KT is a 24 year old female completing her studies. While home for spring break, she presents to her primary care physician because she has been worried about her academic, professional, and personal future since class restarted in late August. She is constantly worried about passing all of her exams and that she is going to be the only one of her friends that graduates school without a ring on her finger. WD is a 49-year-old male who suffered a myocardial infarction one week ago. Upon discharge, it was noted that WD appeared depressed. At a follow-up visit with his physician a week later, WD met criteria for a diagnosis of major depressive disorder. His past medical history includes: treatment refractory hypertension, diabetes mellitus (type II), and severe uncontrolled narrow angle glaucoma JM is a 42 year old female who was referred for management of insomnia. She reports that she is unable to sleep at all during the week (difficulty going to sleep and staying asleep) and sleeps all day on Sunday. She currently takes temazepam (Restoril) 30 mg HS (recently increased from 15mg). She also experiences depression due to an abusive relationship with her boyfriend as well as her current lack of employment. She reports poor sleep hygiene (reads and watches TV in bed), drinks 6-8 cups of coffee throughout the day and does not pay attention to how late she eats or exercises.

Introduction
In this case study, three individuals with different demographic characteristics and medical histories are presenting with symptoms of anxiety, depression, and insomnia. KT, a 24-year-old female, is experiencing worry and stress related to her academic and personal life. WD, a 49-year-old male, developed depression following a myocardial infarction. JM, a 42-year-old female, is struggling with insomnia and depression due to an abusive relationship and unemployment. This paper will analyze the potential causes and contributing factors to their mental health conditions, as well as possible treatment options for each individual.

KT’s Anxiety
KT is a young female who is feeling worried and anxious about her academic, professional, and personal future. This perpetual state of anxiety is affecting her daily life and leading to concerns about her performance in school and her relationship status. The cause of KT’s anxiety may be multifactorial. It is possible that she is experiencing academic pressure and has high expectations for herself, leading to feelings of being overwhelmed. Additionally, societal pressure and comparison to her friends’ achievements may be contributing to her anxiety.

WD’s Depression
WD, a middle-aged male, developed depression following a myocardial infarction. It is well-established that a major life event such as a heart attack can trigger or exacerbate depression. In WD’s case, his past medical history of treatment refractory hypertension, diabetes mellitus (type II), and severe uncontrolled narrow angle glaucoma can contribute to his depression. The burden of managing multiple chronic illnesses, coupled with the fear of another cardiac event or complications from his other medical conditions, can significantly impact his mental health.

JM’s Insomnia and Depression
JM, a middle-aged female, is experiencing both insomnia and depression. She reports difficulty falling asleep and staying asleep during the week, while sleeping excessively on Sundays. JM’s insomnia may be attributed to several factors. Her poor sleep hygiene practices, such as reading and watching TV in bed, can contribute to the disruption of her sleep-wake cycle. Additionally, her consumption of 6-8 cups of coffee throughout the day, lack of attention to eating and exercise timing, and her recent increase in temazepam dosage may also be influencing her sleep patterns.

JM’s depression is likely related to several factors in her life. She is currently in an abusive relationship, which has been shown to be a significant risk factor for depression. Additionally, her unemployment can contribute to feelings of low self-worth and hopelessness, further exacerbating her depressive symptoms.

Treatment Options
For KT’s anxiety, cognitive-behavioral therapy (CBT) may be an appropriate treatment approach. CBT focuses on identifying and challenging negative thought patterns and developing coping strategies for managing anxiety. Additionally, incorporating stress management techniques and relaxation exercises may be beneficial for KT in reducing her overall anxiety levels.

For WD’s depression, a combination of pharmacotherapy and psychotherapy may be recommended. Antidepressant medication, such as selective serotonin reuptake inhibitors (SSRIs), can be effective in managing depression. Additionally, cognitive-behavioral therapy (CBT) can help WD identify and challenge negative thought patterns and develop adaptive coping strategies. It is important to closely monitor WD’s medical conditions and possible interactions with psychiatric medications.

For JM’s insomnia and depression, a comprehensive treatment plan may be necessary. Improving sleep hygiene practices, such as creating a relaxing bedtime routine and avoiding stimulating activities before bed, can promote better sleep. Behavioral interventions, such as stimulus control therapy and sleep restriction techniques, may also be helpful for managing insomnia. Addressing the underlying issues contributing to JM’s depression, such as the abusive relationship and unemployment, will be crucial. Individual or group therapy sessions focusing on trauma and employment counseling may aid in her recovery.

Conclusion
In this case study, three individuals presented with different mental health conditions, including anxiety, depression, and insomnia. The causes and contributing factors to their conditions were discussed, along with possible treatment options. It is essential to assess each individual’s unique circumstances and tailor treatment plans accordingly. A multidisciplinary approach, involving medication, therapy, and lifestyle modifications, can provide the best chance for recovery and improved mental well-being.