Anxiety & Sleep-Wake Disorders

Anxiety & Sleep-Wake Disorders

Summary of Clinical Case

A 20-year-old woman is taken to the local ED as a result of symptoms related to a mental health disorder. Objectively, she appears restless, swiftly wanders off the point, has rapid speech, and paces around the emergency room. Subjectively, her parents report that she lost her job and has not slept for 3 nights. She thinks that she is very important for minions to hold her back.

DSM-5-TR Diagnosis

Based on the summary of her report one of the major problems presented by the patient is a general anxiety disorder. According to DSM-5, General Anxiety Disorder (GAD) involves excessive worry and anxiety that occurs for more than 6 months due to certain events in a person’s life (Munir, Takov & Coletti, 2022). For an individual to be diagnosed with GAD he or she must meet the DSM-5 diagnosis criteria which include specifiers such as the presence of excessive worry and anxiety concerning certain activities and the worry may be challenging. Other cognitive and physical specifiers presented by the patient include restlessness, insomnia, more fatigued than usual, and trouble sleeping. The symptoms of GAD presented include ongoing worry and tension about her tattoo job, irritability, restlessness, fear of making wrong choices, overthinking plans problems with sleeping, and fatigue. It is evident that the patient is stressed and worries a lot about her work.  The severity of the patient’s GAD is that it interferes with her normal functioning.

Pharmacological Treatment

When it comes to medications, certain antidepressants such as SSRIs can help relieve the anxiety symptoms presented by the patient.  The patient’s anti-anxiety drugs can be provided to her by a psychiatrist or a doctor. These medications can help in addressing anxiety issues, reduce irritability, and help in easing intrusive thoughts caused by GAD (Munir, Takov & Coletti, 2022).). Effective medication for the patient would be Selective serotonin reuptake inhibitors (SSRIs)’s. Considering that her GAD is moderate prescribing her Lexapro would help with her anxiety problems. Lexapro works by balancing the levels of serotonin in the brain leading to a reduction in anxiety.

Non-Pharmacological Treatment

Effective non-pharmacological intervention for the patient’s anxiety is cognitive-behavioral therapy combined with medications. CBT will help her learn specific skills for improving his symptoms and build his confidence in managing the symptoms and avoiding the triggers (DeGeorge, Grover & Streeter, 2022). Cognitive-behavioral therapy will help promote positive behaviors and thought patterns for the patient. CBT can also help in alleviating the symptoms of GAD exhibited by the patient and also improve his quality of life. Since CBT focuses on updating unhelpful thinking patterns and finding active coping strategies, it is likely to work well with a patient who is experiencing several anxiety issues.

Assessment of the Treatment

Lexapro is a type of SSRI that is highly effective in treating anxiety and depression. It is also highly appropriate for GAD since it helps reduce anxious thoughts and psychological symptoms such as headaches, muscle tension, and sleep issues (DeGeorge, Grover & Streeter, 2022). In most U.S pharmacies, Lexapro is sold for 4 dollars for a 30-day supply or 10 dollars for a 90-day supply. There is a high potential for patient adherence to Lexapro medication. Many patients have shown significant adherence to the medication since it helps in relieving most of their anxiety symptoms.



DeGeorge, K. C., Grover, M., & Streeter, G. S. (2022). Generalized Anxiety Disorder and Panic Disorder in Adults. American Family Physician106(2), 157-164.

Munir, S., Takov, V., & Coletti, V. A. (2022). Generalized anxiety disorder (nursing). In StatPearls [Internet]. StatPearls Publishing.




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