A 28-year-old soldier returns from Iraq and begins experiencing periodic bouts of anxiety. She complains that she wakes up frequently and cannot get a full night of sleep. Recently, she also has been getting frequent headaches and noticed a few ulcers in her mouth. A physical examination and lab tests do not reveal any local or systemic disease.

Discussion Questions

1. Based on the patient history and the signs and symptoms, discuss how stress is related to her condition.
2. Discuss other stress-related problems that this patient might experience if her coping strategies are not effective.
3. Discuss the potential strategies for coping with the stress.

Mr. K is a 32-year-old man who was found in his apartment at 2 AM, babbling incoherently and apparently experiencing hallucinations. His friends report that he had been to a party that night and, since the recent breakup of his marriage and loss of his job, he tends to overdo it at social events.

They report that during the evening, he consumed very little alcohol but did take a small pill given to him by another partygoer. Paramedics could find no puncture marks and no powder in or around the nose, but his blood pressure was elevated, as was his body temperature. He appeared dehydrated and agitated.

Discussion Questions

1. Based on patient history, reports from his friends, and the signs and symptoms noted by the paramedics, identify substances that Mr. K might have consumed.
2. Based on patient history, discuss the social factors that predisposed him to substance abuse.
3. Discuss any additional problems that he might encounter if he continues his present course of substance abuse.