Case Study Susan

Susan is a 40 year old stay at home mother of 2 school children.  Anthony is 11 years old and Mia is 9 years old.    She has been married to husband Rob for 12 years.  Susan reports drinking red wine daily.  She states she drinks after the kids are asleep and has around three to four glasses per night.  She was referred by her physician where she was being treated for migraines and gastrointestinal problems.  After a full medical work up Susan was found to be physically healthy.  Susan also reported an inability to sleep sound, muscle tension and excessive persistent worry about the safety of her family.  Susan has been suffering from these symptoms for approximately a year.  She reported the symptoms have gotten worse after her children both attend school.  Susan also cares for her aging parents and her responsibilities have increased over the past year.  She worries that if one parent dies her responsibilities will increase in caring for the surviving parent.    

After reviewing Susan’s case study it appears that Susan fits the criteria from the DSM 5 Axis I for Generalized Anxiety disorder, GAD.  Generalized Anxiety code 300.02, is categorized as suffering from excessive or disproportionate anxiety, (worry) symptoms more days than not for a period of six month or more.  Susan would have to meet three of the six criteria to officially be diagnosed with the generalized anxiety.  With the limited information provided Susan meets four of the criteria.  She also meets the DSM V criteria for alcohol abuse code 305.00.  This is categorized as attempting to stop or cut down on drinking with no success, spends a lot of time drinking, recovering or being drunk in the day, continues to drink even though it is causing family problems, and drinks to handle stress.  

When examining Susan’s case study she presents with an uncontrollable and often irrational worry regarding the safety of her family, children and husband.  Although stress does not cause anxiety the additional stress of caring for her aging parents appear to intensify the symptoms of her GAD in addition to her alcohol dependence and lack of coping skills.  When examining Susan’s emotional state and substance use, she demonstrates an uncontrollable anxiety or worry, intrusive thoughts, and the uncertainty regarding her parent’s health, her children’s school day and her husband’s work day is causing apprehension and dread about the future. Susan reports using alcohol particularly red wine to sooth these worries.  Susan reported muscle tension and in inability to relax or have restful sleep without being intoxicated and has reported recent restless sleep while intoxicated.  Susan reported she also suffers from a difficulty concentrating, putting off overwhelming things, and avoiding anxiety producing stressors.  Physically Susan reported having gastrointestinal problems and migranes. This is also an indicator of generalized anxiety and alcohol dependence.  She reported feeling tense, trouble sleeping, restlessness, and stomach problems.  With no specifics if it is nausea, diarrhea or other issues.      

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