Monday, August 6, 2012

Aftermath

A woman comes to you because she hasn't been able to find a job ever since she escaped an abusive relationship.  She feels her heart race and has trouble breathing every time she meets someone named "John," the name of her ex-boyfriend. She dreams about that relationship and has disturbing memories and thoughts constantly. And yet, she does not want to talk about the relationship or what happened. She gets pretty upset when you try to tease out the details. Finally, she admits avoiding restaurants and bars they frequented together. In fact, she doesn't go out at all; she says the things she used to enjoy in the past simply don't make her happy anymore. She feels distant and cut off from people, feels emotionally numb, has trouble falling asleep, and feels easily startled.

Challenge: What's the most likely diagnosis?

4 comments:

Reflex Hammer said...

Panic disorder with agoraphobia?

Anonymous said...

Adjustment disorder with depression

Anonymous said...

ptsd

Craig Chen said...

i always found psych / DSM disorders hard to diagnose because there's so much overlap, but one of the anons got the disease I intended...PTSD
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Aftermath

This is post traumatic stress disorder, characterized by intrusive thoughts, nightmares, and flashbacks of past traumatic events, avoidance of reminders of trauma, hyperviligance, and sleep disturbance.

Source: UpToDate.