Miss Okito Horo was referred to psychotherapy due to intermittent depressive and anxiety symptoms. Furthermore, she was found to be agoraphobic, preventing her from attending classes as well as from interacting with peers and other people. In fact, she had to convert to a remote mode of learning that made her feel more comfortable than being physically present in lectures. Additionally, Miss Okito has suffered from dyslexia and dysorthography since childhood. Both of these issues are developmental disorders that are linked to reduced processing speed, difficulties in multimodal temporal processing, and attention deficit (Nukari et al., 2020). The patient’s academic performance and overall functioning are affected only in public; hence, supporting her remote studying and encouraging adherence to pharmaceutic treatment is recommended.
Dyslexia, which is often accompanied by other psychiatric diseases, prevents individuals from everyday social interactions and affects an individual’s quality of life. It is described as a developmental disability characterized by problems with memory, reading speed, time organization, and writing (Nukari et al., 2020). The latter is known as dysorthography, which is present in Miss Okito. Furthermore, research shows that university students with dyslexia frequently report difficulty in planning, memorization, organization, and absent-mindedness (Nukari et al., 2020). These patients may develop anxiety, depression, or other mood disorders because of their frustration, which further exacerbates their daily functioning (Nukari et al., 2020). It was shown that neuropsychological intervention significantly improves the symptoms early in life, but if it remains untreated, it affects these individuals’ lives in adulthood (Nukari et al., 2020). Since Miss Okito seems to have issues that were not adequately addressed during her childhood, evidenced-based intervention should be used to help her remain functional.
Miss Okito continues studying remotely and works part-time as a cleaner for Bidvest Noonan. Her employer had to make some adjustments to her schedule by allowing her only work during closing hours to minimize her interaction with the visitors or other employees. The patient therapy should be adjusted accordingly, ensuring that Miss Okito’s interaction with other people is minimized to prevent unnecessary suffering and avoid causing anxiety symptoms.
The recommended intervention, in this case, includes individual psychotherapy, pharmacologic treatment, and rest at home. Miss Okito should continue online learning and a part-time working schedule, but it is expected that she may increase her social interactions over the course of therapy. The problems of dyslexia and dysorthographia can be addressed through special exercises. In the case of the former, audiobooks and reading tasks may be utilized, while in the latter issue, specific writing challenges should be introduced (Nukari et al., 2020). Research showed sustained amelioration of dyslexic symptoms with individual neuropsychologic approach five months after the end of the intervention (Nukari et al., 2020). Moreover, therapy sessions should be offered to help the patient with depression and anxiety. Additionally, the proposed medications are selective serotonin reuptake inhibitors (SSRIs). Indeed, SSRIs are the preferred medication for anxiety and major depression (Edinoff et al., 2021). Although this pharmacologic group possesses some adverse effects, the benefits outweigh the risks.
In summary, Miss Okito, a college student diagnosed with anxiety, depression, agoraphobia, and dyslexia, was referred for further evaluation and treatment. It will be better to allow her to study remotely and work at least once a day. Management recommendations include SSRIs, individual psychotherapy, and psychologic intervention with tasks to address dyslexic and dysorthographic symptoms. Overall, it is essential to reassure Miss Okito that her mental health issue can improve with proper intervention.
References
Edinoff, A. N., Akuly, H. A., Hanna, T. A., Ochoa, C. O., Patti, S. J., Ghaffar, Y. A., Kaye, A. D., Viswanath, O., Urits, I., Boyer, A. G., Cornett, E. M., & Kaye, A. M. (2021). Selective serotonin reuptake inhibitors and adverse effects: A narrative review. Neurology International, 13(3), 387–401. Web.
Nukari, J. M., Poutiainen, E. T., Arkkila, E. P., Haapanen, M. L., Lipsanen, J. O., & Laasonen, M. R. (2020). Both individual and group-based neuropsychological interventions of dyslexia improve processing speed in young adults: A randomized controlled study. Journal of Learning Disabilities, 53(3), 213-227. Web.