Here is a case study that illustrates how mental health challenges can come and go in your life. Right now during the COVID-19 pandemic, many people are experiencing mental health challenges such as anxiety, depression and panic.


The name in the story has been changed for the privacy of the individual. 


The Initial Counseling Process

Natalie is a young adult who struggled with anxiety during a particularly difficult transition she experienced in her teens. With the support of her mother, Natalie went to counseling, was prescribed an anxiolytic (anxiety-relieving) medication, learned some new techniques to manage the issues that triggered her overwhelming feelings of anxiety, and within a few months, Natalie made considerable progress in mastering her anxiety.

She grew stronger from the entire experience and moved forward with confidence, no longer relying upon the medication or the counseling, and never looked back at the anxiety she had conquered.

Woman worries about coronavirusFast forward five years and enter the COVID-19 pandemic.

Natalie had spring allergies and felt rundown from working hard as a food server and online college student in the rural county where she lives. She began to have significant respiratory symptoms and was very concerned that her symptoms may be  related to the coronavirus. Her doctor’s office gave her a virtual telehealth appointment, but said that she will not be offered a COVID-19 test, as she was not in any high-risk category.


Late the next evening, she began really struggling to breathe. She felt tremendous pressure on her chest and could not take a deep breath, so her mother took her to the urgent care clinic. To Natalie’s dismay, the physicians still do not offer her a COVID-19 test, merely dismissed her with the news that she was having a panic attack, and sent her home with a single tablet of the anxiolytic medication that she found helpful years before.


Natalie was uncertain what or who to believe about the conflicting messages she heard about the prevalence of the virus, the likelihood of whether or not she may have been exposed, and whether or not her symptoms were life-threatening or “all in her head.” Her mother managed to get her a followup appointment to be checked out in a few days and she hoped she would soon get the antibody test.


Over the weekend Natalie is nearly frantic, as her symptoms continued to progress.


She struggled to breathe at night so much that she was unable to sleep.


She was emotional and tearful and struggling with each breath.


She did not trust her ability to make good decisions, did not trust her knowledge of her body and what is going on, and certainly did not feel that empowered confidence of having the tools and resources to handle her anxiety that she had just a few years ago.


She felt so defeated to be battling this anxiety demon again, so powerless and embarrassed and frustrated by the whole ordeal.

Natalie’s mother began making phone calls in desperation, trying to find anyone who could help her daughter on a Saturday morning. Someone gave her the phone number to Jewish Family Service of San Antonio and although she was uncertain who she was calling or what help she might find, she connected with the On Call therapist.


The therapist spent a few minutes talking with Natalie about what she was experiencing and together they did a few breathing exercises. The therapist explained the importance of breathing from way down in her solar plexus (from the navel point) in order to get that oxygen to her brain and to her extremities. Oxygen was what her body needed, whether the issue was caused by a virus in her respiratory tract or the flood of anxiety-related chemicals that were washing over her brain and body.


After several minutes on the phone together, Natalie began to relax enough that her breathing was less labored, and the therapist began to inquire about medication options in managing her anxiety. Natalie started crying, stating that the emergency room visit a few days ago was very expensive and could only give her one tablet of medication. She didn’t know how she would make it through the weekend, much less until her medical appointment the next week. The therapist began discussing the array of mental health services that were available, suggesting that a return to counseling via teletherapy might be helpful to Natalie in combination with an outpatient visit with a psychiatrist or psychiatric nurse practitioner.


The therapist made her aware of a mental health urgent care facility in our community that offers weekend hours. She provided her with the name, number, and address of the clinic and Natalie was extremely grateful for this information.


When they wrapped up the call, Natalie was calmer and more hopeful. She had made arrangements to begin counseling with JFS this week via teletherapy services on a sliding fee and she was leaving with her mother for the mental health urgent care clinic seeking a prescription for medication that might relieve her anxiety.


“This is such a scary time right now,” Natalie commented.  “I never thought that anxiety would take hold of me again like this.  I’m so grateful for your help.”

Disclaimer: The contents of the Jewish Family Service of San Antonio blog are for general use or informational purposed only. The content is not intended to be a substitute for professional medical advice, diagnosis or treatment. The use of any information contained on this site is solely at your own risk. If you would like to speak in detail with a licensed therapist, please email referrals@jfs-sa.org.

If you have a medical emergency, please call 911 or your doctor right away.