Essay Sample on Assessing and Treating Clients With Anxiety Disorders

Introduction

It is normal to be anxious due to fear of certain situations. However, some people tend to have extreme anxiety for no reason. This kind of anxiety is referred to as anxiety disorder. "Experiencing occasional anxiety is a normal part of life. However, people with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations" (Mayo Clinic Staff, 2018).

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"There are at least five types of anxiety disorders, and only the doctor can tell you which one you are suffering from" (Njenga, 2018). Examples include Generalized Anxiety Disorder (GAD), Obsessive-Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD), agoraphobia, panic disorder, Social Anxiety Disorder (SAD) amongst others. The doctor will diagnose a patient with anxiety disorder only if one of these two conditions prevail: The fear is out of proportion and when the anxiety affects the normal life of the patient.

Anxiety disorders are treatable. There are two major treatment methods for anxiety. These are psychotherapy (also known as talk therapy) and medication. Talk therapy involves counselling of the patient.

Medication involve administration of anti-anxiety medications and/ or antidepressants drugs such as Zoloft, Imipramine and Buspirone to the patient.

This paper is a case study of an anxiety disorder patient's reaction to the three drugs outlined above.

Decision Point 1

The first decision made on the approach to use to treat the patient had three options. The treatment could begin by either administering imipramine 25 mg po BID, Sertraline (Zoloft) 50 po daily or buspirone 10 mg po BID. Amongst these options, Sertraline was selected as the first-line and long-term treatment drug for the patient's Generalized Anxiety disorder (GAD). This decision was based on its effectiveness, tolerability and safety. According to (Stahl, 2014), Sertraline (especially Sertraline 1A) inhibits the reuptake of serotonin thus reducing the symptoms of anxiety in the patient. Patients with moderate and severe GAD respond much better to Sertraline (Zoloft) 50-100 mg orally daily as compared to placebo (Arcangelo, et al., 2017, pg. 706).

Imipramine was not chosen because the patient admitted to alcohol abuse yet it is a TCA (Tricycle antidepressant). TCAs increase the effects of alcohol on the nervous system.

Buspirone on the other hand, belongs to azapirones group of drugs which are anxiolytic and antidepressants. Its main effect to the patient is relieving the cognitive effects of GAD. In our case, it was not selected because of its unreliable tendency over long-term treatment of somatic and behavioral symptoms.

Decision Point 2

Four weeks after the first treatment based on the first decision, the patient returned to the hospital for checkup. He reported to the Psychiatric mental health practitioner (PMHNP) that he had no tightness in his chest, no shortness of breath and decrease in his anxiety in the last 5 days. The second decision on the best way to administer medication to the patient included the following options: (1) Increasing Zoloft dosage to 75 mg orally daily, (2) Increasing Zoloft dosage to 100 mg orally daily and (3) Not changing the dosage.

It was decided that the dosage was to be increased to 75 mg orally daily after a four-week period. This is done because the effects of the drug are not felt right away; it may delay up to 6-8 weeks before its therapeutic actions can be seen.

Decision Point 3

Four weeks later, the patient reported further decrease in his anxiety. The decision point three was to be made from these three options: (1) Maintain current dose, (2) increase current dosage to 100 mg orally daily and (3) adding an augmentation agent such as buspirone (BuSpar) (Hamilton, 1959).

The best decision was to continue administering the current dosage because it proved efficient since the symptoms had reduced by about 61%. The medication was thus favorable to the patient in the dosage amounts he was being given daily. This decision was also arrived at considering the fact that the patient had no side effects. If we increase the dosage, the drug may cause serious side effects which may bring discomfort to the patient, and thus slow his response to medication.

Ethical and Legal Considerations

This begins by conducting a thorough historical, physical and mental assessment of the patient. The confidentiality of the patient should be secured by the PMHNP. "The PMHNP must ensure confidentiality of client's treatment information, obtaining informed consent and keeping clients informed of evidence-based research associated with drug therapy, the intended therapeutic actions, potential adverse events, and other adverse drug reactions must be explained with written instructions as well" (Fisher, 2016)

The patient has to be well informed and educated of every little information involving his treatment.

Conclusion

Zoloft is the right medication to use for this particular patient because his body systems are responding well to the treatment. However, administration has to be done carefully to ensure it is a success.

References

Arcangelo, V. P., Peterson, A. M., Wilbur, V., Reinhold, J. A. (2017). Pharmacotherapeutics for advance practice: A practical approach (4th ed.). Philadelphia, PA: Wolters Kluwer.

Fisher, M. A. (2016). Introduction. In Confidentiality limits in psychotherapy: Ethics checklists for mental health professionals (pp. 3-12). Washington, DC: American Psychological Association. doi:10.1037/14860-001

Mayo Clinic Staff (2018). Anxiety disorders. Retrieved March 27, 2019, from https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961.

Njenga, F. (2018). Signs you have an anxiety disorder. Retrieved March 27, 2019, from https://www.businessdailyafrica.com/lifestyle/fitness/Signs-you-have-an-anxiety-disorder/4258372-4644910-roa1f8/index.html.