Summary
The patient (Ms. Lisa Pittman) presents to the healthcare setting with inquiries regarding potential treatment for Hepatitis C+ and rehabilitation after the adverse impact of addiction. Ms. Pittman mentions smoking cannabis from one to two times a week, reportedly due to having a medical card allowing its consumption. In addition, she consumes alcohol several times per week.
Psychiatric and Psychosocial History
Ms. Pittman has never been treated for psychiatric disorders and has no caregivers who could provide consistent support. She has never been subjected to hospitalizations due to her psychological condition and has never taken medications. There is a history of psychiatric issues and drug and alcohol abuse, including her mother, father, and her brother. Ms. Pittman’s mother has a history of benzodiazepine use and anxiety, and currently lives in a different state. The patient’s father was convicted of sexually assaulting her; she is not in contact with her brother. Ms. Pittman has a history of possessing illegal substances and convictions for theft and is on probation.
Medical History and Treatment Objectives
The only relevant piece of medical history is that Ms. Pittman has an amoxicillin allergy. It is necessary to address the patient’s excessive anxiety that has troubled her for some time. To relieve the symptoms, it is also imperative to consider Ms. Pittman’s dietary habits, such as the lack of healthy food intake and the increased use of drugs, which creates a nutritional deficiency and overall psychological disturbance.
Differential Diagnoses
Ms. Pittman’s health causes her significant stress and anxiety, which prevents her from taking control over her health and adhering to a treatment regime. The restlessness and trouble concentrating, which characterize her anxiety disorder, contribute to her desire to consume drugs and alcohol because they make her feel relaxed and stress-free. In addition, it is possible that Ms. Pittman struggles with panic disorder, which is characterized by the experience of panic attacks and anticipatory anxiety, which causes her to withdraw. She fears for her health but is not strong enough to stop using drugs and alcohol on her own. To reduce the consistent anxiety regarding her condition, it is important for her to take control and do everything she can to get clean. Finally, PTSD is a possible differential diagnosis for Ms. Pittman because of her childhood experience of being sexually abused by her father. The condition is characterized by repeated disturbance in remembering traumatic events, such as sexual abuse and experiencing severe emotional distress. It is highly possible that Ms. Pittman has used drugs and alcohol for a long time as a way to deal with PTSD symptoms, unknowingly making them worse.
Discussion and Recommendations
It is recommended to apply cognitive behavioral therapy to treat the patient’s addiction, anxiety, and panic, and stress disorders. Because her cognitive functioning is normal, CBT can help Ms. Pittman get hope about her condition, enhance her rational thought processes, and improve her capability to relax and get peace while developing the self-esteem necessary for recovery (Mayo Clinic Staff, 2019). CBT treatment aims to give Ms. Pittman a sense of control over her health and facilitate predictability, which helps to reduce the occurrence of avoidant and escape-like behaviors. CBT will also help create a consistent schedule that the patient can follow in coming for check-ups to evaluate the progress of recovery and adjust treatment if necessary.
Reference
Mayo Clinic Staff. (2019). Cognitive behavioral therapy.