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· Crespo Abel Viltres

· Department of Nursing, St. Thomas University

· NUR 620: Psychiatric Management I

· Dr. Wilson-Romans

· May 31, 2023

· Comprehensive Treatment Approach for Generalized Anxiety Disorder

· Generalized Anxiety Disorder (GAD) is a prevalent mental health condition characterized by excessive and uncontrollable worry that significantly impairs daily functioning. This case study presents the case of Ms. JN, a 24-year-old law student grappling with debilitating anxiety symptoms, affecting her academic performance, emotional well-being, and overall quality of life. With a focus on evidence-based guidelines, this essay formulates a comprehensive treatment plan for Ms. JN, encompassing pharmacological and non-pharmacological interventions.

· Formulation:

·  Ms. JN’s predicament encompasses overwhelming anxiety, resulting in a perpetual worry beyond her control. This condition aligns with the diagnostic criteria for GAD, which manifests as persistent anxiety accompanied by psychological and physical symptoms (Koenigsberg, 2020). While Ms. JN acknowledges experiencing anxiety in the past, its recent escalation to debilitating levels necessitates a proactive approach to address her distressing symptoms.

· Comprehensive Treatment Approach for Generalized Anxiety Disorder

· Generalized Anxiety Disorder (GAD) is a prevalent mental health condition characterized by excessive and uncontrollable worry that significantly impairs daily functioning. This case study presents the case of Ms. JN, a 24-year-old law student grappling with debilitating anxiety symptoms, affecting her academic performance, emotional well-being, and overall quality of life. With a focus on evidence-based guidelines, this essay formulates a comprehensive treatment plan for Ms. JN, encompassing pharmacological and non-pharmacological interventions.

· Formulation:

·  Ms. JN’s predicament encompasses overwhelming anxiety, resulting in a perpetual worry beyond her control. This condition aligns with the diagnostic criteria for GAD, which manifests as persistent anxiety accompanied by psychological and physical symptoms (Koenigsberg, 2020). While Ms. JN acknowledges experiencing anxiety in the past, its recent escalation to debilitating levels necessitates a proactive approach to address her distressing symptoms.

· List of Patient’s Problems and Prioritization

· Ms. JN presents with interconnected problems related to her generalized anxiety disorder (GAD). The primary concern is her excessive anxiety and uncontrollable worry that significantly impairs her daily functioning. This overwhelming anxiety directly affects her ability to perform routine tasks and engage effectively in academic pursuits. Secondary problems include academic stress and difficulty concentrating, which intensify her anxiety and hinder her academic performance. Ms. JN also experiences fatigue and associated physical symptoms such as frequent headaches and muscle spasms, further adding to her distress. Additionally, her sleep difficulties disrupt her ability to obtain restorative sleep, contributing to cognitive impairment. Addressing these issues holistically is crucial for improving Ms. JN’s overall well-being and quality of life.

· Pharmacological Treatment

· The recommended pharmacological treatment for Ms. JN would be a low starting dose of a selective serotonin reuptake inhibitor (SSRI) such as escitalopram or sertraline. SSRIs have demonstrated efficacy in treating generalized anxiety disorder (GAD) symptoms. These medications work by modulating serotonin levels in the brain, improving mood, and reducing anxiety. Starting with a low dose allows for gradual titration to minimize potential side effects while optimizing therapeutic benefits (Carl et al., 2019). The appropriateness of SSRIs for GAD, their cost-effectiveness, established effectiveness, favorable safety profile, and potential for patient adherence make them the first-line pharmacological treatment option in this case. Regular monitoring will be essential to address any emerging concerns and ensure optimal treatment outcomes.

· Non-pharmacological Treatment

· Cognitive-behavioral therapy (CBT) is the recommended non-pharmacological intervention for Ms. JN’s generalized anxiety disorder (GAD). CBT focuses on identifying and challenging negative thought patterns and maladaptive behaviors associated with anxiety. It aims to equip individuals with effective coping strategies and skills to manage anxiety (Carl et al., 2019). The rationale for CBT in Ms. JN’s case is based on its appropriateness, cost-effectiveness, effectiveness, safety, and potential for patient adherence. CBT addresses the cognitive and behavioral aspects of GAD, providing Ms. JN with tools to challenge and reframe anxious thoughts, develop problem-solving skills, and implement relaxation techniques (Newman et al., 2020). By addressing the root causes of anxiety, CBT empowers individuals to take an active role in their treatment and promotes long-term self-management (Carl et al., 2019). Furthermore, CBT is considered safe and cost-effective and has consistently demonstrated efficacy in reducing anxiety symptoms and improving overall well-being in individuals with GAD.

· Conclusion

·  The comprehensive treatment plan for Ms. JN’s GAD should incorporate pharmacological and non-pharmacological interventions. The recommended pharmacological approach entails initiating low-dose SSRI treatment, considering its appropriateness, cost-effectiveness, proven effectiveness, safety profile, and potential for patient adherence. Additionally, implementing CBT as a non-pharmacological intervention aligns with its appropriateness, cost-effectiveness, efficacy, safety, and potential for patient adherence. The synergistic integration of these evidence-based interventions is vital for enhancing Ms. JN’s well-being, facilitating her academic pursuits, and providing her with the tools to manage her anxiety effectively.

· Ms. JN presents with interconnected problems related to her generalized anxiety disorder (GAD). The primary concern is her excessive anxiety and uncontrollable worry that significantly impairs her daily functioning. This overwhelming anxiety directly affects her ability to perform routine tasks and engage effectively in academic pursuits. Secondary problems include academic stress and difficulty concentrating, which intensify her anxiety and hinder her academic performance. Ms. JN also experiences fatigue and associated physical symptoms such as frequent headaches and muscle spasms, further adding to her distress. Additionally, her sleep difficulties disrupt her ability to obtain restorative sleep, contributing to cognitive impairment. Addressing these issues holistically is crucial for improving Ms. JN’s overall well-being and quality of life.

· Pharmacological Treatment

· The recommended pharmacological treatment for Ms. JN would be a low starting dose of a selective serotonin reuptake inhibitor (SSRI) such as escitalopram or sertraline. SSRIs have demonstrated efficacy in treating generalized anxiety disorder (GAD) symptoms. These medications work by modulating serotonin levels in the brain, improving mood, and reducing anxiety. Starting with a low dose allows for gradual titration to minimize potential side effects while optimizing therapeutic benefits (Carl et al., 2019). The appropriateness of SSRIs for GAD, their cost-effectiveness, established effectiveness, favorable safety profile, and potential for patient adherence make them the first-line pharmacological treatment option in this case. Regular monitoring will be essential to address any emerging concerns and ensure optimal treatment outcomes.

· Non-pharmacological Treatment

· Cognitive-behavioral therapy (CBT) is the recommended non-pharmacological intervention for Ms. JN’s generalized anxiety disorder (GAD). CBT focuses on identifying and challenging negative thought patterns and maladaptive behaviors associated with anxiety. It aims to equip individuals with effective coping strategies and skills to manage anxiety (Carl et al., 2019). The rationale for CBT in Ms. JN’s case is based on its appropriateness, cost-effectiveness, effectiveness, safety, and potential for patient adherence. CBT addresses the cognitive and behavioral aspects of GAD, providing Ms. JN with tools to challenge and reframe anxious thoughts, develop problem-solving skills, and implement relaxation techniques (Newman et al., 2020). By addressing the root causes of anxiety, CBT empowers individuals to take an active role in their treatment and promotes long-term self-management (Carl et al., 2019). Furthermore, CBT is considered safe and cost-effective and has consistently demonstrated efficacy in reducing anxiety symptoms and improving overall well-being in individuals with GAD.

· Conclusion

·  The comprehensive treatment plan for Ms. JN’s GAD should incorporate pharmacological and non-pharmacological interventions. The recommended pharmacological approach entails initiating low-dose SSRI treatment, considering its appropriateness, cost-effectiveness, proven effectiveness, safety profile, and potential for patient adherence. Additionally, implementing CBT as a non-pharmacological intervention aligns with its appropriateness, cost-effectiveness, efficacy, safety, and potential for patient adherence. The synergistic integration of these evidence-based interventions is vital for enhancing Ms. JN’s well-being, facilitating her academic pursuits, and providing her with the tools to manage her anxiety effectively.

· References

· Carl, E., Witcraft, S. M., Kauffman, B. Y., Gillespie, E. M., Becker, E. S., Cuijpers, P., Van Ameringen, M., Smits, J. A., & Powers, M. B. (2019). Psychological and pharmacological treatments for generalized anxiety disorder (GAD): A meta-analysis of randomized controlled trials. Cognitive Behaviour Therapy, 49(1), 1-21. https://doi.org/10.1080/16506073.2018.1560358

· Koenigsberg, J. Z. (2020). Generalized anxiety disorder (GAD). Anxiety Disorders, 77-115. https://doi.org/10.4324/9780429023637-7

· Newman, M. G., Zainal, N. H., & Hoyer, J. (2020). Cognitive‐behavioral therapy (CBT) for generalized anxiety disorder (GAD). Generalized Anxiety Disorder and Worrying, 203-230. https://doi.org/10.1002/9781119189909.ch10