Sondra - Sondra Sondra, a 26-year-old employed married...

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Sondra 1 of 2 Sondra, a 26-year-old employed married woman is referred to a psychiatrist by her gynecologist. He reports that she is “off work, depressed, suicidal, stumbling around at home on all kinds of medications, and has no active gynecological disease.” He says that he has “had it” with both her and her mother who “have just worn me out, always complaining about something and phoning me day and night.” Besides, “they never pay their bills.” The patient is a member of a locally prominent but erratic family. She has been divorced once and married for the second time 2 years before this evaluation; she has no children. Sondra has difficulty walking into the office, bracing herself on the walls and furniture at times but at other times fully supporting herself. She never actually falls. She relates that this sometimes happens to her without warning. She complains, “I am horribly depressed and just want to end it all. I also want to get off all of thee medications.” She reports that she has had many health problems since she was a young teenager. She has seen literally hundreds of doctors but has never found one who has really helped her. She has been seeing her gynecologist for dysmenorrheal, which she says began virtually at menarche. She describes severe cramping (for which she takes Empirin with codeine) and “gushing blood” for 7 or 8 days each menstrual period. She also says that her menstrual periods are very irregular. However, she has never been anemic, and extensive gynecological workups have not identified any pathology. She takes Fiorinal for “migraine” headaches (which lasts for days). In fact, she reports that she is having migraine at the time of the interview, although she does not seem to be bothered by light or noise. She also reports having frequent chest pains that
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Sondra - Sondra Sondra, a 26-year-old employed married...

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