[21F] Experiencing chronic emotional and dissociative symptoms

Patient Description

A 21-year-old female has been experiencing a complex array of symptoms including chronic sadness that fluctuates in intensity, apathy with a loss of interest in previously cared for activities, and anxiety exacerbated by intrusive thoughts. The patient also reports severe dissociative episodes and has had thoughts of self-harm but currently has no plan for self-harm or suicide. These emotional symptoms have been present for many years, with apathy being noted for approximately 14 years. The patient's sadness is more pronounced at night, and there is no history of elevated mood or increased energy. Additionally, the patient has been diagnosed with Ehlers-Danlos syndrome, postural tachycardia syndrome, irritable bowel syndrome, and delayed sleep phase syndrome. Current medications include Fluoxetine, Hydroxyzine, Linaclotide, and Ibuprofen, with no known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, it seems like you may be experiencing the following:

  • Major Depressive Disorder (MDD): This is characterized by persistent feelings of sadness, loss of interest in activities you used to enjoy, feelings of worthlessness or guilt, and thoughts of death or suicide. The symptoms you've described, such as apathy, sadness, and emotional numbness, are common in MDD.

    • Treatment typically involves psychotherapy (talk therapy), medications such as antidepressants, or a combination of both.
  • Anxiety Disorder: You've mentioned having OCD and experiencing severe anxiety due to intrusive thoughts. Anxiety disorders are characterized by excessive and persistent worry and fear about everyday situations.

    • Treatment typically involves psychotherapy, medications, or both.
  • Dissociative Disorders: These involve problems with memory, identity, emotion, perception, behavior and sense of self. Dissociative symptoms can potentially be a part of post-traumatic stress disorder (PTSD), which can occur in individuals who have experienced or witnessed a traumatic event.

    • Treatment for dissociative disorders often involves psychotherapy and sometimes medication.

Please note that these are potential explanations based on the symptoms you've described, and a healthcare professional would need to evaluate you to make a definitive diagnosis.

What you can do

  1. Seek help from a mental health professional: It's important to reach out to a healthcare provider who can provide a thorough evaluation and appropriate treatment. This could be a psychiatrist, psychologist, or a licensed mental health counselor.

  2. Reach out to trusted individuals in your life: Let them know what you're going through so they can provide support.

  3. If you're feeling suicidal, it's really important to reach out to professionals immediately. In the U.S., you can contact the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or use the Crisis Text Line by texting HOME to 741741.

What you should look out for

If your symptoms worsen or if you start to have thoughts of harming yourself or others, it's important to seek help immediately. You can go to the nearest emergency room or call a local emergency number. In the U.S., this is 911.

Remember, it's important to reach out to a healthcare provider for a definitive diagnosis and treatment. This information is intended to be educational and should not be used as a substitute for professional medical advice.

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11 mo ago

People Also Ask


What are the common symptoms of Major Depressive Disorder (MDD)?

Common symptoms of Major Depressive Disorder include persistent sadness, loss of interest in activities, changes in appetite or weight, sleep disturbances, feelings of worthlessness or guilt, difficulty concentrating, and thoughts of death or suicide.


How can anxiety disorders be managed effectively?

Anxiety disorders can be managed through a combination of psychotherapy, such as cognitive-behavioral therapy (CBT), medications like SSRIs or benzodiazepines, lifestyle changes, and stress management techniques.


What are dissociative disorders and how are they treated?

Dissociative disorders involve disruptions in memory, identity, emotion, perception, and behavior. They are often treated with psychotherapy, which may include cognitive-behavioral therapy or other therapeutic approaches, and sometimes medication to manage symptoms.


What should someone do if they experience thoughts of self-harm?

If someone experiences thoughts of self-harm, it is crucial to seek immediate help from mental health professionals, contact a crisis hotline, or go to the nearest emergency room. In the U.S., the National Suicide Prevention Lifeline is available at 1-800-273-TALK (1-800-273-8255).


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