Mental Health Case Study: Generalized Anxiety Disorder and Panic Disorder

This essay evaluates the differences between generalized anxiety disorder and panic disorder given the symptomatic characteristics. It also analyzes the significance of empathy towards development of therapeutic relationship with a patient and communication skill set required to interview Peter effectively. Additionally, it provides medication advice for Paroxetine.

Running head: MENTAL HEALTH CASE STUDY 1
Mental Health Case study
Name of Author
Institution
Date of Submission

MENTAL HEALTH CASE STUDY 2
Mental Health Case Study
Generalized Anxiety disorder and Panic disorder
Anxiety is a normal reaction to stressful situations and may abound certain benefits. For
instance, in the case of Peter, who is an electrician, anxiety may help him to be prepared for any
danger and hence pay close attention to his work. On the other hand, uncontrolled anxiety can be
a major mental health problem. This essay would evaluate the case of Peter to assess the
differences between generalized anxiety disorder and panic disorder given the symptomatic
characteristics.
Generalized anxiety disorder entails the occurrence of persistence and excessive worry
that eventually interferes with the daily activities of a patient. It should be noted that the worry is
often associated with physical manifestations such as restlessness, fatigue, insomnia, difficulties
in concentration as well as tension in the muscles. Stein and Sareen (2015), notes that the worries
associated with the mental issue surround daily work responsibilities, family members and other
minor issues. These symptoms can be deduced from the case of Peter. According to the case
study, Peter experiences insomnia and digestive issues, reports excessive and persistent worry,
and fears making any mistakes. These symptoms all point to generalized anxiety disorder.
Further, the worries affecting Mr. Peter are all arising from daily responsibilities as an electrician
and the overall aspects of his life.
On the other hand, panic disorder describes recurrent panic attacks that occur without any
actual danger taking place. Er (2015), notes that panic disorder accompanies a sudden onset of

MENTAL HEALTH CASE STUDY 3
fear in the patient manifesting accelerated heart beat, shortness of breath, sweating, numbness,
and detachment from self. The case of Peter manifests symptoms of sweating and accelerated
heartbeat only as components of panic disorder. However, according to Diagnostic and Statistical
Manual for Mental Disorders (DSM-5), a panic disorder case must at least manifest four
symptoms for its qualification. Hence, the case of Peter cannot be categorized as a panic
disorder.
As noted above, generalized anxiety disorder and panic disorder share some common
characteristics yet distinct from each other. For instance, generalized anxiety disorder manifests
persistent worry over daily activities, while panic disorder manifests persistent panic attacks.
Also, individuals with panic disorder may fear to go insane and losing control while generalized
anxiety disorder patients may experience worries that only affect their concentration making
them feel sick. Given that Peter shows no sign of losing control and any occasions of panic
attacks, he only suffers from generalized anxiety disorder.

MENTAL HEALTH CASE STUDY 4
Significance of Empathy
Effective and efficient management of a health condition requires the development of a
relationship with the patient. The engagement would ensure the development of a therapeutic
relationship between the patient and the medical professional. Getting into a therapeutic
relationship with a patient prompts the need to understand their feelings and situations first
(Levett-Jones, 2018). This essay would analyze the significance of empathy towards
development of therapeutic relationship with a patient (Peter).
The case study reveals that Peter is constantly worried. Given the nature of his job as an
electrician that needs high concentration, he must be very worried about his safety. The nurse
must engage in the relational world of Peter to view and feel the world as he does. As such, the
nurse would be able to explore the meanings and impact the feelings and experiences have for
Peter as an individual. Empathy would allow a nurse to get into the subjective experience of
Peter as a patient so that they validate if their understanding accurately reflects what Peter is
going through. The process of developing empathy would entail resonating with the subjective
experiences of Peter to be able to deliver a non-judgmental understanding of their health and
wellbeing. Consequently, empathy allows the nurse to develop a working human bond with Peter
as he would feel understood and cared for by the nurse without being judged (Nienhuis et al.,
2018).
Besides, empathy would place the nurse into the shoes of Peter to influence the
development and implementation of appropriate solutions. Acceptance of the situation requires

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development of a close therapeutic relationship and trust. Empathy would entail development of
trust between Peter and the nurse so that acceptance and consequent treatment procedures can be
undertaken successfully. When Peter experiences empathy from the nurse they would gain
greater self-understanding of their situation. The self-understanding emanates because he would
feel secure and happy to interact and cooperate with the nurse. Hence, development of a
therapeutic relationship to enhance the management of the mental condition will be easier
(Flaskas, 2018; Evans et al., 2017).
In conclusion, the use of empathy in the development of therapeutic relationship is
indispensable. Empathy promotes understanding of the situation of Peter, enhances Peter’s self-
understanding, and influences the development of trust and security. Therefore, empathy is a
necessity for development of a working therapeutic relationship with Peter.

MENTAL HEALTH CASE STUDY 6
Nurse Communication Skills
Communication skills are important, especially for medical professionals as nurses.
Communication is especially critical for mental health nursing due to the unique situations of the
patients. It is worth highlighting that the success of a therapeutic relationship between a patient
and the nurse hinges largely on the communication skills (Brown, 2015). This essay will assess
the communication skill set required to interview Peter effectively.
While communicating with Peter, it is important to empower him. Empowering Peter
would help sustain the interview. This is because it would give Peter the confidence that he is at
the center of the treatment process and hence feel free to provide all the necessary information
regarding the health condition. Empowerment places a lot of control to Peter so that they can
reveal information about themselves without being coerced by the nurse (Evans et al., 2017).
Consequently, the nurse would have to adopt a soft low tone while communicating with
Peter. Peter is already very worried about many aspects of his life; he needs to be addressed in an
empathetic manner. The soft tone is a depiction of respect and understanding of the feelings of
Peter. In addition the nurse should employ good listening and turn-taking skills while
interviewing Peter. In a situation like for Peter where he is extremely worried and disturbed
continuously he should be given enough time to express himself. The nurse should be taking
notes down to ask questions later. When Peter is interrupted between his statements he would
feel as if the nurse is dominating the communication process and hence hold back some
information (Riley, 2015).

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The emotional weight of the generalized anxiety disorder weighs a lot on Peter, and he
should feel well understood during the interview. It is also worth highlighting along the same
vein of thought that while interviewing Peter; his preferences must be given priority while
talking. He must be given enough time to think and communicate his views. In case the nurse
fails to understand some aspects of the communication, they may seek clarification politely.
Thus, in clinical practice communication skills are essential as part of evidence-based practice
(Lai, 2016).
Notably, interviewing Peter requires critical communication skills that include good
listening, turn-taking, adoption of the right tone, and empowering Peter during the interview for
motivation. These skills would enable easy communication and conduction of the interview
successfully with Peter. This is because they prioritize the interests and preferences of Peter as a
patient first above all.

MENTAL HEALTH CASE STUDY 8
Paroxetine Medication Advice
Drugs are an essential part of the treatment and management of symptoms for many
health conditions. All medications have their therapeutic benefits and adverse effects. For the
case of Peter, he has been commenced on Paroxetine 20 mg daily dose for the management of his
symptoms. However, there are pertinent issues he must understand about the drug to achieve his
quality of health and wellbeing (Levett-Jones, 2018).
Paroxetine as a drug has a major adverse side effect that should be communicated to
Peter as a precaution. According to the Food and Drug Administration (FDA), Paroxetine has a
black box warning. This is the most serious warning label from FDA. An antidepressant like
Paroxetine can influence suicidal thoughts and behaviors. Given the case of Peter, whereby he is
persistently worried about many issues around his life, any factor that may stimulate suicidal
thoughts should be well addressed. Management starts with communication about the possible
effects of the medication. Peter should be informed that the suicidal thoughts majorly occur
during the first few months of treatment or when the dosage is changed. Hence, the family
members, medical professionals, and workmates should report any changes in Peter’s moods,
feelings, and behaviors. This is because unknowingly, the suicidal thoughts pose great danger to
his life and the lives of others (Bystritsky, 2018).
Moreover, Paroxetine can cause serotonin syndrome disorder which is a life-threatening
condition. The symptoms of the syndrome can be devastating to an individual and the people
around them. These include coordination problems, hallucinations, and trouble thinking. Hence,
Peter should not be allowed to operate in high-risk environments without a company to help with

MENTAL HEALTH CASE STUDY 9
coordination. Similarly, Peter should never withdraw from Paroxetine suddenly. The withdrawal
should be a gradual process and under the guidance of a medical professional. There are serious
withdrawal effects that can occur when the drug is stopped abruptly by the patient. The
symptoms include sweating, nausea, shaking and a feeling of confusion, irritability, and changes
in sleeping cycles (Nevels, Gontkovsky & Williams, 2016).
In summary, Paroxetine as a medication can adversely affect and disrupt the life of an
individual. Peter should be informed about all the possible adverse effects of the drug.
Knowledge of the effects would allow him to seek support and get mentally prepared to face
them. For instance, Paroxetine can influence the development of suicidal thoughts in an
individual that may cause harm to self and other people.

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References
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Bystritsky, A. (2018). Pharmacotherapy for generalized anxiety disorder in adults. UpToDate.
Last updated: January.
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