Case 2: Volume 1, Case #14
The Scatter-Brained Mother Whose Daughter has ADHD, Like Mother, Like Daughter
This case study is about a 26-year-old divorced woman who has two young children. Her
8-year-old daughter was recently diagnosed with ADHD. During her daughter’s appointments, it
was noted that this patient also had many symptoms of ADD. It was thought that she might be
suffering from the same condition which has been undiagnosed all her life. The research about
the heritability of ADD has been studied for decades. This research indicates that genes play a
vital role in the etiology of attention deficit hyperactivity disorder (ADHD) and its comorbidity
with other disorders. The heritability of ADD is 74%[Far18].
During the first appointment with this patient, it is discovered that she is also suffering
from GAD. At the beginning of this scenario, the question is presented as to whether or not it is
a good idea to prescribe a stimulant to a patient with GAD. The premise of that question is that
stimulants will increase anxiety and worsen one condition while treating the other.
There is more to the story of ADD and GAD than it seems at first. The symptoms that
cause the psychiatrist to diagnose GAD and even depression may be the symptoms of ADD or
ADHD in reality. Approximately 4.5 percent of the adult population suffers from ADHD. A very
large percentage of those adults have symptoms of anxiety and depression. One third of adults
with ADHD have a depressive disorder (major depression or dysthymia), and approximately one
in eight have a generalized anxiety disorder[Fei07].
The question in my mind is which came first, the chicken or the egg. The one thing I
decided was diagnosed was the ADD. If the ADD is causing the symptoms of anxiety then
treating the ADD would alleviate the anxiety. “Comorbid conditions are independent conditions
This study source was downloaded by 100000809669238 from CourseHero.com on 08-04-2022 14:38:51 GMT -05:00
https://www.coursehero.com/file/35368765/Case-2-week-9-discussiondocx/
, that exist concurrently in a patient. In contrast, depression and anxiety features that occur in
patients with ADHD frequently are a direct result of the ADHD and continue to exist only by
untreated symptoms of ADHD” [Fei07]. If the anxiety were comorbid, then it can be treated
after it is determined how the patient responds to the treatment of the ADD. I agreed that
prescribing the amphetamine was a good choice to start treatment.
Three Questions
1. Will you rank and describe what you believe to be the top five problems you have right
now that you would like to focus on resolving? I would do that to help define the goals
of treatment. To evaluate the effectiveness of therapy regarding the patient’s priorities,
her priorities and perceptions need to be recognized. This will give observable outcomes
that can be the goals of treatment. For instance, controlling or eliminating the frustration
she feels in relationship to her children or being unable to organize her life. If she has
difficulty starting or completing projects and is constantly loosing things and those issues
improve or become so infrequent that they are insignificant, that is progress. She will
have a concrete measurement of her progress. Knowing that things are getting better will
help with the anxiety and depression as well.
2. What medical conditions or issues are you now being treated for or have been in the past?
Because amphetamines or similar substances are used to treat attention deficit disorders,
it is important to know about the patient’s physical condition. Glaucoma, structural heart
defects, cardiac arrhythmias, seizures, liver or kidney impairment, mania, tics, substance
abuse, heart failure, and even diabetes may be contraindications for prescribing CNS
stimulants. At the very least, the patient’s should be monitored for these conditions.
3. Do you have a family history of any of the above conditions? Many chronic diseases
have genetic risk factors. Even if the patient is not and never has been diagnosed or
This study source was downloaded by 100000809669238 from CourseHero.com on 08-04-2022 14:38:51 GMT -05:00
https://www.coursehero.com/file/35368765/Case-2-week-9-discussiondocx/
The Scatter-Brained Mother Whose Daughter has ADHD, Like Mother, Like Daughter
This case study is about a 26-year-old divorced woman who has two young children. Her
8-year-old daughter was recently diagnosed with ADHD. During her daughter’s appointments, it
was noted that this patient also had many symptoms of ADD. It was thought that she might be
suffering from the same condition which has been undiagnosed all her life. The research about
the heritability of ADD has been studied for decades. This research indicates that genes play a
vital role in the etiology of attention deficit hyperactivity disorder (ADHD) and its comorbidity
with other disorders. The heritability of ADD is 74%[Far18].
During the first appointment with this patient, it is discovered that she is also suffering
from GAD. At the beginning of this scenario, the question is presented as to whether or not it is
a good idea to prescribe a stimulant to a patient with GAD. The premise of that question is that
stimulants will increase anxiety and worsen one condition while treating the other.
There is more to the story of ADD and GAD than it seems at first. The symptoms that
cause the psychiatrist to diagnose GAD and even depression may be the symptoms of ADD or
ADHD in reality. Approximately 4.5 percent of the adult population suffers from ADHD. A very
large percentage of those adults have symptoms of anxiety and depression. One third of adults
with ADHD have a depressive disorder (major depression or dysthymia), and approximately one
in eight have a generalized anxiety disorder[Fei07].
The question in my mind is which came first, the chicken or the egg. The one thing I
decided was diagnosed was the ADD. If the ADD is causing the symptoms of anxiety then
treating the ADD would alleviate the anxiety. “Comorbid conditions are independent conditions
This study source was downloaded by 100000809669238 from CourseHero.com on 08-04-2022 14:38:51 GMT -05:00
https://www.coursehero.com/file/35368765/Case-2-week-9-discussiondocx/
, that exist concurrently in a patient. In contrast, depression and anxiety features that occur in
patients with ADHD frequently are a direct result of the ADHD and continue to exist only by
untreated symptoms of ADHD” [Fei07]. If the anxiety were comorbid, then it can be treated
after it is determined how the patient responds to the treatment of the ADD. I agreed that
prescribing the amphetamine was a good choice to start treatment.
Three Questions
1. Will you rank and describe what you believe to be the top five problems you have right
now that you would like to focus on resolving? I would do that to help define the goals
of treatment. To evaluate the effectiveness of therapy regarding the patient’s priorities,
her priorities and perceptions need to be recognized. This will give observable outcomes
that can be the goals of treatment. For instance, controlling or eliminating the frustration
she feels in relationship to her children or being unable to organize her life. If she has
difficulty starting or completing projects and is constantly loosing things and those issues
improve or become so infrequent that they are insignificant, that is progress. She will
have a concrete measurement of her progress. Knowing that things are getting better will
help with the anxiety and depression as well.
2. What medical conditions or issues are you now being treated for or have been in the past?
Because amphetamines or similar substances are used to treat attention deficit disorders,
it is important to know about the patient’s physical condition. Glaucoma, structural heart
defects, cardiac arrhythmias, seizures, liver or kidney impairment, mania, tics, substance
abuse, heart failure, and even diabetes may be contraindications for prescribing CNS
stimulants. At the very least, the patient’s should be monitored for these conditions.
3. Do you have a family history of any of the above conditions? Many chronic diseases
have genetic risk factors. Even if the patient is not and never has been diagnosed or
This study source was downloaded by 100000809669238 from CourseHero.com on 08-04-2022 14:38:51 GMT -05:00
https://www.coursehero.com/file/35368765/Case-2-week-9-discussiondocx/
