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was attempting to remain strong for her family, and to do that, she believed she needed to cope without the assistance of medication or therapy.

Three months after her son’s death, she was asked by her employer to make a business trip. Three days before she was scheduled to depart, she experienced a severe anxiety attack. She experienced an unreasonable fear of leaving her home and family. Business trips were not an unusual expectation of her job, but at that time she could not get past the fear of being away from her family.

This obvious post-traumatic distress reaction prompted her to seek counseling. After several visits engaged in talking therapy, she found no help or relief from the grief. The counseling did nothing to improve her recently developed pessimistic outlook. By this time, she realized that in another six months, she could easily become overcome with feelings of grief and devastation, along with the now admitted feelings of depression, so she consulted with her primary caregiver and tried an SSRI to combat the feelings of depression. Initially the antidepressant alleviated the symptoms but she stopped the medication after three months because she no longer felt that the drug was necessary.

While episodes of extreme grief have since subsided, Susan still occasionally experiences panic attacks and is somewhat pessimistic about the future.

Case Study 2

April just had a baby boy. The excitement, the love, and the full experience was wonderful. She was enjoying the baby at home when she had a seizure. She was taken to the hospital and placed on an IV drug used for seizures due to eclampsia, which she had not experienced prior to the birth. During the three days in the hospital, April became more and more depressed. There was no reason found for the seizure, and since the baby was three weeks old, the physicians did not think it was caused by the pregnancy or the delivery. April went home and described herself as “lifeless.” She had a two- year-old and a new baby. She did not want to take care of either and often told her supportive mother that she wanted her to take them home. April was placed on an antidepressant and began to feel better, but it took nearly nine months for her to finally feel she was out of her depression. She saw no psychiatrist or other counselor during this time. She was a very accomplished professional but found it hard to work during this time. She had a supportive husband and mother. Her mother lived in a different town, so visits were less frequent than if she lived in town. April had no other support. She finally took herself off the antidepressant.

Case Study 3

Linda had many problems. She recalls being in her room when she was a teenager thinking about committing suicide. She never told anyone how she felt and kept functioning at a very high level. She married right out of high school, even though she was ready to go to college. Her room was paid for and she had a roommate. Anxiety of living with someone, even though it was a friend, was completely stifling. So she married instead and had two children. Eventually, she went to college. At the age of 30, she divorced her husband of ten years. She “hit bottom” and sought help with a MSW counselor. She did lots of talk therapy and even saw a psychiatrist a couple of times at the counselor’s request. She was placed on numerous drugs that were always being changed. In hindsight, the issue may have been that the psychiatrist did not know her. Linda became increasingly worse and started thinking about suicide. She sought out a psychiatrist, who worked with her to keep her safe. She saw him every other day for about two months in lieu of hospitalization. Linda continued to work and raise her children without any support from her ex-husband. After many more medication changes, a very


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