She complains that she wakes up frequently and cannot get a full night of sleep. Recently,
she also has been getting frequent headaches and noticed a few ulcers in her mouth. A
physical examination and lab tests do not reveal any local or systemic disease.
1. Based on the patient history and the signs and symptoms, discuss how stress is
related to her condition.
I believe she is having panic attacks. A “panic attack refers to a sudden brief episode of
discomfort and anxiety. Panic disorder, and anxiety disorder, develops when panic attacks
are frequent or prolonged (Hubert and VanMeter, 2017)”. I believe her anxiety is due to
her background, being a veteran returning home from Iraq. She could be experiencing
PTSD due to her time in Iraq. One of the symptoms that comes with PTSD is having
“upsetting dreams or nightmares about the traumatic event (Mayo Clinic, 2018)”. Panic
disorders can cause an “increased discharge of neurons which can occur in the temporal
lobes (Hubert and VanMeter, 2017)” this would explain her frequent headaches. The
panic attacks and frequent anxiety are causing her stress which are resulting in the mouth
ulcers. Mouth ulcers are common a “common cause of stress, and a recent study points to
the relationship between mental health and oral health (Dilling, 2020)”.
2. Discuss other stress-related problems that this patient might experience if her
coping strategies are not effective.
If she lets the panic attacks continue, she will begin to have “palpitations or tachycardia,
hyperventilation, sweating, sensations of choking or smothering, and nausea accompany
the feeling of terror (Hubert and VanMeter, 2017)”.
3. Discuss the potential strategies for coping with the stress.
Treatment for panic disorders can consist of “psychotherapy combined with drug therapy,
usually antianxiety agents, such as alprazolam (Xanax) or diazepam (valium) (Hubert and
VanMeter, 2017)”. However, I believe if she attended VA meetings, where she could sit
with a group and talk about her episodes of anxiety with others who have experienced the
same thing, she may be able to overcome her panic attacks. In return, this would help her
overcome her stress and anxiety.
Mr. K is a 32-year-old man who was found in his apartment at 2 AM, babbling incoherently
and apparently experiencing hallucinations. His friends report that he had been to a party
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