Utterance
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| D_ACT
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Okay. And how much do you drink? | 1irq
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I don't drink. | 0id
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Okay. Um, also, Are you married? | 5yq
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Yeah. married. | 7ack
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Okay. And children? | 5yq
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No. | 9on
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Okay. And just some, some just some additional questions is looking at your kind of GYN history. Are you last menstrual period? | 1irq
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Okay. I'm in menopause. | 0id
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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
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Yeah, I've been I've been nauseous | 0id
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Okay | 3gc
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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
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Yes | 7ack
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. 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
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Yeah. | 7ack
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Okay. | 3gc
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Yeah, I was in North Carolina. | 0id
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All right. | 3gc
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I've just never had this kind of pain before. | 0id
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Okay | 2gt
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Hi, Hazel Hey doing today. | 2gt
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Okay. | 2gt
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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
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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
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Alright, so was there a time for like, recently when you had to give presentations? | 1irq
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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
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How would you consider those? | 1irq
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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
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So this presentation you gave with that received a poor score, maybe it was just an isolated incident. | 4crq
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Yeah, like I was saying I wasn't feeling very well. | 6cd
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But that experience has still led to a lot of things anxiety with subsequent presentations, | 5yq
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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
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All right. So, would it be okay if we kind of step through the whole process of giving a presentation | 5yq
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Sure. All right. | 8op
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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
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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
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Okay, so you start feeling anxiety. A few days before presentation? | 4crq
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Yeah, I would say a few days mostly. | 6cd
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When does it start to get really distressing for you? | 1irq
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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
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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
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early childhood, | 0id
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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
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Um, I would say like, Am I prepared enough? Like, did I do enough? | 0id
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All right. So your thought is, did I do enough preparation? | 5yq
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Yeah. Which leads to maybe I did is what I'm really thinking like, I'm not prepared enough as I should be. | 8op
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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
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So at that point, I'm usually like, more like anxious, maybe like irritable a little bit. Mostly. | 0id
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And that goes substantially unchanged that feeling for how long? | 1irq
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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
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Right, so the same type of thought just more intense, more intense and the feeling is also more intense. | 4crq
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Yes. | 6cd
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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
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Yeah, I've been feeling really low and I think I might be depressed. | 0id
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You think you might be depressed? | 1irq
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Have you ever felt this way in the past? | 1irq
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I mean | 0id
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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
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having any feelings of sad sadness, hopelessness? | 5yq
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Yeah, | 7ack
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yeah? | 4crq
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Yeah. I haven't been able to sleep. | 6cd
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trouble sleeping? | 1irq
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This has been going on for a month. | 0id
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Yeah | 3gc
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Have you noticed a change in your ability to experience fun or pleasure? | 1irq
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I haven't really thought about it. But I mean, I still have fun sometimes. | 0id
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I just noticed that most of my | 3gc
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most time you're sad, but you still have fun. Have you lost an interest in pursuing things that are fun? | 1irq
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Any change in your appetite or weight in the last couple weeks? | 1irq
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And you mentioned the sleep disturbance not been sleeping as much as you'd like to? | 1irq
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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
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So that's been affecting your energy level? | 5yq
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Yeah. | 7ack
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Do you feel restless or the opposite kind of slowed down and having either one of those feelings. | 1irq
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have been having any feelings of worthlessness? | 5yq
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No. | 9on
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like that? | 4crq
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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
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How about your concentration level any changes there? | 1irq
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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
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Have you been having any thoughts related to death or dying? | 5yq
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Nothing like that. No. | 9on
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So these symptoms you've been describing, have been causing limitations in your functioning in what areas | 1irq
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what work | 4crq
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at home to | 0id
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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
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Any drug or alcohol use? | 5yq
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NO | 9on
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How about any medical conditions? | 5yq
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Nothing | 9on
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see or hear things other people can't see or hear? | 5yq
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No. | 9on
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Has it ever happened to you? | 5yq
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No. Never | 9on
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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
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like make mania, | 4crq
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like mania? Yeah. Nothing like that. Ever. | 6cd
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Has there been any major event in the last month? Or maybe before that did you think might be causing this | 1irq
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nothing Nothing's in there significance happened to make me feel this way | 0id
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