Psych Case formulation
Order Instructions: case formulation on
Name: Laura
Current Complaint: ‘Fix my emotions’
History of Presenting Illness:
Laura is a 37-year old, separated, unemployed female. She presented with a diagnosis of major depressive disorder (recurrent) and generalized anxiety disorder with panic attacks. She is currently taking Paxil. She reported using Trazodone, but due to side effects she discontinued taking the drug. In July 2012, she was hospitalized for chest pain, a tingly sensation in her arm, blurred vision, and a heart rate in the 200’s. She was diagnosed with tachycardia, muscle tension causing nerve pain, panic attack, and depression. Paxil has controlled the ‘panic attack’, ‘uncontrollable crying episode’ and desire of ‘just wanting to give up’. She attributes her depression and anxiety to the following:
1. Failed relationship: She is currently separated from her second husband, who was emotionally abusive to her and cheated on her. She got out of that relationship to protect her 13 year old son. Her first marriage lasted seven and a half years.
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