Generalized anxiety, panic, social anxiety, PTSD, and the medical mimics that fool everyone.
8 cases
A 48-year-old woman with GAD and multiple SSRI/SNRI failures is skeptical about buspirone after hearing it 'doesn't work.' This case explores why buspirone's reputation undersells its utility, how to identify ideal candidates, and why dosing and expectation-setting are the difference between success and failure.
A 28-year-old woman is referred after an ER visit where she disclosed intrusive thoughts of harming her infant. She was started on risperidone and referred for 'psychotic features.' This case explores the critical differential between harm OCD and genuine psychosis, and the treatment implications of getting it wrong.
A 29-year-old software engineer turns down a promotion to avoid public speaking. Explore the diagnosis and treatment of social anxiety disorder, distinguish it from introversion and avoidant personality disorder, and learn why SSRI plus CBT with exposure hierarchy is the gold standard.
A 31-year-old software developer presents after his 4th ER visit in 3 months for chest pain, palpitations, and fear of dying — all with negative cardiac workups. Walk through the differential diagnosis, panic disorder criteria, behavioral assessment, and evidence-based treatment planning.
A 32-year-old woman referred for 'treatment-resistant depression' arrives 15 minutes late, avoids eye contact, and gives vague answers. She's been through four providers, three SSRIs, and carries an informal BPD label no one has formally diagnosed. The clinical picture shifts when you stop treating the symptoms on the surface and start wondering what's underneath them.
A 26-year-old graduate student presents for insomnia that started 'a few months ago.' She's controlled, articulate, and wants a sleeping pill. Over the course of the interview, the real reason she can't sleep begins to surface — but only if you create the conditions for it. This case teaches trauma-informed assessment when the patient isn't ready to say the word.
A 28-year-old combat veteran is referred for "auditory hallucinations and paranoid behavior." But the voices have a context, the visions have a trigger, and the paranoia has a reason. Walk through the critical distinction between trauma-driven re-experiencing and true psychosis.
A 42-year-old teacher presents with escalating anxiety, but the tremor, weight loss, and palpitations tell a different story. Learn to distinguish genuine psychiatric illness from medical mimics — and why the labs are never optional.
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