Assessment of Mr. James condition-

Mr. James is showing signs and symptoms of panic disorder with agoraphobia. There are high incidence and prevalence of panic disorder with agoraphobia which is usually associated with increased risk of psychiatric morbidity in the form of depression; suicide; alcohol/substance abuse; minor tranquilizer addiction; generalized anxiety disorder; social, simple, and sexual phobias; and impaired social, marital, and vocational functioning (Markowitz, Weissman, Ouellette, Lish & Klerman, 1989). Such patients with panic disorder usually experience sudden and repeated attacks of severe anxiety or fear which can last up to several minutes. The symptoms can be so strong and may resemble to heart attack (Hatfield R.C., 2014). Mr,. James had similar strong feeling of heart attack when he experienced the panic attack. These attacks can occur at anytime, anywhere and therefor such patients tend to worry so much about such panic episodes that it affects their normal social life and can lead to isolation (Hatfield R.C., 2014). Similar way, Mr. James is getting isolated from the society due to fear of having panic attack in public place.
Psychological disorders are usually run in a family. Patients usually have one or more relatives who are having any kind of psychiatric disorder (Hatfield R.C., 2014). In a similar way, patient of panic disorder with agoraphobia usually have someone in family who is having or had such disorder. In case of Mr, James, the family history shows that his mother and his ant had this disorder. Even his ant was isolated for 7 years because of this condition. It’s clear from his family history that genetic is main factor for developing this condition. Other important aspect is surrounding environment. The surrounding environment has both positive and negative impact on person’s mental status (Hatfield R.C., 2014). In case of Mr. James, his wife is also experiencing psychiatric disorder i.e. depression and is on SSRI. Even his all 3 sons are also experiencing sort of psychological disturbance. The stress originated from such environment is another pre-disposing factor for developing PD with agoraphobia in Mr. Jame.