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August 4, 2026

Depression, Anxiety, Substance Use, and Chronic Pain CASE STUDY 4

Ms. R.D. is a 45-year-old female presenting with insomnia, fatigue, chronic low back pain, and mood changes.History

PMH: Chronic pain, prior opioid exposure
Reports alcohol use nightly
PHQ-9: 17, GAD-7: 15
Student Assignment Requirements
1. Pathophysiology (25%)
Neurobiology of depression and anxiety
Substance use impact on CNS
Pain–mood interaction
2. Mental Health Assessment (35%)
Diagnostic differentiation
Suicide risk screening
Substance use screening
Safety planning
3. Pharmacology & Integrated Treatment (30%)
Antidepressant selection and titration
Avoidance of high-risk medications
Non-pharmacologic and referral planning
4. APA & Evidence Use (10%)
RUBRIC – CASE STUDY 4 – Mental Health, Substance Use & Chronic Pain (100 Points)

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