1. What is the most appropriate diagnosis? The diagnosis for this 27-year-old man is Generalized Anxiety Disorder (GAD) 300.02 (F41-1) with provisional diagnosis of Panic Disorder (PD) 300.01 (F41.0). This gentleman has significant distress, disability and impairment in functioning because of his avoidance of work and social interactions. He also has fears of being a bad father, of being disliked by co-workers, and of his wife leaving the marriage even though there are no indications that she is dissatisfied with the marriage. These concerns consume his thoughts and he is unable to stop worrying even though he acknowledges that his worries are unfounded. He over estimates the danger and level of fear he should have in his worries about his parent’s health. His father had a myocardial infraction, but is well, but the patient’s fears persist. This patient also reports experiencing an edgy feeling and muscle tension that are criteria for GAD. He reports symptoms specific to panic attacks, such as dizziness, sweating palms, heart palpitations and ringing of the ears. However, he does not use the word panic attack. He does not state …show more content…
P. has demonstrated avoidance behaviors along with panic disorder. Avoidance is a maladaptive behavior to reduce the sense of danger, and vulnerability. This maladaptive behavior may contribute to her impairment in occupational, and social functioning (Castonguay & Oltmanns). She may become so impaired that she will become unable to work. Her panic attacks may begin to spread to other situations that she may avoid as listed in the criteria for Agoraphobia. Panic Disorder places her at risk of constraining other social activities, problems in her marital functioning, substance abuse, sleep dysregulation due to nocturnal panic attacks, an increased risk of suicidal ideation and attempts (Castonguay & Oltmanns). Panic Disorder has been linked to a 10-fold increase in suicide risk (Castonguay &