PU Having Higher Diagnosis Rates of Anxiety Discussion Response

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REPLY TO DISCUSSION:

Anxiety is a common diagnosis amongst women.  Women are two times more at risk for anxiety than men, starting at the age of puberty (ADAA, 2021).  There are many theories as to why this is.  However, it is known that the chemical makeup of a woman’s brain differs from men.  In women, the fight-or-flight response is higher in women than men.  With this being on higher alert, women can reach a higher threshold for anxiety causing factors of life.  Serotonin is another key factor in anxiety.  If we think about “Social norms” for women such as taking care of children, taking care of the home, working, and the inherent drive to make sure that people are taken care, can increase the chance of anxiety.  These stressors will compile over time and a woman will eventually realize that something is not right.  

There are many forms of treatment for anxiety.  It is important to understand what the patient is wanting out of treatment.  Do they want a more homeopathic, take medication, or try cognitive behavior therapy.  Not every woman who has anxiety has gone through “trauma.”  With this being said, it is still important to evaluate the causative factors of what is triggering their anxiety. It is important to have a trusting relationship with patients, so that they feel comfortable opening up and discussing this issue (Shanahan & Cunningham, 2021).  This trusting relationship will allow for the patient to tell us if she is fatigue, low libido, low interest, etc.  It is important to find something that is most bothersome for the patient as well.  This helps to establish goals for the patient to see if the treatment is working. 

I would do a thorough physical examination, medical history, family medical history and lab work.  I would get a CBC, CMP, TSH with free t3-t4, iron binding, vit. D, lipid panel, and HgA1c.  This lab work covers a wide variety of pathologies that could be inflicting similar symptoms of depression/anxiety.  Mental health disorders such as anxiety are those that do not allow for a patient to manage emotions/thoughts, behaviors, or interactions with others (WHO, 2021).  There are great disparities for treatment of those with mental health disorders according to the WHO.  However, I feel as if we are definitely more aware as a society regarding mental health. 

As a healthcare provider, it is important to assess the whole person.  I believe that mental health should be evaluated at every visit.  I don’t mean that we have an in-depth conversation regarding past traumas.  However, if a trusting relationship has been developed or is being developed a simple question of how they are doing, could suffice.  “How are we doing?” “How is life right now?” “Do you feel like you’re coping with life’s stresses?” These are simple questions that I think can help with the WHO initiative of addressing these illnesses and break the cycle of under diagnosis.