Dr Marie Tan-Paredes

My Health North Richmond

Level 1, North Richmond Village

6-16 Riverview St

North Richmond

NSW 2754

06.02.2024

Re: Tyminga Dawson (DOB: 26.12.1987)

Dear Dr Tan-Paredes,

Thank you for referring Tyminga Dawson for a GP MHCP in August, 2023 for “opinion and management of depressive symptoms, which had been triggered by her father’s cancer diagnosis in November, 2022 and and his passing in May 2023. I write to provide you with a review for this referral.

Tyminga attended her first appointment of this plan on the 23rd of August, 2023. She had three appointments between then and October, 2023, after which she missed a few appointments. She let me know in November, 2023 that she was “doing ok; was pregnant with twins and had too many appointments” at that time. I have had no further contact with her since then.

Initial Presentation

At the time of her initial consultation, Tyminga reported a deterioration in mood following her father’s diagnosis of cancer in November, 2022. She described it as “a shock”. She was involved with his treatment, taking him to appointments. However, since his death in May, 2023, Tyminga reported dwelling on past difficult life experiences and “replaying events over and over again.” She also had guilt around her availability to be with her son and support her father during his illness and the medical choices that her father preferred and compromises he had to make.

Symptoms included low mood and irritability. Tyminga also had anger that her father had died so young, when other people got to live longer lives. She reported bouts of excessive crying and wanting to withdraw from people. Attending work was difficult due to heightened emotions. She reported episodes of anxiety, rising to panic when in public places, with a need to “get out”. Tyminga also reported feeling overwhelmed dealing with her bereavement and 1 year old child.

Medication

No psychotropic medication

Supports

Lives with husband and one-year-old child.

Her sister is a strong support.

Works part-time doing admin for concreting firm. Had returned to full-time work in October, 2023.

Past medical history

No previous mental health history or physical health history.

Reaction to Covid vaccine – “dizziness; couldn’t walk; dyspnoea; numbness and tingling down left side; increased WBC and cardiac issues” GP transferred care to ED; Pfizer allergy put on medical records.

Allergic to bees.

IVF treatment to conceive first child.

Family history

Brother: depression

MGM: ? borderline personality disorder.

Maternal uncle: schizophrenia; drug induced psychosis

Sister: mood dysregulation/? Bipolar disorder

Update

Tyminga reported significant improvement following her first appointment. She stated that she felt much calmer and happier and her anxiety had decreased. She missed the next few appointments, due to other life commitments.

At the end of September, Tyminga reported that she had had an embryo transfer, which had been successful. She is currently pregnant with twins.

In October, Tyminga reported that she was “doing ok. I’m trying to come to terms with it all.” In November, she advised that she had a lot of other appointments to do with the pregnancy, and will get back in touch should she need to resume therapeutic support.

Formulation:

35 year old Caucasian employed female, living with husband and one-year-old son, presenting with low mood and anxiety following the death of her father in May 2023.

Impression:

Bereavement, resolving.

Plan

Close referral.

Should Tyminga need further support at another time, I would be happy to see her.

Yours sincerely,

Michelle Hookham