Generalized Anxiety Disorder (GAD)
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A 57-year-old female presents at the urging of family for lifelong, untreated anxiety, acutely worsened by her husband's terminal cancer diagnosis. She reports chronic worry, insomnia, fatigue, irritability, poor concentration, and episodic palpitations/dyspnea without true panic attacks. PMH: dyslipidemia, surgical hypothyroidism, borderline HTN. Recent smoking cessation. Prior SSRI trial resulted in homicidal ideation; she refuses both SSRIs and benzodiazepines, leaving her without an active management plan. Substance use noted.