Diagnosis : Generalized Anxiety Disorder

1. Diagnosis: Generalized anxiety disorder (primary diagnosis)

Illness anxiety disorder

Separation anxiety disorder

Severity rating: 5

Additional information: irritable bowel syndrome, Celiac disease at age 25, cannot bear a child

2. By looking through the case study, the most prominent problem Sara struggles with, is her persistent worry about different parts of her life including her job status, health and her relationship with her husband. For the past six months, she has been anxious and worried excessively, leading her to have difficulty sleeping. As she admitted, “ I cannot shut my brain off anymore, I am worrying all the time”, therefore her condition met the primary criteria of generalized anxiety disorder which is the excessive worry for at least 6 months more days than not, about diverse events and activities. Being restless, irritable, having sleep difficulty and being easily fatigued are four factors of GAD that are apparent in this case. “I have always had lots of energy but now at times I struggle to get out of bed and drag myself thorough the work day”; it indicates the fatigue she recently experienced. Fidgets with her jewellery when speaking and a nervous laugh she has, shows her persistent anxiety. Moreover, she was recently diagnosed with irritable bowel syndrome which has a high comorbidity with anxiety disorders. In conclusion, since she is persistently worried about different aspects of her life and she has the criteria for GAD, generalized anxiety disorder is the most likable disorder she has.

About the second diagnosis, the reason I believe she has symptoms of illness anxiety disorder, not somatic symptom disorder, is that she has no severe physical symptom l...

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...hem as the result of her efforts, and then conclude that she has the ability to confront the problems she has.

As it is mentioned earlier, one of the characteristics of people with generalized anxiety disorder is cognitive avoidance. In order to overcome this issue, the therapist could ask Sara to imagine worse problems, to not only break her cognitive barrier but also change the way she looks at her current situation; for instance, asking her to imagine that she has no job or she has AIDS, and then ask her what is the next step? What are you going to do?

Since one of the prominent concerns she has is related to health, she needs to be reassured by a physician that these symptoms are not dangerous, along with being aware about the fact that she misinterprets these symptoms and these symptoms can be created if she persistently focus on the certain parts of her body.