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Full name	Nicole Lebek
Age	Child
Patient condition details	Nicole is 14 years old girl who suffers of panic attacks . NICOLE HAS MANY COMPULSIONS WHICH SHE DOES to calm down her head - as she said . She can't recognised what is making her stressed but she said she feels very often overstimulated and then she got panic attacks .Her compulsions she called routines, many of them in the day - washing face 75 seconds, washing hands 45 seconds, preparing food , eating it and counting - if the number is ugoy [ for example 53 is not nice] then she must do something else like washing hands to settle down with head . We have sessions once a week .So far I know she suffer OCD with BED . She is having binges on almost every day . She is afraid to go to school as feeling stressed , she does not know what is a stress caused of what .
Medication	None
How many pages	1
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Patient Summary: Nicole Lebek

Patient Information

• Name: Nicole Lebek
• Age: 14 years old
• Gender: Female

Presenting Concerns

Nicole is a 14-year-old girl who is currently experiencing significant mental health challenges. Her primary concerns include frequent panic attacks and obsessive-compulsive behaviors. She describes her condition as feeling very overstimulated, which often leads to panic attacks. Despite her distress, she has difficulty pinpointing the sources of her stress.

Panic Attacks

Nicole experiences panic attacks that she cannot attribute to specific triggers. These episodes can be overwhelming, leading her to seek comfort and control through compulsions that she refers to as "routines." The unpredictability of her panic attacks has made her increasingly anxious, especially regarding social settings such as school.

Compulsions and Routines

Nicole's compulsions manifest in various rituals that she engages in throughout the day. These compulsions appear to serve as coping mechanisms aimed at providing her with a sense of control over her overwhelming feelings. Notable routines include:

• Washing Face: 75 seconds
• Washing Hands: 45 seconds
• Food Preparation: She meticulously prepares and counts her food intake, closely monitoring specific numbers to find comfort.
• Counting Rituals: Nicole associates specific numbers with feelings of discomfort or "ugliness," such as the number 53, which she deems unacceptable. This leads to further compulsions like re-washing her hands to relieve her anxiety.

These coping mechanisms help Nicole manage her distress momentarily, but the compulsive nature of her routines indicates the presence of obsessive-compulsive disorder (OCD).

Additional Diagnoses

Based on Nicole's signs and symptoms, she appears to experience:

• Obsessive-Compulsive Disorder (OCD): Characterized by unwanted, intrusive thoughts and compulsive behaviors that aim to relieve the associated anxiety.
• Binge Eating Disorder (BED): Nicole reports frequent episodes of binge eating, which occur almost daily. This behavior adds another layer of complexity to her existing psychological struggles.

Academic and Social Impact

Nicole's anxiety significantly impacts her social life, particularly her ability to attend school. She expresses a profound fear of the stress associated with being in an academic environment. The culmination of her panic attacks and OCD behaviors has made it increasingly challenging for her to engage with her peers and participate in educational activities.

Therapeutic Support

Nicole attends therapy sessions once a week to address her ongoing challenges. During these sessions, we work on:

• Identifying Triggers: Helping Nicole explore potential triggers that contribute to her feelings of overstimulation and resulting panic attacks.
• Coping Strategies: Teaching her effective strategies to manage her anxiety without relying solely on compulsive behaviors.
• Self-Compassion: Encouraging Nicole to cultivate a more compassionate relationship with herself amid her struggles with OCD and BED.

Current Medication

As of the current assessment, Nicole is not on any medication. It may be beneficial to discuss medication options in future sessions to alleviate some of her symptoms, especially if her condition does not improve with therapy alone.

Conclusion

In summary, Nicole Lebek is a 14-year-old girl struggling with panic attacks, compulsions associated with OCD, and binge eating behaviors. The impact of these conditions on her daily life is significant, particularly in the academic and social realms. Continued therapeutic support is essential as we work towards identifying triggers, developing healthy coping mechanisms, and fostering a greater self-understanding and acceptance.