorder

Mar 23, 2019

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Generalized Anxiety Disorder. Brittany Smith Wake Forest University Fall 2012 October 29, 2012. Background Information. Affects psychological health, causes physiological effects, and diminishes the overall quality of life Characterized by excessive worrying, somatic symptoms

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• anxiety symptoms
• substance abuse
• anxiety diagnostic
• general anxiety disorder
• short term psychodynamic psychotherapy

Presentation Transcript

Generalized Anxiety Disorder Brittany Smith Wake Forest University Fall 2012 October 29, 2012

Background Information Affects psychological health, causes physiological effects, and diminishes the overall quality of life Characterized by excessive worrying, somatic symptoms Lifetime prevalence rate of 5% GAD is undertreated, misdiagnosed (sometimes mistaken for hypochondriasis, panic disorder, dysthymic disorder)

Methods • Z. Smith Reynolds Library website • Narrowed down topics • Diagnosis/comorbidity • Assessment • Psychotherapy (originally looked at “treatment”, which included research about pharmacological treatments as well) • Journals used: Journal of Clinical Psychiatry, Journal of Consulting and Clinical Psychology, American Journal of Psychiatry • Key search terms: • “Generalized Anxiety Disorder and CBT” • “Effects of Psychotherapy in GAD” • “Comorbidity in Generalized Anxiety Disorder”

Diagnosis Diagnosing this disorder can be difficult because of the following issues: • Physiological symptoms that people experience are often thought to be the result of medical conditions, not GAD • GAD has undergone different changes in its diagnostic criteria • Great variability in the reporting of GAD symptoms • The diagnostic threshold is ambiguous • GAD has a very high comorbidity rate with other anxiety disorders, Bipolar Disorder, substance abuse disorders, and Major Depressive Disorder (symptoms overlap)

General Anxiety Disorder: “The Comorbid Disorder” • Approximately 90% of individuals with Generalized Anxiety Disorder also have another coexisting condition (Simon, 2009) • Nearly 2/3 of these people have Major Depressive Disorder • High rates of comorbidity with Substance Use Disorder • Alcohol consumption leads to heightened anxiety levels, as a result of hyperexcitability of the autonomic nervous system (Brady, Tolliver, Verduin, 2007) • Diagnosing coexisting GAD and SUD can be difficult because symptoms of GAD overlap with alcohol withdrawal symptoms

Assessment tools • The HARS (HAM-A) is a clinician rated measure that assesses the intensity of anxiety symptoms • BAI focuses on somatic symptoms of anxiety. This inventory was created as a measure to distinguish anxiety symptoms apart from those associated with depression. • The STAI is commonly used in clinical environments to diagnose anxiety, as well as to differentiate it from depressive syndromes

Psychotherapeutic Treatment • Cognitive Behavioral Therapy (CBT) is currently considered to be most effective (some sources report that CBT in conjunction with medicinal treatment is efficacious) • Study comparing CBT and AR showed that though CBT and AR were highly effective, change in worry led to change in somatic anxiety to a greater extent in CBT than in AR (Donegan & Dugas, 2012) • Study comparing long term effects of Short term Psychodynamic Therapy (STPP) and CBT found both to be effective, but CBT was superior (Salzer, Winkelbach, Leweke, Leibing, Leichsenring, (2011) • Further research should be done on other treatments

Conclusion • Overall lack of research available on GAD, in comparison to other anxiety disorders • Diagnostic criteria may change in DSM V to help mitigate the issue with comorbidity • Long term effects of psychotherapy should be observed more in future research

Resources • Brady, M. D., Tolliver, M. D., & Verduin, M. D. (2007). Alcohol use and anxiety: Diagnostic and management issues. American Journal of Psychiatry, 164(2), 217–221. • Donegan, E., & Dugas, M. J. (2012). Generalized anxiety disorder: A comparison of symptom change in adults receiving cognitive-behavioral therapy or applied relaxation. Journal of Consulting and Clinical Psychology. doi:10.1037/a0028132 • Portman, M. E., Starcevic, V., & Beck, A. T. (2011). Challenges in assessment and diagnosis of generalized anxiety disorder. Psychiatric Annals, 41(2), 79–85. doi:http://dx.doi.org.go.libproxy.wfubmc.edu/10.3928/00485713-20110203-06 • Salzer, S., Winkelbach, C., Leweke, F., Leibing, E., & Leichsenring, F. (2011). Long-term effects of short-term psychodynamic psychotherapy and cognitive-behavioural therapy in generalized anxiety disorder: 12-Month Follow-up. Canadian Journal of Psychiatry, 56(8), 503–8. • Simon, N. (2009). Generalized anxiety disorder and psychiatric comorbidities such as depression, bipolar disorder, and substance abuse. Journal of Clinical Psychiatry, 70(2), 10-14. • http://totalpict.com/anxiety%20rating%20scale

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Hannah, an anxious child

Hannah (not a real person) was a 10-year-old girl from a close, supportive family who was described as 'anxious from birth'. She had been a shy, reserved young girl at pre-school, but she integrated well in grade 1 and began making friends and succeeding academically. She complained several times of severe abdominal pain that was worst in the morning and never present at night. She had missed about 20 days of school during the previous year because of the pain. She also avoided school excursions, fearing the bus would crash. She had difficulty falling asleep and frequently asked her parents for their reassurance.

Hannah was worried that she and members of her family might die. She was unable to sleep at all before a test. She could not tolerate having her parents on a different floor of the house from herself, and she insisted on securing the house to an unnecessary extent in the evenings, fearing intruders. Her insecurity, need for constant reassurance, and school absenteeism were frustrating and upsetting for her parents.

Hannah had no personal history of traumatic events. She exhibits symptoms typical of childhood anxiety disorder, which is thought to occur in about 10% of children, equally in boys and girls before puberty. This type of disorder is diagnosed when anxiety is sufficient to interfere with daily functioning, for example Hannah's school attendance and sleep. These effects can increase and interfere to a progressively greater extent with age-appropriate functioning at home, at school and with peers, and also places sufferers at risk of developing mood disorders or substance abuse disorders in the future.

Many children experience fears; fears that are developmentally normal. Children with anxiety disorders, however, experience persistent fears or other symptoms of anxiety for months. Children can experience all the anxiety disorders experienced by adults. However, they can also experience separation anxiety disorder and selective mutism (failure to speak in certain social situations, thought to be related to social anxiety), which are unique to children. The duration of Hannah's difficulties and the symptoms, including inability to sleep, attend school regularly, go on school excursions, or face tests without extreme distress are all developmentally inappropriate, suggesting an anxiety disorder.

There is a range of common symptoms seen in anxious children. Symptoms involving thoughts include worrying, requests for reassurance, 'what if.' questions, and upsetting obsessive thoughts. Common symptoms involving behaviours include difficulty in separation, avoiding feared situations, tantrums when faced with fear, 'freezing' or mutism in feared situations, and repetitive rituals, or compulsions. Common symptoms involving feelings include panic attacks, hyperventilation, stomachaches, headaches and insomnia.

To screen quickly for one or more anxiety disorders in children, four questions are often useful:

• Does the child worry or ask for parental reassurance almost every day?
• Does the child consistently avoid certain age-appropriate situations or activities, or avoid doing them without a parent?
• Does the child frequently have stomachaches, headaches, or episodes of hyperventilation?
• Does the child have daily repetitive rituals?

These questions address the main thoughts, behaviours and feelings related to anxiety seen in children.

Megan Rodgers wishes to acknowledge an article entitled 'Childhood Anxiety Disorders' written by Dr Manassis, a Staff Psychiatrist at the Hospital for Sick Children and the Center for Addiction and Mental Health in Toronto, Ontario, on which this article is based.

Written by Megan Rodgers ADAVIC Volunteer June 2004

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Patient Case Presentation

Figure 1.  Blue and silver stethoscope (Pixabay, N.D.)

Ms. S.W. is a 48-year-old white female who presented to an outpatient community mental health agency for evaluation of depressive symptoms. Over the past eight weeks she has experienced sad mood every day, which she describes as a feeling of hopelessness and emptiness. She also noticed other changes about herself, including decreased appetite, insomnia, fatigue, and poor ability to concentrate. The things that used to bring Ms. S.W. joy, such as gardening and listening to podcasts, are no longer bringing her the same happiness they used to. She became especially concerned as within the past two weeks she also started experiencing feelings of worthlessness, the perception that she is a burden to others, and fleeting thoughts of death/suicide.

Ms. S.W. acknowledges that she has numerous stressors in her life. She reports that her daughter’s grades have been steadily declining over the past two semesters and she is unsure if her daughter will be attending college anymore. Her relationship with her son is somewhat strained as she and his father are not on good terms and her son feels Ms. S.W. is at fault for this. She feels her career has been unfulfilling and though she’d like to go back to school, this isn’t possible given the family’s tight finances/the patient raising a family on a single income.

Ms. S.W. has experienced symptoms of depression previously, but she does not think the symptoms have ever been as severe as they are currently. She has taken antidepressants in the past and was generally adherent to them, but she believes that therapy was more helpful than the medications. She denies ever having history of manic or hypomanic episodes. She has been unable to connect to a mental health agency in several years due to lack of time and feeling that she could manage the symptoms on her own. She now feels that this is her last option and is looking for ongoing outpatient mental health treatment.

Past Medical History

• Hypertension, diagnosed at age 41

Past Surgical History

• Wisdom teeth extraction, age 22

Pertinent Family History

• Mother with history of Major Depressive Disorder, treated with antidepressants
• Maternal grandmother with history of Major Depressive Disorder, Generalized Anxiety Disorder
• Brother with history of suicide attempt and subsequent inpatient psychiatric hospitalization,
• Brother with history of Alcohol Use Disorder
• Father died from lung cancer (2012)

Pertinent Social History

• Works full-time as an enrollment specialist for Columbus City Schools since 2006
• Has two children, a daughter age 17 and a son age 14
• Divorced in 2015, currently single
• History of some emotional abuse and neglect from mother during childhood, otherwise denies history of trauma, including physical and sexual abuse
• Smoking 1/2 PPD of cigarettes
• Occasional alcohol use (approximately 1-2 glasses of wine 1-2 times weekly; patient had not had any alcohol consumption for the past year until two weeks ago)

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