Physical
Check the following symptoms that apply:
☒Headaches ☐Accident prone
☐Fatigue
☐Teeth grinding
☐Insomnia
☒Restlessness
☐Weight change ☐Neck/shoulders tight
☐Colds
☒Pounding heart
☐Digestive upsets ☐Increase in alcohol, drug, or tobacco use
☒Others: She trembles and her mouth become dry.
Stress Level (1=low, 5=high) 5
Physical Assessment
Amy portrays some physical symptoms that result from stress. Once she is stressed, she becomes restless as she moves around her house as a means of coping with the stress. She shakes a lot, and her mouth becomes dry as a result of too much anxiety. Her pounding heart makes her restless. The stress levels are high because it has a score of 5.
Mental
Check the following symptoms that apply:
☐Forgetfulness
☒Confusion
☐Dull senses
☐Lethargy
☒Poor concentration ☒No new ideas
☒Low productivity ☒Boredom
☐Negative attitude
☐Others____________________________
Stress Level (1=low, 5=high) 5
Mental Assessment
Amy has high-stress levels. She is confused because she doesn’t know what she worries about at times. She doesn’t concentrate in class as she pays more attention to detecting an attack out of stress. She gets bored and wants her children and husband always to make frequent calls. The result of low concentration and boredom is low productivity. She always uses similar methods to deal with her stress. It demonstrates her lack of new ideas in dealing with stress.
Emotional
Check the following symptoms that apply:
☒Anxiety
☒irritability
☐The “blues” ☒depression
☐Mood swings ☐nervous laugh
☐Bad temper ☒worrying
☐Crying spells ☐easily discouraged
☐Others_________________________________________________________
Stress Level (1=low, 5=high) 4
Emotional Assessment
A score of 4 is equally a high level of stress. She always worries so much about her family. This worrying situation has made her develop anxiety. As a result, she has become more irritable and developed feelings of depression.
Social
Check the following symptoms that apply:
☒Isolation
☐Lowered sex drive
☐Resentment ☒Nagging
☒Loneliness
☒Fewer contacts with friends
☐Lashing out ☐Using people
☒Clamming up ☐Increased fault finding/blaming
☒Others: social phobia
Stress Level (1=low, 5=high) 5
Social Assessment
Leaving Amy at home, makes her feel isolated and becomes so lonely. The isolation makes Amy want her family members always to call her so that she can stop feeling lonely. As a result, the husband seems like Amy nags her a lot. Amy has a social phobia of her current situation. She has a clamming up behavior, and it has made her have fewer contacts with friends. She is always quiet when she goes to class so that she can escape silently when her situation demands so.
Spiritual
Check the following symptoms that apply:
☐lack of meaning
☐questioning life’s purpose
☒feeling empty inside
☒the diminished sense of faith
☐less time spent praying or meditating ☒less time spent in nature
☒feeling isolated and disconnected from others
☐Others____________________________
Stress Level (1=low, 5=high) 3
Spiritual Assessment
Amy spends a little time with nature. She is afraid to be driven because she thinks she can get an attack. She fears getting embarrassed by the attacks. She feels isolated and disconnected from people. The isolation makes her feel empty inside. She has a diminished sense of faith because we don’t have a situation where she prays to her God whenever she is alone.
Treatment Plan
To deal with depression, Amy should prepare a regular schedule of exercise whenever she is disturbed. She should be assertive and have self-confidence. It enables her to interact with other people rather than living in isolation, and attend her classes when there are seats at the back of the class. She should be encouraged to adopt the use of meditation. It will divert her attention from stressing moments to think deeply about ideas that can help her gain relief.
Amy should develop a stress-hardy habit to enable her to look at her stress as an opportunity for personal growth rather than a threat. This stress-hardy technique will help her to attend classes and avoid being absent from school for fear of her embarrassments. Acceptance of oneself can help a great deal to deal with her secretive life. The practice will increase self-esteem and promote positive interaction of Amy with people.
Being lonely makes one feel neglected. Amy has developed stressful moments when her husband and children are away from home. She should seek help from social support groups that will help her from worrying so much about her family. She can also set aside time at least once a day to relax alone for twenty minutes. This time should be used to practice abdominal breathing, mindful breath counting, and exercising. The deep breath will enable Amy to be aware of her body’s requirements spontaneously. She should breathe deeply as a way of reducing tension and discomfort to let her body relax. She should repeat this procedure for at least ten minutes.
Worry –problem-solving technique is one of the best methods of overcoming anxiety. This technique is done to determine the cause of the problem. Amy should brainstorm to find solutions to her problems. She can then evaluate how effective each solution is in tackling her problem. She is expected to commit to following through with the solutions.
To overcome fear, Amy, is to prepare a hierarchy of stressing events. The order should begin with the least to the most stressful ones. Develop the real-life coping strategies for application in real-life situations. The result will be self-relaxation and stress-coping thoughts that will enable her to overcome her challenges. A successful strategy used to overcome particular stress should be reinforced.
Developing self-talk that is rational and realistic. Unpleasant emotions are the results of Irrational thinking that increase stress levels. Amy should accept that at times when people are away, she has no reason always to think that her family is in danger. She ought to overcome irrational ideas by reflecting on situations that do not cause anxieties and distressing emotions. Refuting silly ideas will enable Amy to be in touch with reality and thus enable her to accept day to day life activities.
Wrong interpretations of events that cause suffering make one miserable. She ought to think positively that her family is safe wherever they are. She should be free of fear and anxiety of uncertainty as a way of coping with stress. It is wrong to think that things are working the way they are not supposed to. It generates self-talk that results in intense irritation and pressure.
Amy always uses the same method to deal with stressful moments. She reduces her depression by walking in her house. She doesn’t employ new ideas to deal with her present situation. Applying new techniques may help to deal efficiently with the stress. Walking in the house is only short-lived. She should learn from the mistakes of her experience to adopt new, efficient modes of dealing with her stress.
Amy should be encouraged to make a stress awareness diary for recording the anxious thoughts worry behavior and tense events that an associated with some symptoms. The diary has time in which the stress occurs and the time the symptoms resulting from the pressure emerge. This practice will help her to cope with stressful situations or even avoid them. The recording will monitor the improvement of anxiety and worry behavior evident in Amy’s life.
Worry behaviors are meant to anticipate something positive. When she feels tense she can use the cue controlled relaxation. Instead of being anxious about bad things happening in the future, Amy should think of an alternative behavior that has positive outcomes rather than is worried about being worried. She should try to make herself comfortable, to overcome her worries. Amy should sit in front of the class rather than sitting at the back to escape in cases of emergencies. It is even better to practice more than one alternative behavior at a time, to cope with lots of anxieties.
Each time Amy is worried, she should fill a risk assessment form to lower her anxiety. A risk assessment has strategies to cope with her anxiety and estimates accurate consequences of if the catastrophe occurred. An explanation is necessary for Amy on how other people have used the same method and survived. She should be made aware of how long the process will last to be effective. Her anxiety levels should be checked at the end of the assessment and compare to initial levels.
Diversion of one’s mind can help deal with stress. Amy can adopt watching television programs, surfing the internet, or participating in sporting activities. These actions will enable her to reduce her anxieties when her family is away. The exercises will help her to cope with restlessness and also reduce her headache levels. As a result, her physical fitness will improve a great deal. Exercising will provide her the required relaxation that reduces her pounding heart and boredom from loneliness. She will have no opportunity to be worried about how her children are faring.
To save Amy from her social phobia of getting embarrassments, she can get a tutor who can teach her from the comfort of her home. Learning in school makes her not to concentrate because she tends to be worried about her situation. She only thinks about how she will boycott a class wherever stress overwhelms her. It will enable her to withdraw from the physical environment so that she can acquire the required concentration in class at home.
Proper eating, taking alcohol and use of recreational drugs will enable Amy to reduce levels of discomfort that she experiences when her family is away. She should also increase her intake of vitamin B to cut down on stress.