Social anxiety disorder essay

He reports to feeling anxious when facing new people and gets difficult to start new conversations. He always reports early for meetings as he is anxious entering rooms with people already seated. He has had few dates with the opposite sex but none has materialized yet so he stays alone in his apartment. He agrees that the fear is excessive and unreasonable but he cannot avoid it. He had been working at his friend's real estate business which he enjoyed as he used to work in the back office rarely interacting with clients, however, the business was sold seven months ago and his new position requires him to interact with new people, attend meetings 29and lead discussions about something he says has been tremendously difficult and he fears his new boss will judge him to underperform.

His paternal grandmother and father are alive and have no chronic illnesses, they live alone and are still strong and active. Social/ lifestyle history MS denies using any recreational drugs. He takes wine often which he claims is helpful when he feels lonely. He takes at least three glasses daily but does not take beer. He denies any history of smoking. Lungs: MS reports having difficulties in breathing when facing a crowd or new individuals, he reports that otherwise, his breathing is clear with no difficulties or pain. Cardiovascular: MS reports palpitations in social places or circumstances, he denies any persistence of the palpitations when in a comfortable place, denies an edema or chest pain. Abdomen and gastrointestinal systems: Denies any abdominal pain, any difficulties in swallowing, denies any difficulties in bowel movements.

Neurological: Denies any occurrences of numbness, paresthesia, falls, or disturbances in motion or hearing. He denies any changes in taste sensation, denies any changes in posture and gait. Speech: The speech is slowed with hesitations. Thought Process/Content The patient thought process is logical and coherent. His thought process is in the normal range and goal-directed there is no morbid correlations or an impairment of the reality. He had thought blocks often during the conversations and seemed to take time to respond to questions. Thought content: The patient is preoccupied with what others are thinking about him He verbalized his thinking of what his boss would think if he knew his difficulties and repetitively asked what I thought of him so far during the conversation.

Disc margins sharp, no hemorrhages or exudates. Ears- Earing is good on both Weber (Weber midline AC>BC). and Rhine’s test, Tympanic membranes grayish with a good cone of light. Pinna and tragus- are non-tender on palpation. Nose: Nasal mucosa pink, nasal septum midline, no noted sinus tenderness, no mucus congestion. Capillary refill is less than 3 seconds. Heart sounds S1 and S2 heart is of regular rate and rhythm. There is no heart murmurs heard on auscultation. The point of maximal displacement heard at the 5th intercostal space and midclavicular line, no peripheral edema noted. Heart rate 103 on our first meeting and 78 midway into the conversation beat per minute. The symptoms displayed must not be directly due to substance abuse or a general medical condition or other mental condition.

The rationale for the diagnosis is that MS presents with high distress due to fear of being judged by his new boss, he is afraid meeting clients and other new people he is not familiar with. This has caused him great distress and interfered with his social life and his work where he feels uncomfortable. This condition has been manifesting in MS’s life since he was young. Panic disorder is defined as per the DSM 5 as the occurrence of recurrent, unexpected panic attacks which are characterized by abrupt experience of intense fear and discomfort that can escalate to high limits within a short time and during which period at least four of the following symptoms are present; trembling and shaking, palpitations, abnormal sweating, chest pain, feeling of choking, dizziness, nausea, abdominal pain shortness of breath among others.