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Rationale (what did you see that supports the diagnosis?)
The client is a mature (thirty-eight years old) woman with a fear of elevators. The patient is currently unemployed. She failed one of her job interviews approximately two years ago as she could not manage to overcome her elevator fear in the building of a company that had vacancies at that moment. Moreover, she avoids using elevators in everyday life because there is a possibility of panic attacks that might occur when dealing with lifting mechanisms. The issue described above first appeared at the college that the patient attended for two years but did not manage to graduate. Also, the client’s heartbeat increases, and it becomes harder for her to breathe when she is obliged to take an elevator. Agoraphobia is an appropriate diagnosis in this case as it implies fears of various social situations that are usually followed by panic-attacks and other symptoms that can occur in nervous individuals.
Developmental Disorder(s): No diagnosis
Rationale (what did you see that supports the diagnosis?)
There were no developmental issues as this woman entered an educational institution, which means that she passed all the necessary exams. Moreover, she has a good appetite. Therefore, no mental or physical developmental issues can be considered in the given case.
Personality Disorder(s): F60.3 Borderline Personality Disorder
Rationale (what did you see that supports the diagnosis?)
When the client is obliged to take an elevator, her behavior becomes unstable and abnormal. Moreover, she cannot control her emotions when dealing with elevators. Nevertheless, her uncontrolled actions might cause harm to the surrounding people. Also, the patient ended her relationships because she thought she was a burden on her ex-boyfriend. Sometimes, she regrets hastily decisions she made before. However, the client is not a confident person as she thinks negative about her body, temperament, and behavior.
Medical Disorder(s): No diagnosis
Rationale (what did you see that supports the diagnosis?)
Although there are no major complaints, the patient is allergic to something as she takes appropriate medicine on a daily basis. As it was mentioned above, her appetite is good. Moreover, she has never had any problems with drugs or alcohol before.
Client Strengths:
- The client is not alcohol addicted, which is very beneficial for her emotional condition and physical health in general.
- The client is not drug addicted, which means that she is not a weak person because the patient has many stresses every day.
- The client does not have any mental issues that usually influence people who are afraid of staying in a confined space for an extended period.
- The client has a good appetite and sticks to a healthy diet to remain strong and to prevent vitamin deficiency, which is essential for people who experience many stresses.
- The client does not have insomnia or other illnesses that might influence her night rests. When people sleep well, they feel more energized and active.
- The client does not think about committing suicide. Although the patient has a tough situation in her life, she does not want to give up because of her elevator fears.
- She has sympathy for people who surround her and does not want to burden them with her problems and personal concerns.
- The woman is calm in everyday life. However, panic attacks might occur in the client if she has to deal with her elevator fears.
Comments/Differential Diagnosis. (Did you consider any other possible diagnoses? Identify them here, and discuss your rationale for not selecting them. You can also use this section to discuss additional observations which helped you with your diagnostic decision making.
Another diagnosis that might be considered in this case is the major depressive disorder because the client is lonely and does not want to socialize (American Psychiatric Association, 2013). She does not have friends, is not in a relationship, and feels awkward in public places due to her elevator fears. However, it is not necessary to be a professional psychologist to tell that the patient is in depression because her sullen mood and glum face can describe the person’s attitude towards her life.
Reference
American Psychiatric Association. (Ed.). (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Washington, DC: American Psychiatric Publishing.
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