Peter Smith a 73 years old male with mild type II diabetes , calls to schedule an appointment. He states that he is feeling very anxious and fatigued and is having difficulty eating and sleeping. He arrives at the clinic with his wife and need to check in. During the patient interview, he states that he wakes up in the middle of the night almost nightly. He also has many things when he cannot even fall asleep. In addition , he has lost about 8 pounds in the last month. His symptoms started when his son died 6 month ago. What is the most likely diagnosis for this patient? What specific symptoms make you suspect this condition?

It is probably grief.  There are several types. Prolonged grief is also a possibility.  There is not enough information to give an accurate diagnosis. There are tests that can rule out any physical ailments.  I suspect grief due to the anxiety, fatigue and difficulty eating and sleeping.  The weight loss is what makes me thinks lab work rule out first.

Many other factors would have me recommend he see his endocrinologist that treats his Diabetes to follow up on his labs and rule out any changes.  If labs are normal, I would recommend talk therapy. 6 months is relatively recent, and grief is unique per person. There is no time table.

Explanation:

The Seven Stages of Grief. Dr. Kübler-Ross refined her model to include seven stages of loss. The 7 stages of grief model is a more in-depth analysis of the components of the grief process. These seven stages include shock, denial, anger, bargaining, depression, testing, and acceptance.

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