Problem: She reports a two-year escalation in anxiety characterized by intrusive, perseverative worry and catastrophic thinking that can feel paralyzing and difficult to "turn off." Episodes are associated with marked physiologic arousal and culminate in panic attacks, occurring about four times per month. During severe anxiety she "shuts down," describing detachment from her surroundings consistent with dissociative symptoms. She feels on edge, has difficulty initiating tasks, and reports impaired concentration and task completion with increased errors.
Patient endorses a longstanding history of depressive symptoms, including persistent low mood, hopelessness, and feelings of shame and worthlessness. She reports a suicide attempt in late April 2025: while driving to work, she intended to crash her vehicle into a tree but instead pulled into a parking lot, became acutely distressed, and after a phone call with her mother - presented to the emergency department. She was admitted for a 72-hour inpatient suicide watch. She and her husband report several difficult depressive episodes toward the end of last year, prompting his concern. Need Assignment Help?