Submit your diagnosis for the client in the case (attached below). Follow the guidelines below. The diagnosis should appear on one line in the following order.? Note: Do no

CASE OF HELEN

Intake Date: May xxxx

IDENTIFYING/DEMOGRAPHIC DATA:

Helen is a 39-year-old Caucasian female of Greek ancestry who has been married for 21 years. She lives with her husband and her 15-year-old son. Her daughter is a sophomore in college and lives on campus. Helen owns an ice cream parlor.

CHIEF COMPLAINT/PRESENTING PROBLEM:

Helen presents for treatment complaining of an increased sense of hopelessness and a persistent feeling of being a failure. She relates that she has no motivation and nothing seems to bring her pleasure. Helen reports feeling very sad and has difficulties getting out of bed in the morning, having irregular sleep patterns, frequently awakening throughout the night and staring at the clock, unable to fall back to sleep. Helen reports intense periods of anxiety affecting her sleep and occurring upon awakening and she especially worries about her children, her business, and things going on in her neighborhood, and wondering if everything will work out in her family members’ lives. She states that her anxiety becomes so severe that it makes her teeth chatter uncontrollably. Helen reports that she experiences periods of tearfulness and crying during the day especially when things are particularly stressful at her business. She is always tired and fatigued and has difficulty making even simple business decisions.

HISTORY OF PRESENT ILLNESS:

Helen states that she has always worried about being successful and that recent marital problems have increased these feelings. She states that feelings of impending disaster plague her in the morning and that these anxious feelings have been going on since last June. Client states that she feels as if her “anxiety regulator” has broken. She admitted that she found out last June that her husband was emotionally involved with another woman.

Client stated her husband would disappear for several hours each day and she later discovered that he was spending time over a neighbor’s house while the neighbor’s husband was at work. Client states that her husband made it clear that he was getting close to the neighbor because Helen’s schedule left little time for him and that Helen was very involved with her parents and other family members. Helen is unable to explore as to whether this relationship involved physical intimacy. Helen believes she would fall apart if her husband had been having sex outside the marriage. Helen states the discovery of her husband’s emotional affair led to an intense period of frequent and severe “attacks” which included chest pains, shortness of breath and dizziness. When this happens, she just wants to throw up. Client states that since she found out about the affair she has bizarre dreams, suffers from night sweats and chills, and wakes up with a feeling that she is going crazy. Since June, Helen has lost 35 lbs. and has difficulty concentrating on running her business. Although her attacks would come on suddenly, they did not last very long, but it seemed like hours.

Helen noted since this all came out her husband reportedly stopped going to the neighbor’s house. She states that she cannot shake feelings of anxiety, especially when she is unable to reach her husband. She has spent the last several months worrying about the attacks happening when she cannot reach her husband. Helen states she also began worrying about dying. She reports a previous period of depression that began four years ago after her husband asked for a divorce. She identified feelings of hopelessness and sleep disturbances as well as persistent thoughts of suicide. Client states she began psychotherapy and was put on Prozac for about one year. She was able to deal with the threat of divorce and felt generally happy for two years, until her husband disclosed this relationship in last year.

Client reports years of worrying about her life, her children and all of her family members. Even though it makes her irritable, she doesn’t even try to stop it anymore. The situation with her husband only increased things for her to worry about. She expresses concern about her business although there is no indication that there is any trouble.

CURRENT FAMILY ISSUES AND DYNAMICS:

Helen was married in nineteen years ago. Helen was given her business by her father at age 24 and is successful in the business. She comes from a family of business owners. Client has two children. Clients reports she separated from her husband two times because of his unmotivated behavior.

MENTAL STATUS EXAM:

Helen presents friendly and cooperative and is dressed neatly in appropriate attire. Helen’s mood is depressed. She is oriented to time, place, and person. She demonstrates general knowledge consistent with education. Helen demonstrates proper judgment, insight, and normal memory, both recent and remote. Additionally, Helen presents with normal perceptions and normal stream of thought. Helen’s speech is spontaneous. She initially presents with an appropriate affect although she demonstrates a moderate lability to her mood. Her expression of mood ranged from intense laughter to periods of uncontrollable sobbing. Mood was congruent with expression. Helen appeared anxious when discussing monetary matters and cried when describing marital difficulties. She denies active suicidal/homicidal ideation but states that her family would be better off if she were dead so that they could collect on the insurance.