Introduction
The modern environment could be considered a complex phenomenon that offers numerous challenges to individuals who have to overcome them to become successful and preserve their leading positions in society. However, this task might be too complicated for individuals. Moreover, according to numerous research works, numerous representatives of the young generation might suffer from the extremely high level of expectations demonstrated by their relatives (Boyd-Franklin, 2013). It could become a significant problem which will affect both physical and mental health of a patient. Moreover, the constant stress and lack of sleep might deteriorate the situation significantly and precondition the appearance of a great need for treatment. In this regard, the given paper delves into the similar case as the patient suffers from the lack of understanding among family members, anxiety, and sleeping disorder.
DCM-5 Diagnosis
Therefore, the case revolves around a thirty-year-old African-American female who experiences significant stress due to the pressure from her employee and family members. As we have already stated, these factors could result in the occurrence of substantial health problems. For this reason, the leading task is to diagnose a patient using DCM 5 as the primary guide and taking into the account all symptoms the patient demonstrates. First, she suffers from an obvious sleep disorder. High level of employees demands does not leave her a chance to sleep enough. Additionally, the situation is complicated by the fact that she is not able to resist her employees because of unreasonably high expectations of her family. Therefore, the last factor which should be taken into account when diagnosing a patient is imprisonment of her younger brother who will live with the family after his release. In such a way, the combination of these factors has a crucial impact on the patient emotional sphere and stipulates the development of complete exhaustion.
The given symptoms could be used to suggest three differential diagnoses which are a sleep disorder, stress because of workload, and stress because of family issues. Therefore, DMC 5 characterizes all these problems as anxiety disorders preconditioned by different reasons. Therefore, the diagnostic criteria suggested by the guide to investigate the case and determine the final diagnosis include insomnia, depressed mood, feelings of worthlessness and inappropriate guilt, loss of energy, etc. (Reynolds & Kamphaus, n.d.). Regarding the case, all these factors could be observed. The patient is not able to cope with her status of a golden child and has to work harder than usual to fulfill her family members expectations.
Under these conditions, her problems with sleep and mood could be diagnosed as generalized anxiety disorder (300.02 (F41.1.)) with the tendency to become a major depressive disorder (296.xx (F32.x)) (“Complete list of DSM codes by disorder (DSM-IV Diagnostic Categories),” n.d. ). It is evident, these diagnosis demand introduction of appropriate measures to mitigate the negative impact of psychological factors on the patients health. DCM 5 recommends considering a set of stressors that impact a person along with the radical reconsideration of her lifestyle, relations, and perspectives on the most critical issues. The anxiety, worry, and other physical symptoms might cultivate distress and deteriorate efficiency in social spheres (Boyd-Franklin, 2013). At the same time, these factors could contribute to the appearance of new health issues. For this reason, if the problem remains and there are no signs of improvement, a pharmaceutical treatment that includes antidepressants could be suggested to improve the state of the patient and guarantee her recovery.
Interventions
Genogram
Considering the above-mentioned information, an intervention with the primary aim to improve the patients state and prevent the further development of depression becomes the primary task. First, it is fundamental to create a genogram to see the structure of the patient’s family.
The given scheme demonstrates that the patient (Jasmine) has a comparatively big family. She has two brothers and a sister. There are two uncles who are very close to Jasmine and also consider her a golden child. David, the patients brother, is in prison at the moment. However, he soon will be released and will live with the family.
Treatment Goals and Objectives
The first treatment goal is to decrease the level of stress which prevents the patient from living the full life and results in the appearance of numerous health problems. The given purpose is fundamental regarding the tendency towards the accumulation of the level of stress and emergence of new symptoms that might deteriorate the situation significantly. For this reason, the leading factors that promote anxiety in the patient should be identified and eliminated to attain success and assist Jasmine in her recovery. Considering the information gathered during the communication with a patient, the high job pressure, and family expectations are the most problematic aspects related to the case. For this reason, the main objectives of this treatment goal are to teach a patient how to come with stress that comes from the job, from the family, and demonstrate relax practices that could be used.
The first aim of treatment is the acquisition of coping mechanisms to manage stress that comes from the job. The fact is that the patient is not able to resist her employees and has to work harder than usual. It is stipulated by the fear of failure and inability to meet fulfill family members expectations. Under these conditions, it is essential to teach a patient to cope with the high level of stress that comes from working in harsh conditions. First, she should be explained that the given job is not the only place where she could work, and there are alternatives she could use if she decides to leave. Second, the fundamental role relaxation plays in her mental and psychical state should be explained for the patient to find time to recover.
The second objective is the development of the patients ability to resist family and live not looking back for their approval. At the moment, the family environment remains one of the leading stressors that affect the patient. It means that she is deprived of a potent supportive tool as traditionally close people help to relax and forget job issues. In its turn, it stimulates the rapid growth of stress levels. In this regard, a patient should be explained that her family members will love her no matter what her current status is. It is an important goal which should be achieved to help the patient to recover and eliminate anxiety disorder.
Finally, stress coping strategies include different relaxation practices that might become efficient if a patient experiences a constant stress. For this reason, Jasmine should be prescribed massage therapy. At the moment, it is one of the most efficient ways to manage stress and recover after long working periods. Regarding the fact that the patient suffers from exhaustion and feels the lack of forces, massage could be considered an efficient approach to recover. Moreover, it will demonstrate a critical role relaxation practices like this play in the treatment process. That is why the given goal remains essential in terms of the suggested intervention.
Therefore, as it is stated above, the patient also suffers from the sleeping disorder stipulated by different factors like stress, relations with family, high level of responsibility, etc. That is why the second treatment goal is the cultivation of the patients sleep culture and her ability to sleep 8 hours per day. The given aim becomes crucial regarding the tendency towards the deterioration of the situation and complicated character of the job (the patient works in Navy). There are also two main objectives related to this goal: to focus on viewing the home as a safe place and to determine the method that will help a patient improve the quality of her sleep.
First of all, the home should be taken as a safe place for a person to relax here and recover after a long working day (Friedman, 2013). Regarding the patients case, at home, she has to preserve concentration to meet all requirements family members have. Moreover, she is not able to discuss her problems at work as it might be appreciated as a sign of failure. Under these conditions, a patient does not have a desire to go home after her work. Moreover, she acquires disturbed sleep patterns and is not able to refresh. That is why the patient should be prescribed to consult with a psychologist to alter her attitude to home.
Second, the problem of the sleep disorder should be solved. Investigations show that a person who has insomnia acquires numerous health problems like loss of energy, inability to concentrate, significant mood oscillations, etc. In this regard, the patient should be assisted in her attempts to restore appropriate sleep patterns and recover. The patient’s symptoms prove the psychological nature of the problem which means that if the main stressors have been eliminated, the patient will be able to sleep enough. However, the patient should be prescribed with particular antidepressants like citalopram (Celexa) to decrease the level of anxiety, help to relax, and recover (Reynolds & Kamphaus, n.d.).Therefore, these treatment goals become crucial for the patients further recovery and her ability to cope with stress and high expectations. Moreover, the focus on sleep disorder and anxiety stipulated by the high level of stress should be considered the most appropriate treatment practices that demonstrate high efficiency and positive outcomes.
Conclusion
Altogether, the given case evidences a pernicious impact stress and anxiety have on a person. The patient, a 30-years old African-American woman, has to fulfill expectations of her family as she has always been considered a unique child. However, it becomes a great burden for her, and the patient is not able to relax. For this reason, the relaxation practices should be considered extremely important for people who perform diverse tasks every day. Moreover, the lack of sleep creates the basis for the development of depression and anxiety disorders. That is why it is essential to assess the patients case to suggest the most efficient practices and coping strategies to help people with similar diagnoses and health problems.
References
Boyd-Franklin, N. (2013).Black families in therapy: Understanding the African American experience (2nd ed.). New York, NY: Guilford Publications.
Complete list of DSM codes by disorder (DSM-IV Diagnostic Categories).(n.d.). Web.
Friedman, R. S. (2013). Commentary on family-directed structural therapy: Ten years of building on family strengths. Journal of Family Strengths, 13(1), 1-5.
Reynolds, S., & Kamphaus, R. (n.d.). Major depressive disorder. Web.