Read Aloud the Text Content

This audio was created by Woord's Text to Speech service by content creators from all around the world.

Text Content or SSML code:

Tanya is a 42-year-old single mother with three children. Tanya became a homemaker at age 26 when she had her first child. After delivery, she had postpartum depression, was hospitalized, and did not drink for an entire year. Two years later, she continued to experience periods of depression and anxiety and started drinking again to “help her nerves.” Tanya drank three to four glasses of wine every night for years and felt that the wine calmed her down and helped her sleep. Tanya divorced 2 years ago and went back to work part time in an office. Her 16-year-old son lives with his father and her 13-year-old twin daughters live with her. Tanya reports that over the past several years, she has been drinking more, particularly on the weekend when she stays home and drinks up to a gallon of wine a day. Recently, she has begun to experience blackouts where she can’t remember anything she did the previous day. She reported her continuing problems with feelings of sadness and hopelessness, interspersed with feelings of anxiety about her work performance and her children. Her primary care doctor referred her to the mental health clinic and she went to the appointment accompanied by her sister. Tanya shared her concerns about her mood. She describes having a hard time falling asleep at night and then wakes up often during the night. She feels anxious and irritable most of the day, has no appetite, has lost enjoyment in her life, and has been avoiding family and friends. Though she has felt this way off and on her whole life, it is worse now than it has ever been. Feeling anxious has interfered with her ability to work. Tanya reports that her daughters have been angry and withdrawn lately. One of them openly uses cigarettes and alcohol. Tanya responds by yelling at her, which she later regrets. Tanya’s sister reports that the children are worried about their mother’s drinking. Tanya is surprised but acknowledged that her weekend drinking might be a problem. She is willing to try to cut down on her drinking if she could get some help for her anxiety and depression. Six months ago, Tanya’s primary care doctor prescribed the anti-anxiety medicine, clonazepam, once a day. Some days she takes two or three extra doses when she needs them to manage her feelings of anxiety. She agreed to attend an intensive outpatient evening program. She and the practitioner developed a crisis plan before she left the office, which identified the situations that worsened her symptoms and the supports she could turn to if she needed help. While in the intensive outpatient program, Tanya saw a psychiatrist for a medication evaluation and a therapist for individual counseling. The psychiatrist recommended that she taper off the clonazepam and start fluoxetine, an antidepressant medication. She tried to reduce the clonazepam, but found that her anxiety and depression seemed worse and that she couldn’t sleep at all. Over the next several months she struggled to reduce her use of alcohol and clonazepam. Her depressive symptoms improved only a little when the antidepressant medication dose was increased. At the same time, she worked with her practitioner on her concerns about her daughters. Recently, her sister called the therapist and said that Tanya had received a ticket for driving while intoxicated last weekend. In the following months, she was ordered by the court to attend self-help groups and counseling. While under court-ordered treatment, she became completely sober, but it took several more months for her depressive symptoms to improve.