IIUM Repository

Patient trying to tell something else: severe stress during COVID-19 pandemic

Abdullah, Fa’iza and Mohd Razib, Mohd Zhafri and Mat Nor, Mohd Basri (2022) Patient trying to tell something else: severe stress during COVID-19 pandemic. International Journal of Care Scholars, 5 (1). pp. 65-71. ISSN 2600-898X

[img] PDF (Article) - Published Version
Restricted to Registered users only

Download (192kB) | Request a copy


Identifying mental health illness poses a dilemma, particularly the distinction between heart disease and severe stress. Without early intervention, it can escalate into psychiatric disorder and suicide. A 44-year-old man sought cardiologist consultation for the "heart disease" symptoms. As a medical laboratory technician in charge, his commitments and extensive responsibility during the COVID-19 pandemic add to his hypertension and dyslipidaemia comorbidities. Despite non-significant investigations related to heart disease, he returned with the same intense unresolved symptoms. His Depression Anxiety Stress Scales 21-item assessment revealed severe stress. Stress management counselling includes detecting the underlying stress impacted by the COVID-19 pandemic, behavioural changes, and stress coping skills was done in 4 sessions. The 1st one-hour session was to instil positive thinking and behavioural changes of the severe underlying stress and to counsel the stress coping skills. Stress coping skill includes relaxation techniques (Deep Breathing Technique and Progressive Relaxation Method) and spiritual empowerment (Islamic Integrated Meditation). The next three counselling sessions of thirty minutes duration to heighten the stress management counselling (positive thinking, stress coping skills, spiritual empowerment) as well as to review his wellbeing and physical diseases control were done at two-week interval. At twelve-week follow-up, reassessment of stress level showed significant improvement with no similar symptoms. This case highlights the clinical complexity and diagnostic challenges in detecting mental health illness. Diagnostic acronym PROMPT with the 'PT' refers to 'Patient Trying to Tell Something Else' demonstrated; without a high index of suspicion, mental health ailment may be overlooked. This case also underlined the integration of behavioural changes, stress coping skills, and spiritual empowerment in stress management counselling.

Item Type: Article (Case Report)
Additional Information: 5838/96722
Uncontrolled Keywords: Mental health; COVID-19 pandemic; Severe stress; Heart disease; Stress management
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
R Medicine > RB Pathology
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): Kulliyyah of Medicine > Department of Anaesthesiology & Intensive Care
Kulliyyah of Medicine > Department of Family Medicine (Effective: 1st January 2011)
Date Deposited: 11 Feb 2022 10:53
Last Modified: 16 Mar 2022 16:01
URI: http://irep.iium.edu.my/id/eprint/96722

Actions (login required)

View Item View Item


Downloads per month over past year