Utterance
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D_ACT
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Okay. And how much do you drink?
1irq
I don't drink.
0id
Okay. Um, also, Are you married?
5yq
Yeah. married.
7ack
Okay. And children?
5yq
No.
9on
Okay. And just some, some just some additional questions is looking at your kind of GYN history. Are you last menstrual period?
1irq
Okay. I'm in menopause.
0id
So going back into the history again, have you You said your mom had migraines earlier on. Have you been around and no other you haven't been nauseous or have you been?
1irq
Yeah, I've been I've been nauseous
0id
Okay
3gc
actually a week ago I was in North Carolina for a family reunion, okay. And there was a four year old who was sick there. I don't know what they had, but they, I guess I guess they ended up taking them into emergency.
0id
Yes
7ack
. It came on gradually and it's been constant pain in the frontal area. medical history you're on hyper you have high blood pressure, but that's controlled with diet. No surgical history. No really has The pain though isn't really impacting your day to day living daily life. You tried to Tylenol, Motrin, it didn't help otherwise no medications. You've got the family history of your mom with migraines. Otherwise your family is healthy. Yeah. You smoke about a half a pack a day. Do don't drink. And then you were you said you took a trip about a week ago? Two weeks ago?
1irq
Yeah.
7ack
Okay.
3gc
Yeah, I was in North Carolina.
0id
All right.
3gc
I've just never had this kind of pain before.
0id
Okay
2gt
Hi, Hazel Hey doing today.
2gt
Okay.
2gt
Okay. Yeah. I know when we met last time for your intake. You were concerned about some presentations that you had to give at school. Yeah. And you want to talk about that today?
0id
Yes. So, in school. I am in school for teaching. And we have to give presentations a lot as you can imagine, on different things and So it's something that's recurring. And what happened was, I gave a really bad one one time. My way of presentation. Yeah, I wasn't feeling very well. And I gave, I think I was just really tired from studying all night and I gave a really bad presentation. And then like now ever since, like when I've tried to give subsequent presentations, I'm just so nervous, and I'm up there like sweating and like starting to forget what I'm gonna say. And I'm just like, a fear of, of getting up there and having to get a presentation because I feel like I'm gonna bomb it.
0id
Alright, so was there a time for like, recently when you had to give presentations?
1irq
Yeah, I mean, like, before and earlier in my life, I'm towards the end of my degree. So you know, throughout program I have.
0id
How would you consider those?
1irq
pretty well, I mean, I consider myself a pretty good student. So normally I do pretty well, it seemed to, you know, come out of nowhere.
0id
So this presentation you gave with that received a poor score, maybe it was just an isolated incident.
4crq
Yeah, like I was saying I wasn't feeling very well.
6cd
But that experience has still led to a lot of things anxiety with subsequent presentations,
5yq
oh, yeah. Like, I'm worried about my grades suffering as a result. And you know how long well I'm going to do.
8op
All right. So, would it be okay if we kind of step through the whole process of giving a presentation
5yq
Sure. All right.
8op
Just before I start with that, is this something that leads to anxiety? Like right now or other times are really just in that moment when you're presenting?
1irq
Mostly. It's most intense in that moment. And like maybe like leading up to it, like in preparation that I know that this is going to happen. Like, I always know when I'm going to present like, it'll be like the teacher will say, Oh, well, you know, your this Thursday, someone else's next Thursday. So the closer it gets to that event, the more anxious I am, like in anticipation.
0id
Okay, so you start feeling anxiety. A few days before presentation?
4crq
Yeah, I would say a few days mostly.
6cd
When does it start to get really distressing for you?
1irq
like two days before or one day before that? I'm like, Oh, my gosh, like, Am I ready? Like what if I mess up? You know what if Get a bad grade all these like what ifs.
0id
Okay, so would you be okay if we step into this process and kind of break down the steps of the presentation? Alright, so let's so what's one of the classes you're taking now?
1irq
early childhood,
0id
So let's say you have a presentation in that class a few days from now. I just have just a normal presentation. Yeah. All right. So, Let's now move to two days out, where you would start to feel a little anxiety about it. Yeah. What's going through your mind at that two day out point?
1irq
Um, I would say like, Am I prepared enough? Like, did I do enough?
0id
All right. So your thought is, did I do enough preparation?
5yq
Yeah. Which leads to maybe I did is what I'm really thinking like, I'm not prepared enough as I should be.
8op
So that's that's the thought you're having 40 hours before the presentation. I'm not prepared enough. And kind of thinking about that thought. And what happens afterward? Do you have a reaction like any type of emotional, affective, affective reaction to that?
1irq
So at that point, I'm usually like, more like anxious, maybe like irritable a little bit. Mostly.
0id
And that goes substantially unchanged that feeling for how long?
1irq
I'm like The day before it like kind of gets more intense when I'm like nitpicking like, well, I forgot this or I didn't forget this and, you know, remembering what happened last time when I didn't do so well and worrying about my grade, like more thoughts pop in my head of things that I forgot or what if sort of things.
0id
Right, so the same type of thought just more intense, more intense and the feeling is also more intense.
4crq
Yes.
6cd
sure you understand you've been having some symptoms which have been bothering you, but can you tell me what you think's going on?
1irq
Yeah, I've been feeling really low and I think I might be depressed.
0id
You think you might be depressed?
1irq
Have you ever felt this way in the past?
1irq
I mean
0id
years ago I you know, felt had some of these similar things. But I didn't really think about it much and I mean, it's gone on for like, I've been feeling this way for like a month. And, you know, I I think something's wrong.
0id
having any feelings of sad sadness, hopelessness?
5yq
Yeah,
7ack
yeah?
4crq
Yeah. I haven't been able to sleep.
6cd
trouble sleeping?
1irq
This has been going on for a month.
0id
Yeah
3gc
Have you noticed a change in your ability to experience fun or pleasure?
1irq
I haven't really thought about it. But I mean, I still have fun sometimes.
0id
I just noticed that most of my
3gc
most time you're sad, but you still have fun. Have you lost an interest in pursuing things that are fun?
1irq
Any change in your appetite or weight in the last couple weeks?
1irq
And you mentioned the sleep disturbance not been sleeping as much as you'd like to?
1irq
Correct. It's really hard for me to fall asleep. And sometimes I'll just lie there for hours at night and it's, you know, awful focused, and I'm tired all day, because I didn't sleep at night. And when I get home and it's time for bed again, I still can't fall asleep.
0id
So that's been affecting your energy level?
5yq
Yeah.
7ack
Do you feel restless or the opposite kind of slowed down and having either one of those feelings.
1irq
have been having any feelings of worthlessness?
5yq
No.
9on
like that?
4crq
no, I mean, like not really no, like, I don't feel worthless. I just you know, I just I'm still sad. I don't know why I'm sad.
6cd
How about your concentration level any changes there?
1irq
Yeah, it's it's hard to concentrate at work and, and in general even at home because I just am so tired. not sleeping and tonight I just get distracted by like, you know, like, I'll be over, come with emotion and I out of nowhere, like it's hard for me to pay attention to what I'm doing. If I'm getting distracted by those thoughts.
0id
Have you been having any thoughts related to death or dying?
5yq
Nothing like that. No.
9on
So these symptoms you've been describing, have been causing limitations in your functioning in what areas
1irq
what work
4crq
at home to
0id
I want to play with my cat I usually like my cat for like an hour every night, just because I'm at work all day but I haven't I've been having trouble like even doing that. Yeah, so I would say and then even like my relationships to like my social life, it's been affecting it.
0id
Any drug or alcohol use?
5yq
NO
9on
How about any medical conditions?
5yq
Nothing
9on
see or hear things other people can't see or hear?
5yq
No.
9on
Has it ever happened to you?
5yq
No. Never
9on
do you feel now recently wherever you're at a state where you're cheating too happy, like had a lot of energy and
1irq
like make mania,
4crq
like mania? Yeah. Nothing like that. Ever.
6cd
Has there been any major event in the last month? Or maybe before that did you think might be causing this
1irq
nothing Nothing's in there significance happened to make me feel this way
0id