Helga, a 23-year-old nursing student, was referred to her school's psychology clinic by her professor due to worries about her schoolwork and feelings of distress. Helga worries excessively about failing out of college, her family becoming ill, and being unable to support them financially. She has trouble sleeping due to nightmares about these worries. Although she sees them as common fears, her anxiety is disrupting her sleep, relationships, and daily life. The psychologist diagnoses Helga with generalized anxiety disorder based on her excessive and uncontrollable worrying about multiple events interfering with her functioning.

1. Cassandra Glebavicius
PSY 345
Case Study:
Helga, a 23 year old college student and nurse was referred to her school psychology
clinic by one of her professors, Dr. Didyham in response to recent conversations she had taken
part in with Helga. They spoke about worries that Helga had with her school work, and would
constantly come to Dr. Didyham expressing her anguish. Helga had been experiencing feelings
of distress and irritability, and complained often that she felt she “had no control over her life”
and felt as though she was a “failure” and no matter what she did she would never be accepted
by her parents or her peers. Her professor noted Helga’s positive grades, with a 3.7 GPA as a
college Senior, and that Helga had asked for extra credit opportunities and was always onto her
professor about posting grades and getting extra help in the course, though she had an A+ in the
course throughout the entire semester.
Helga states that she has felt this way for “a long time, probably since my sophomore
year.” She cannot sleep at night because she worries about getting bad grades and failing out of
college, which she says will result in her flipping burgers at Denny’s for the rest of her life. She
also states that she constantly worries about her family and her two children, Alex who is 5, and
Ana who is 2. “If you saw the things that happen in hospitals or the people we treat, you would
worry too” she says, fearing that her family will become ill and she will have to support them on
her own. “I don’t make much yet; my husband just got a position at a law firm and supports us
for the most part, but he’s only an intern and we struggle a lot. Without the money he brings in
every month, my whole family will starve.” Helga talks more about how she has trouble
sleeping, saying that she has nightmares a lot of various bad things happening to her and her
loved ones. She finds that she is always tired because of it, and it gets in the way of doing her
schoolwork and her work life.
Helga tells Dr. Didham that she doesn’t need to see a psychologist, she thinks that these
problems are just fears that she has, failing out of school, and her family becoming ill. She says
failure is a common fear in society, and that she deals with it the best she can. Helga states that
she is “just stressed” and “has trouble sleeping at night, but doesn’t everyone?” When asked
about her medical history, she states that she is “healthy as a horse” and has never had any
problems other than a common cold or allergies to pollen in the spring, and that there are no
major diseases or disorders that run in her family.

2. Diagnosis
Axis I Generalized Anxiety Disorder
Axis II Diagnosis Deferred
Axis III Allergies (Pollen)
Axis IV Financially lower-economic status, Stressors from employment
Axis V 60
Symptoms
Helga has undergone great stress in her life for approximately 2-3 years while in college,
regarding different situations, such as failing a test or her family falling ill. She feels as though
the stress she feels is incontrollable and that she cannot target her mind away from these worries.
She experiences symptoms such as restlessness and disturbances in her sleep patterns such as her
nightmares. Helga is obviously very distressed about her situation and cannot fully function in
her life because of it. She believes her problems to only be fears, but there are various
differences in what she views as fear, and thus expanding these disruptions as anxiety. Fear of
failing a test may be normal for some, and possibly common, which is why she may see her
anxiety as simple fears, but it is clear that she cannot distract herself from these problems and
they are a constant bother to her. Even if she is not going to be taking a test in the present future,
or her children are not ill at all, she still worries constantly and excessively. These worries also
disrupt her sleep and her relationships and everyday life, which would be highly uncommon if
her problem were simply a fear. These symptoms characterize a generalized anxiety disorder.