Reference no: EM133212248

Norman, a 22-year-old part-time receptionist and administrative assistant, had been employed in this role for 10 months working 30 hours per week. He had been absent from work for a month on the day of the consultation and was preparing to return to work. On entering the department, his mobility difficulties ancd an obviously awkward gait and altered balance were noted. He disclosed treatment by his GP for stress, anxiety and depression. He described previous short-term absences resulting from nausea and vomiting, relating these to his anxiety at attending work. In the previous five to six weeks, in addition to nausea he also referred to difficulty sleeping, restlessness, loss of appetite, palpitations and rumination on his low self-esteem. Rumination can be a negative effect of stress. Genet and Siemer (2012) claim that rumination moderates the relation between unpleasant daily effects and negative mood.

Although excessive rumination is maladaptive, McFarland et al (2007) agree that some limited self-focus can be beneficial. Norman felt anxious about returning to the same situation and was accessing counselling support to help anxiety management. Hunsley et al (2014) suggest that psychological treatments are of at least equal benefit to medication for common mental disorders.

He had been prescribed 75mg of Venlafaxine a day with good effect. Venlafaxine is a serotonin and noradrenaline re-uptake inhibitor used to treat depression or generalised anxiety disorder.

His GP also prescribed 5mg of diazepam a longacting benzodiazepine anxiolytic - to be taken as required. Recently he had not taken this as he felt better.

1. How can Norman fight with the stress and can have a stressful, successful and happy life?

2. Read the concept of stress management with this case and its consequences.