placed on as required Clonazepam.
His mental status improved, and he became stable as at his review on 10 December 2013. On
11 December of 2014 he reported that he was under a lot of stress at work and that he has not
been on his medication for about a month prior to the review as he had ran out of the
prescription. He spoke about his temper and anger problems and the escalation of his use of
Cannabis which he believed helped to control his anger. He does not see any relationship
between his use of Cannabis and behaviour and mental state. He understood that Cannabis use
can cause behavioural change, suspiciousness, nervousness, abnormal thoughts, paranoia and
episodes of anxiety that resemble panic attack, according to Health Canada.
During his visit on 12 March 2015, he complained about his frustrations, recurrent trouble at
work, anger problems and road rage. He said he was encouraged to see his EFAB [sic] for
psychotherapy by the management at work. He admitted that he had seen a psychologist and
other therapist in the past for his mood and anger problems. He began to miss work and in April
2015, he complains about management style at work. He said he was struggling to conform to
their new management style. On 26 August of 2015, he said that on the month of the
anniversary of his father’s death, his dog died. He said that his mother who had dementia was
awaiting placement for a nursing home, and that he was being called every time to help make
decisions. He was feeling overwhelmed not just about his family problems but also work-related
issues. On 19 October 2015, he presented very depressed and anxious, which promoted me to
give him sick leave. He remained unstable as of November 30, 2015 and had to be sent to
psychotherapy even though he had declined to attend therapy in the past due to his previous
experiences.
On February 2 of 2016, we felt that he was recovering and needed to go back to work in a
graded fashion, but he chose to return to full-time work on 15 February of 2016. It was his
decision to return full-time work. From experience, having been out of work for such a long time,
it would be a struggle for anyone to get into the new politics, style and structure of work that he
or she could have been alien to, without being gradually introduced to it.
I am not privy to what happened to him at work on 17 February 2016 or his relationship with his
supervisor’s [sic] or colleagues.
To answer your question, being aggressive and belligerent is not a future [sic] of anxiety disorder
or major depressive disorder or combination of both, but it is important to note that many
individuals with depression that is comorbid with anxiety reports or exhibits irritability, e.g.,
persistent anger, a tendency to respond to events with angry outbursts or blaming others, an
exaggerated sense of frustration over minor matters.
It would be difficult to determine if the said behaviour which he exhibited prior to his dismissal
was due to his anxiety, major depressive disorder, Cannabis use or exclusively anger
management issues, knowing that, he has had these issues for many years and has been on
treatment both with the use of medication and psychotherapy and at the same time was able to
maintain his job for the same company for the past number of years, in excess of 20 years.
Should he return to work, I suggest that he takes his medication regularly, attends counselling
and stops the use of Cannabis at least during the day. He would require a gradual return to
work, which will help him get used to work and relationship at work.
AB’s general practitioner referred AB to Dr. O because he was struggling with anxiety
and anger problems. AB has been on mediation as well. One medication reduces
anxiety and agitation in case he has anxiety. It helps to decrease anxiety and is taken
as needed. Another medication is taken every day for anxiety and depression.
What Dr. O has been told about the February 17, 2016 incident is hearsay. Dr. O
doesn’t remember if SaskPower contacted him about the return to work and he doesn’t
have anything in his records.
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