Anxiety Disorder/with Axis Scale

Anxiety Disorder/with Axis Scale

The Multiaxial system is used in assessing and providing a comprehensive picture of not only symptoms but the entire scope of factors that might be accounting for a person’s mental health. The DSM diagnostic system has five axes each relating to different mental disorder aspect. Axis I present most acute symptoms, which require quick treatment. It entails panic attacks, major depressive episode and schizophrenic episodes (Nutt & Ballenger, 2003). Axis II is for personality disorders and developmental disorders like mental redundancy. Axis II entails neurological and medical conditions, which might influence psychiatric problems, or complexities like a person with diabetes might experience fatigue leading to depression. Axis IV is associated with psychosocial stressors like death of a loved one, losing job and divorce. While Axis V identifies or reveal a patient level of function based on a scale 0-100 also known as the Global Assessment of functioning (GAF) scale (Dziegielewski, 2010).

When Jane Doe approached me for diagnosis, she looked weary, sleepy, and restless (Brown & Barlow, 1992). She also frightened and panicked when I tried to talk to her. This panic was evident through his frequent heartbeats, wooziness and sweating. She did not involve actively in the interactions more as I often initiated and promoted her to speak on the different aspects. Jane also experienced abnormality in his speech during our conversations. She could often repeat the same words she had said earlier without necessarily knowing that she was repeating herself. Sometimes when I used humor, she rarely smiled or laughed, as her mood remained sad. Another important observation I made was about her content. She delved so much on specific topics which she had experiences’ in her life demonstrating paranoid thinking. Jane looked confused at some point and lack of attention and concentration. To determine her level of concentration I posed a question requiring her to tell me what time and day was it. She was not able to comprehend what day it was (Smoller, Paulus, Gelernter, & Stein, 2009).  Furthermore, I noted something in her presentation; the way of dressing was not modest and she seemed to not care about her cleanliness.  Furthermore, her walking was not systematic but rather a peculiar posture, which was restless. Hence, these observations made me draw conclusion that Jane suffered a mental disorder associated with anxiety disorder (Russell & Hoehn-Saric, 2006). This disorder falls under Axis I as she exhibited panic and symptoms associated to depression hence, they match the DSM-IV criteria for the anxiety disorder.

Another case I handled is of a patient who is an alcohol abuse but who did not meet the DSM-IV criteria for anxiety disorder. This case is normally referred to as differential diagnosis. The diagnosis entails examination of all other possible causes that are related to a certain state of symptoms in order to achieve an appropriate diagnosis (Mavissakalian, &  Prien, 1996). I interviewed the patient and gathered information relating to her family, social history and even personal information that gave a picture of the current condition of the patient. Further, I inquired more from the interviewee friends and coworkers to be able to look for likely causes of the patient condition. The patient is a heavy drinker and often faints. She had, together with these problems experienced nervousness, depression and blackouts.  When I talked to her, she was nervous and appeared not relaxed.  The patient also exhibited lack of attention and concentration.  The information received from his family member, friends were that she experienced an emotional problem when her only children died through a road accident. She loved her child and the loss traumatized her making her begin taking alcohol as a remedy and a consolation of the loss. On the other hand, she told me that actually the loss of the child together with the injuries she got on her body traumatized her much. This information is important as it helped in evaluating the symptoms and in diagnosing it.  Therefore, DSM axis IV helped in providing insight to her symptoms and in diagnosis. She was diagnosed, as having anxiety but alcoholic was included as a deferential diagnosis for future reference.

After this diagnosis, Jane is recommended to undergo treatment, which can be administered as therapy, use of medication and other alternatives. The most effective treatment for Jane anxiety disorder is therapy since it treats both the symptoms and the causes of anxiety (Clark & Beck, 2011). She will be able to vent through her confessions and secret things that deter and make her anxious. Her attitude will be changed and she will be able to relax and learn on the best practices to overcome anxiety. Cases that are not resistant can be treated through medication such as SSRIs, SNRIs while those resistant can be treated with MAOIs and Lyrica (Andrews, 2003). On the case of differential diagnosis, transactional analysis will be used where the focus will be on her cognitive and behaviour functions.  I will help the client in evaluating her past decisions like engaging in alcoholism by helping her examine her past decision and making better decisions in her future life.

Jane diagnosis condition is illustrated in the axis scale below

Axis I= She suffered principal disorder of anxiety that required quick medication
Axis II =Not experienced
Axis III = She did not suffer any medical or neurological disorders
Axis IV = She also faces psychosocial stressors such as the death of her daughter and the injuries she suffered
Axis V = GAF = Jane is under the scale of 41-50. She demonstrated serious symptoms/impairment in her social life depicted through her panic behaviors, interpersonal relations, and alcohol intake among other symptoms

References

Andrews, G. (2003). The treatment of anxiety disorders:clinician guides and patient manuals.

Cambridge: Cambridge University Press.

Brown, T. A., & Barlow, D. H. (1992). Comorbidity among anxiety disorders: Implications for

treatment and DSM-IV.. Journal of Consulting and Clinical Psychology, Vol 60(6), 835-

844.

Clark, D. A., & Beck, A. T. (2011). Cognitive Therapy of Anxiety Disorders:Science and

Practice. New York: Guilford Press.

Dziegielewski, S. F. (2010). DSM-IV-TR in Action. New York: John Wiley and Sons.

Mavissakalian, M., & Prien, R. F. (1996). Long-term treatments of anxiety disorders. New York:   American Psychiatric Pub.

Nutt, D. J., & Ballenger, J. C. (2003). Anxiety disorders. New York: John Wiley & Sons.

Russell, J., & Hoehn-Saric, R. (2006). The Anxiety Disorders. Cambridge: Cambridge

University Press.

Smoller, J. W., Paulus, M., Gelernter, J., & Stein, M. (2009). Diagnosis of anxiety disorders.

FreePatents.

Last Completed Projects