Marlow Reyes

Baseline Intake Outline / First Visit

Opening rapport notes: Marlow arrived twelve minutes early and stayed close to the door for the first part of the visit. Thanked me for the short wait and said that asking for help had taken "about a year of thinking about it".

Presenting concerns (in the client's own words): Describes being "wound up from the second I wake up" and reports three episodes in the past fortnight where the chest tightened enough to pull the car over. Says the worry "doesn't attach to anything in particular, it just runs."

Emotional and physical symptom check: Persistent worry for roughly seven months, sharper since a change of duties at work in March. Sleep onset delayed by 60–90 minutes on most nights, with waking at 4–5 AM and no return to sleep on four of the last seven nights. Appetite reduced — the midday meal is skipped on most weekdays, usually because it is forgotten rather than avoided. Three panic-type episodes in the past fortnight lasting 8–12 minutes, each with chest tightness, shallow breathing and shaking that carried on for close to an hour afterwards. Jaw clenching on waking and headaches through the first half of the morning. Caffeine steady at about four cups daily, unchanged since last year.

Brief life context: Works as a warehouse scheduler on a rotating roster and calls the shift pattern "the part I can't fix". Shares a flat with the same housemate for two years; contact described as friendly but not close. Family live interstate and calls have thinned out since the move, which Marlow attributes to not wanting to worry them rather than to distance.