Problem:
33-year-old trans, born female and now a male, pronounce "They". Current medication regimens includes: Cymbalta 60mg PO daily, Vraylar 3mg PO daily, Wellbutrin 300mg PO daily and Propranolol 10mg PO daily PRN. Last appointment was a month ago. patient reports overall depression better, able to get out of bed and do things. Currently a professor at an University. Feeling anxious about teaching. Anxious about communicating with people at work. Physical symptoms such as clamping, heart racing, and internal dialog. Feels like they are feeling more anxious before class starts. Patient expressed some possible social anxiety; inner critic thoughts, constant worry about how they're going to be judge and perceived. Reports not taking propanolol but will starts being more adherence with it. Currently in therapy; talking about childhood trauma and inner critic thoughts. Will be starting EMDR therapy soon. Things at home has been okay. Bad family interaction a few months ago with their family and their partner. Partner tells them that they need to have a better boundaries with family. Not speaking to family as much as often anymore. Possible social anxiety vs OCD anxiety but more evaluation at future appointment. Titriate Cymbalta 60mg to 90mg po daily. Follow up in 1 month. Need Assignment Help?