Case Study: Generalized Anxiety Disorder and Treatment

This case study examines a patient, Peter, diagnosed with Generalized Anxiety Disorder (GAD). It delves into the symptoms of GAD, emphasizing excessive worry and difficulty managing anxiety. The study highlights the crucial role of empathy in patient care, emphasizing the need for nurses to understand and connect with patients' emotional experiences. It details essential communication skills, including active listening, reflection, and non-verbal cues, for building therapeutic relationships. The case also explores the use of Paroxetine, an SSRI, in treating GAD, discussing dosage, administration, and patient education regarding side effects and contraindications. The study emphasizes the importance of patient awareness and communication with healthcare providers. The assignment provides a comprehensive overview of GAD, its management, and the critical role of healthcare professionals in patient care.

Running Head: GAD
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Generalized Anxiety Disorder
Case study
student
9/15/2019

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Table of Contents
Generalized Anxiety Disorder......................................................................................................................2
Role of Empathy......................................................................................................................................3
Communication skills I would use............................................................................................................4
Paroxetine...............................................................................................................................................6
References...................................................................................................................................................8

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1
Generalized Anxiety Disorder
Individuals who have generalized anxiety disorder (GAD) experience worry
uncontrollably about the usual events and situations. It is also occasionally known as chronic
anxiety neurosis. This particular health issue is different from other normal sensations of
anxiousness (Lader, 2015).
It is usual to feel anxious about certain things in life like financial issues and relationship
issues. A person with this health issue finds it problematic to manage their anxiety and remain
concentrated on daily activities. Symptoms associated with GAD include worrying too much
about daily things, have trouble in managing their worries or sensations of nervousness,
recognize that they feel worried very much more than they must, feel restlessness and trouble in
relaxing, concentration problem, be easily frightened, have trouble in sleeping or staying asleep,
sense tired easily or tired most of the time (Stein & Sareen, 2015). The individual might also feel
headache, muscle aches, stomach pain, or unexplained pain, have difficult time swallowing,
tremble or twitch, irritation or sense on edge, sweat very much, sense light-headed or breathing
problem, and urinate more than usual. GAD occasionally runs in the families; however, no one
distinguishes naturally why certain family members affected with it while others do not
(Newman, Shin & Zuellig, 2016). Investigators have found that numerous parts of the human
brain, in addition to biological processes, play an important role in distress and anxiety. Through
learning additional about how the human brain and body works in individuals with GAD,
investigators might be capable to make better managements. Investigators are also searching for
ways in which the stress and environmental aspects play a role (Lader, 2015).

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Generalized anxiety disorder is different from other health issues like panic disorder
occurs when the body experiences a rush of penetrating mental and bodily symptoms. It can
occur on too quickly for no seeming reason (Newman, Shin & Zuellig, 2016). GAD and the
panic disorder differ in severity and complexity and this might have implications for treatment
response. Some of the symptoms that panic disorder shows are different from GAD such as
recurring panic attacks, fear of losing control, being detached from oneself (depolarization),
chest pain, accelerated heart rate, and trembling (Cui et al., 2016).
Generalized anxiety disorder is experiencing more worries than usual. It is different from
panic disorder in terms of intensities.
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Role of Empathy
Empathy includes the capacity to expressively understand what another individual is
facing. Essentially, it is putting our self in someone else's situation and feeling what they are
feeling (Flaskas, 2018).
When nurses see individual suffering, they might be capable to promptly imagine
themselves in the other individual's place and sense sympathy for what they are experiencing.
Frequently patients want to sense that nurses and other healthcare provider are available for
them. Occasionally they do not want lengthy consultations and excessively involved thorough
information (Linsley & Carroll, 2018). They just want humble, precise and informative
information that is relevant to them and accessible in an open manner. They mostly want to sense
that they matter for the health care provider, and any queries they might have are not
unimportant. They also want to sense valued and respected. It is with empathy that nurses can

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involve and empower peter. With empathy and care, nurses can assist peter to feel positive,
valued and respected. Empathy will permit us to involve and empower Peter to be involved in
the decision making the process about the treatment and response well during the process. as
discussed in the case the Peter is more worried about his work, taxes etc. there is a possibility
that he might also be worried about his children (Nienhuis et al., 2018). Therefore empathy is
really important as it will help him to realize that he is not alone and nurses and doctors are there
to help him in recovery. Empathy is the most important component of effective communication
which is the key factor to build a therapeutic relationship with the patient. The therapeutic
relationship helps the nurse to assess the patient easily as they respond well when they realize
that the listener wants to hear about their situation and will support them. Showing empathy can
help the nurses to reduce the occurrence of any ethical or legal issues that sometimes arise when
the nurses get rude to the patient. Through listening and communicating nurses can understand
and guide Peter. Empathy improves patient-nurse communication and trust, and consequently the
effectiveness of the treatment (Richardson, Percy & Hughes, 2015).
In conclusion, with empathy nurse can help Peter to understand that he is worrying too
much and it can also help to understand the patient's feelings effectively.
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Communication skills I would use
Communication skills are the capabilities commonly used by nurses when exchanging
information with the patient about his or her health issue. Certain examples include
communicating about what the patient is feeling, vital signs, ongoing and future treatment
processes etc. Communication skills include listening, speaking, perceiving and empathising
(MacLean, Kelly, Geddes & Della, 2017).

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There are different communications skills will be used to build a therapeutic relationship
with Peter. Active listening will be the first skills that will help in building a healthier
relationship with him. Peter is facing different worry issues, for example, his work, therefore
listening to his situation carefully can help him to feel good and comfortable (Riley, 2015).
Active listening is the most important and most difficult skill of communication which
requires the listener to make eye contact, leaning forward-facing towards the patient
throughout the conversation. Using some sentences like “yes I understand your situation,
please continue” can also help in developing the therapeutic relationship quickly active
listening also includes helping the patient to be relevant (Sprangers, Dijkstra & Romijn-
Luijten, 2015). Reflecting is another communicating skill that can be used in the case of Peter.
It will include repeating patient’s message verbally or non-verbally, his feeling, encouraging
Him to clarify about any misunderstood information.
Summarization of ideas will also be used for Peter. It will include highlighting the
essential ideas expressed by him, and discussing the information related to his health again so
that he can understand better. Showing empathy is another component of effective
communication in which the patent is dealt with respect and carefulness. Empathy is different
from sympathy and compassion (Townsend & Morgan, 2017). It is essential to react to the
patient's emotional queries and inform the patient everything about his case even if he does
not ask. Knowing different cultures is also essential to understand the patient and his priorities
better. It is believed that non-verbal type of communication is more influential than verbal
communication. The non-verbal cues must be noticed by the nurses to understand the
situation. During the assessment and treatment process, these cues can help the nurses to

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observe his physical and mental signs. It will also help the nurses to observe if the patient is
deteriorating (Martin & Chanda, 2016).
In conclusion, some skills can be used to develop therapeutic relationships such as active
listening, being empathetic, non-verbal communication, reflecting and encouraging the
patient.
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Paroxetine
Paroxetine is recommended to treat mental issues like depression, panic attacks, the obsessive-
compulsive disorder (OCD), disorders associated with anxiety, and PTSD. It works by assisting to
restore the steadiness of some natural material (serotonin) in the human brain. Paroxetine is also
known as a SSRI (Bhattacharya et al., 2015).
Peter is prescribed with Paroxetine 20 mg PO every day. There is a lot of information that
peter needs to know about the drug for fast recovery. He must Read the Guide of the Medication
carefully and, if obtainable, the Patient Information Leaflet delivered by the pharmacist beforehand
he starts taking the drug and every time he gets a refill. If he has any queries, he should ask the
doctor, nurse or pharmacist. He must take this medicine by mouth after or before eating food as
prescribed by the doctor, commonly once every day in the early morning (Bystritsky, 2018). Taking
this drug with food might decline nausea related issues. If this medicine makes him sleepy
throughout the day, then he must talk to the doctor about taking Paroxetine it in the evening time. It
is significant for peter to continue this medicine even if he feels healthy. He should be informed to
not stop taking this medicine deprived of consulting the nurse or doctor. Some situations might
become worse when this medication is unexpectedly stopped. Also, Peter might experience

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indications for example mood swings, headache, fatigue, sleep alterations, and brief feelings
comparable to electric shock. To stop these signs while he is discontinuing treatment with this
medication, the physician might decrease his dose slowly (Nevels, Gontkovsky & Williams, 2016).
He must consult the nurse, doctor or pharmacist for additional details. He should also be
recommended to Report any fresh or worsening signs right away. This particular drug also shows
contraindications if taken with other different drugs like monoamine oxidase inhibitors. As with the
other psychotropic therapeutic products patients should be recommended to avoid consumption
of alcohol while taking paroxetine drug. Clinical investigations have exposed that treatment with
paroxetine is not related to the weakening of cognitive or any psychomotor function. Though, as
with all type of psychoactive therapeutic products, patients must be warned about their capability
to drive a car and control machinery. As the patient has two children at home, he must be
informed to keep the drug out of their reach (Craske, Bystritsky, Stein & Hermann, 2016).
In conclusion, the patient must be informed about the side effects, contraindications of the
drug. He must be educated to inform the doctors in any adverse situation.

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References
Bhattacharyya, R., Mallik, B., Mandal, M., Bhattacharyya, S., Ray, U., & Banerjee, B. B. (2015).
Clinical uses of Paroxetine: an underutilized drug by Physicians. International Journal of
Psychology and Psychiatry, 3(1), 109-117.
Bystritsky, A. (2018). Pharmacotherapy for generalized anxiety disorder in adults. UpToDate.
Last updated: January.
Craske, M., Bystritsky, A., Stein, M. B., & Hermann, R. (2016). Approach to treating
generalized anxiety disorder in adults. Waltham, MA: UpToDate. Accessed August, 18,
2016.
Cui, H., Zhang, J., Liu, Y., Li, Q., Li, H., Zhang, L., & Li, W. (2016). Differential alterations of
resting‐state functional connectivity in generalized anxiety disorder and panic
disorder. Human brain mapping, 37(4), 1459-1473.
Flaskas, C. (2018). The therapeutic relationship in systemic therapy. Routledge.
Lader, M. (2015). Generalized anxiety disorder. Encyclopedia of psychopharmacology, 699-702.
Linsley, P., & Carroll, V. (2018). The therapeutic relationship and emotional intelligence.
In Emotional Intelligence in Health and Social Care (pp. 45-60). Routledge.
MacLean, S., Kelly, M., Geddes, F., & Della, P. (2017). Use of simulated patients to develop
communication skills in nursing education: An integrative review. Nurse education
today, 48, 90-98.

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Martin, C. T., & Chanda, N. (2016). Mental health clinical simulation: therapeutic
communication. Clinical Simulation in Nursing, 12(6), 209-214.
Nevels, R. M., Gontkovsky, S. T., & Williams, B. E. (2016). Paroxetine—the antidepressant
from hell? Probably not, but caution required. Psychopharmacology bulletin, 46(1), 77.
Newman, M. G., Shin, K. E., & Zuellig, A. R. (2016). Developmental risk factors in generalized
anxiety disorder and panic disorder. Journal of affective disorders, 206, 94-102.
Nienhuis, J. B., Owen, J., Valentine, J. C., Winkeljohn Black, S., Halford, T. C., Parazak, S.
E., ... & Hilsenroth, M. (2018). Therapeutic alliance, empathy, and genuineness in
individual adult psychotherapy: A meta-analytic review. Psychotherapy Research, 28(4),
593-605.
Richardson, C., Percy, M., & Hughes, J. (2015). Nursing therapeutics: Teaching student nurses
care, compassion and empathy. Nurse Education Today, 35(5), e1-e5.
Riley, J. B. (2015). Communication in nursing. Elsevier Health Sciences.
Sprangers, S., Dijkstra, K., & Romijn-Luijten, A. (2015). Communication skills training in a
nursing home: effects of a brief intervention on residents and nursing aides. Clinical
interventions in aging, 10, 311.
Stein, M. B., & Sareen, J. (2015). Generalized anxiety disorder. New England Journal of
Medicine, 373(21), 2059-2068.
Townsend, M. C., & Morgan, K. I. (2017). Psychiatric mental health nursing: Concepts of care
in evidence-based practice. FA Davis.

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