Question

Here is the clinical case description for you to evaluate:

Dave is a 41-year-old male who was driving home from work one day and was caught in traffic. He suddenly noticed that his heart was beginning to race. He then felt short of breath, and tightness in his chest. When he began to sweat, he became concerned and drove to the nearest emergency room where they could find nothing physically wrong with him. Since this first time, Dave has felt an intense fear that would reach a peak within a few minutes. During these instances, he would also experience sweating, heart palpitations, chest pain and discomfort, and shortness of breath. Afterwards, Dave began to avoid exercising in fear he would experience heart palpitations that might signal another attack. In addition, he has begun to avoid leaving his house where it may be difficult to get help in the event of another panic attack. He has now begun to rely on his wife to drive their children to their various activities. Although she was understanding at first, Dave’s wife has grown frustrated with what she perceives as his irrational fear of panic attacks.

A) What diagnosis would you give Dave?

		Generalized Anxiety Disorder
		Major Depressive Disorder
		Specific Phobia
		Bipolar 1 Disorder
		Agoraphobia
		Obsessive Compulsive Disorder
		Panic Disorder
		Posttraumatic Stress Disorder
		Persistent Depressive Disorder
		Social Anxiety Disorder

B) What treatment method would you recommend? Choose all that apply.

		Prescribe SSRIs
		Exposure Ritual or Exposure and Response Prevention
		Panic Control Treatment
		Deep Breathing
		Prescribe Lithium
		Exposure Therapy of a Trauma Narrative

C) In approximately 3-4 sentences, write about why you decided to pick the diagnosis that you did.

D) Some details were left out of this clinical description, what if anything would change your mind about giving this diagnosis and why? (3-4 sentences)

Answer 1

A) A panic attack which has led to a traumatic experience therefore, based on the above case study diagnosis is POST TRAUMATIC STRESS DISORDER.

B) TREATMENT:

SSRIs like Zoloft, Paxil Prozac, Effexor

Exposure Ritual or Exposure and Response Prevention Therapy(ERP is usually used to mitigate over the top impulsive issue (OCD), a condition where individuals more than once experience undesirable and troubling contemplations or sentiments, frequently in light of explicit boosts.) for the recurrent worries about if he exercises or goes somewhere he may not the medical help as quickly.

Exposure therapy along with, deep breathing exercises because while thinking about the experience and narrating the traumatic experience one may experience the similar feeling again thereby, to control that triggering affecting the breathing exercises play a very crucial and vital role.

C) As per the symptoms mentioned above about the recurrent worry for the attack to happen again and not stepping out of the house due to the fear of attack, also regular day to day schedule is hampered reflect the diagnosis for PTSD.

D) If by any chance, anything changed my mind it would shift to specific phobia (not panic disorder because the attack didn't happen again as per the case study). As it's mentioned that he would depend on her wife to drive the children to school (as the incident took place while driving) and not exercising is another symptom because again here, he's fearing the recurring of the situation that had occurred.