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    Rachel, 36-year-old woman suffering Severe Anxiety and Depression with Wedding Fast Approaching

    “In these stories, the identities and locations have been changed to ensure client confidentiality.”

    Rachel is a 36-year-old woman who came to see me for two reasons.  The first was that she wasn’t able to attend work because of both anxiety and depression.  The second was that she was due to get married in six weeks and she feared that her anxiety would prevent her from being able to attend her own wedding.  During Rachel’s initial evaluation, she endorsed having symptoms consistent with multiple conditions including Panic Disorder with Agoraphobia, Social Anxiety Disorder, Alcohol Use Disorder, and Major Depressive Disorder.  I also discovered that she had tried several antidepressants in the past.  Nothing had seemed to work and Rachel was feeling hopeless that she would ever feel good enough to be able to attend work or go to her wedding.  Because of her depression, she had missed work for several prolonged periods of time in the past two months.  She was also drinking up to one bottle of red wine several times per week in an effort to numb herself from all the emotional pain she was experiencing. She told me that her anxiety was preventing her from doing even simple things such as going to the grocery store or even driving.  She had started having panic attacks while driving and was very worried that she could have another one and cause a motor vehicle accident. I remember what it was like meeting with Rachel in the beginning.  She reported she had lost almost all hope, she felt like she wasn’t good enough for her fiancé or her job.  She did not wear any makeup,  wore sweatpants and an old beaten up jacket, and made little eye contact with me.  I sensed that she was really frustrated with herself and her life and that things had reached  a breaking point in her life.

    Fortunately, I was able to prescribe a medication for Rachel which provided her significant relief from her anxiety after a short period of time.  In addition, after carefully establishing a rapport with her and helping her to find hope, I then provided her with behavioral strategies to help her understand and manage her anxiety more effectively.   The medication and psychotherapy soon began to work even more effectively.  After just a few weeks, Rachel’s anxiety quickly began to wane; as her anxiety lessened, her depression did as well.  It became evident to me that her depression stemmed from her anxiety.  She began to socialize with friends again and was able to do little things such as go to the grocery store and drive.  She started working again.  I also did some genetic testing to help better manage her symptoms with a more targeted medication approach.  It was discovered that Rachel was deficient in dopamine because of an overactive enzyme in her brain.  I provided her with a medication to compensate for this and as a result she also became much more productive at work.  In a short period of time, her anxiety and depression had lessened significantly and she was more productive.  Now she presented as well dressed,  had also done up her hair and makeup, and it was notable that she now maintained good eye contact with me throughout our sessions.  Rachel decided that she would be able to attend her wedding as planned and was looking forward to it.  She was also no longer drinking alcohol to excess. It was rewarding to see how quickly she improved; in less than six weeks she had started working again,  attended her wedding, and even traveled to multiple countries overseas for her honeymoon.

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