Psychiatric, Family, and Medical History
J oy denied a history of psychiatric diagnoses, hospitalizations, substance abuse, or individual treatments prior to this presentation. She had briefly gone to couples therapy “years ago” and found it “somewhat helpful,” specifically because she felt that she had “learned some tools for how to express myself.” She denied a family history of psychiatric disorders, substance abuse, psychiatric treatments, or suicide attempts.
Joy’s medical history was significant for hypertension diagnosed when she was seventeen years old. Poor adherence to her blood pressure medication regimen over several years had contributed to her recent heart attack. She had brought herself to the emergency room with jaw and arm pain, and after the heart attack was diagnosed she spent several days in the hospital for treatment and observation. Fortunately, she had no functional sequelae from the heart attack, but she did have to take a medication to prevent arrhythmias. Notably, both of her parents had hypertension, and two of her grandparents had died from strokes that had resulted from chronic hypertension.