The current level of medical development imposes severe requirements for making a diagnosis, preventing any problems and errors related to bias and low qualification of the specialist. Thus, relying only on the physician’s personal experience is no longer reliable, and instead, medical communication encourages scientific validity and an instrumental approach to research. A similar philosophy applies to this situation, in which a 35-year-old man is experiencing severe mental and physical health problems.
Several key details should be taken into consideration by the physician when making a diagnosis of a man. First, the man has a whole family with two children who, crucially, are of school age. It is essential to understand that children’s teenage years are often stressful for parents (Crnic & Ross, 2017). Second, information about former jobs — namely, military service and bank — is also clinically valuable because it helps gather a complete patient portrait. Job satisfaction and related occupational stress are seen as essential metrics of mental well-being. Finally, diagnostic tests should always be performed before a specific diagnosis is made to confirm or refute the physician’s hypotheses. Laboratory test results should be available to the treating physician for evaluation.
However, current information is still insufficient to make an accurate diagnosis. The case study points to “multiple tests” from the emergency teams, but these tests are unclear. In terms of the physician’s critical information, the blood pressure measurement and the electrocardiogram should be mentioned. It is likely that the man suffers from cardiovascular disease, which affects back and head pain (Torgashov & Myakotnykh, 2020). In addition, stress and anger can be mediated by feelings of fear, which is caused by a lack of oxygen supply to the tissues. Such feelings of fear often occur in patients with angina and heart attack, so it is very likely that this man suffers from the same. Nevertheless, any cardiovascular abnormalities would have been identified at the screening stages, but his results were excellent according to the scenario. In such a case, it is recommended — this is precisely a recommendation, not a requirement — to do an MRI, which would allow a better study of the patient’s body.
Taking into account all the current circumstances and excellent physical health results, a clinical opinion must be made. In all likelihood, the man suffers from masked depression, in which the body signals a problem through associated symptoms (Shetty et al., 2018). In other words, depression is hard to detect because it is always hidden under the symptoms of various illnesses or addictions, and depression and bad moods are barely noticeable. This description perfectly satisfies this cognitive dysfunction in the male context, but it is interesting to try to determine the causes. It is very likely that military service in Iraq resulted in post-traumatic syndrome — concussion, killing, death-watching — as a result of which the man’s consciousness began to suppress over time (PTSD and DSM-5, 2020). Thus, the patient’s ultimate diagnosis is masked depression against a background of post-traumatic stress disorder.
Therapy for this disorder aims for the long term, as expecting too quick results by now will lead to noncompliance and frustration. Prescription of psychotropic medications such as Fluoxetine, Paroxetine, or Sertraline is suggested as medication therapy (Bhandari, 2021). In addition, systematic consultation with an experienced psychotherapist must allow for an in-depth dissection of the patient’s main fears and overcome the dysfunctional state. It is appropriate to use spiritual practices, meditations, and breathing exercises to go into a trance to be more open to change and overcome anger.
References
Bhandari, S. (2021). What are the treatments for PTSD. WebMD.
Crnic, K., & Ross, E. (2017). Parenting stress and parental efficacy. In K. Deater-Deckard & R.
Panneton (Eds.), Parental stress and early child development (pp. 263-284). Springer.
PTSD and DSM-5. (2020). US DVA. Web.
Shetty, P., Mane, A., Fulmali, S., & Uchit, G. (2018). Understanding masked depression: A Clinical scenario. Indian Journal of Psychiatry, 60(1), 97.
Torgashov, M. N., & Myakotnykh, V. S. (2020). Stress-induced pathology and accelerated aging. Advances in Gerontology, 10(1), 26-34.