This case proves that Angela is a 54-year-old married woman with three adult children.Angela has been the office manager of a small law firm for 20 years and has enjoyed her work until this past year.She has rheumatoid arthritis with minimal impairment that has been managed well with NSAIDs.Moreover, the 54 old married woman has been taking conjugated estrogens for 8 years and decided to stop taking them because of her concern of their risks without sufficient medical benefit. She tolerates the discontinuation without difficulty.
Angela is a 54-year-old married woman with three adult children.However, she has been the office
manager of a small law firm for 20 years and has enjoyed her work until this past year. She has
rheumatoid arthritis with minimal impairment that is managed well with NSAIDs. She takes conjugated estrogens for 8 years and decides now to stop taking them because of her
concern of their risks without sufficient medical benefit. She tolerates the discontinuation
without difficulty.
At her annual medical checkup appointment, she tells her primary care provider that she gains weight because she has no interest in her usual exercise activities and has been overeating, not from appetite but out of boredom. She denies
that she and her husband have marital difficulties beyond the ordinary with the achievements of her children.
She is having difficulty falling asleep at night.She is waking around 4 a.m most mornings without her alarm.She is not going back to sleep even
though she still feels tired. She is finding little joy in her life but cannot pinpoint any particular
concern. Although she is denying suicidal feelings, she is feeling that there is meaning to her life:
“My husband and kids go on fine if I die and probably will not miss me that much.”
The primary care provider is asking Angela to fill out a Beck’s Depression Scale, which
indicates she has moderate depression.