Patient Name: Cassandra Evans
Year of Birth: 1972
Occupation: Secretary, SII
Original Complaint (physical): Undiagnosed chronic illness contracted as a young teenager. Exhaustion.
Original Complaint (psychological): Stress, depression, anxiety.
Brief Summary: Ms. Cassandra Evans suffers from a Chronic Fatigue Syndrome. A horrible affliction that debilitates millions of people, Chronic Fatigue Syndrome is often derided as the "Yuppie Flu" or "Chronic Laziness Syndrome." But it's all too real for this previously active and healthy woman who now finds herself exhausted by ordinary life. I'm helping Cassie get appropriate medical treatment and I'm trying to allow her to cope with the emotional impact of the disease, especially as it effects her romantic relationships. Total number of sessions: 12.
Brief Impression: Cassie Evans is a guarded young woman who desires to become a film actress. Her physical condition is leaving her unable to cope with work and with her personal relationship and with her career desires. She is increasingly agitated and anxious over her medical condition, keeping it secret from all but her closest intimates. Distrustful of all medical personnel and reluctant to undergo additional diagnostic evaluation. She can communicate better through letters than in person, although she is improving at interpersonal communication.
Tentative Diagnosis: Exogenic depression. Anxiety and stress brought on by her medical condition. Slight, though marked paranoid tendency. Cassie has been diagnosed by Doug Halsey at UCSF as suffering from Chronic Fatigue Syndrome. She is happy with having a diagnosis and unsure as to the effect on the rest of her life.
Current Medications: None. Discontinued Prozac, 20 mg once a day on 9/17/96