Ruth, aged 42, is a support worker, mother of 2 and a single parent. She has a long standing phobia and persistently worry that she has not done her job properly, nor taken care of her kids well and worries that the authority might take her kids away as a result.
At the emergency ward, Ruth was made stable. After becoming conscious she was attended to by a duty doctor. She narrated some of her worries about many things in her life. Ruth believes that the reason for the collapse was because of her problems with sleeping. But after further questioning about how things have been for her recently, Ruth discloses to the doctor that she is feeling under considerable stress. Ruth looks distressed and is clearly sweating despite the fact that it is not warm in the hospital. The Doctor asks Ruth how things are for her at work and at home, she responded that she has found work a bit difficult recently. She tells the doctor further that she fears her level of stress and anxiety might cause her to make a mistake at work and deter her from looking after her kids properly.
On examination, no physical problem can be found. Ruth has no medical history of disclosure on file. The on duty doctor could not find anything that was wrong with her so she was discharged and asked her to take some rest off work.
After she was discharged, I sat her down to engage her on caring conversation with some prompting questions. How often have you been bothered by either feeling nervous, anxious, on edge or have you been unable to stop or control your worrying?” Ruth replies that she feels anxious and on edge all of the time, every single day. She informs me that she worries about many things in her life, and her most common thought is ‘what if’? She often imagines the worst happening and states that when she worries, she often feels sick, has headaches, feels butterflies in his stomach and can feel her heart pounding. Ruth often gets hot and sweaty and says her anxiety makes it difficult to concentrate and do her job or play with her children. She is very distressed by her constant worrying and feelings of anxiety and regards it as a sign of weakness.
Furthermore, I asked her again to tell me a bit more about the difficulties her anxiety is causing in relation to her daily life at work and at home? She replied: “I can’t tell you how terrible it is to wake up in the morning feeling as though your head is going to explode and your heart will jump out of your chest. My mind and body are just overwhelmed with fear and I feel so scared. I can’t work properly and I cannot play with my children. I worry I will make a mistake at work because of this and someone will report me to the social service.”
After the short caring conversation, I gave her leaflets that sets out specialist advise on what to do and how to handle such situation and recommends that she book appointment to sees her GP immediately and make sure she tells her GP all that she told me. She left very happy indeed.