Current Symptoms: Panic Attacks, Substance Use, and Suicidality

Sonja-Batten

Booz Allen
Department of Veterans Affairs
Yale University
University of Nevada, Reno

Key Points

  1. Deborah’s primary symptoms included panic attacks, irritability, social isolation, and sleeping problems.
  2. She increased her substance use following the precipitating event, having several drinks before trying to sleep, and smoking marijuana first thing in the morning.
  3. Even if a client is not suicidal, it’s important to assess whether they have firearms at home, especially if they’re veterans.
 
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Symptoms

​As mentioned, Deborah was having panic attacks at least three times a week, and didn’t leave the house at night. She said she was unable to focus. She was highly irritable; small things were really aggravating her and sometimes causing anger flares. She was only sleeping three to four hours a night, and having nightmares almost nightly.

Though she had been drinking regularly prior to the traumatic event at work, upon resigning Deborah no longer had to wait until after work to have her first drink. By the time she sought therapy, the time had crept back and on some days she had her first drink around lunchtime. She had multiple drinks before bed to try to help her fall asleep. She went from being an occasional marijuana smoker to starting each day with it. She said it took the edge off the day.

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