2Anxiety Anx·i·e·ty (n.) A state of uneasiness and apprehension A state of intense apprehension, uncertainty, and fearA condition of heightened and often disruptive tension
3Anxiety Disorders Generalized Anxiety Disorder (GAD) Social Phobia (or Social Anxiety Disorder)Specific PhobiasPost-Traumatic Stress DisorderObsessive-Compulsive Disorder (OCD)
4Generalized Anxiety Disorder Anxiety is an unsettling feeling of worry, being unsure, and fearWhen anxiety lasts for long periods of time, it is a disorder18% of American adults have anxiety disorders
5Symptoms of GADConstant worrying about everyday things (lasting for 6 mos.)Can’t control worriesKnow they worry more than they shouldCan’t relaxCan’t concentrateTrouble sleeping or falling asleepEasily startled
6Physiological Symptoms FatigueMuscle achesHeadachesTremblingIrritableSweatingDifficulty swallowingFeeling light-headedOut of breathHot flashes
7Treatment of Anxiety Medications Therapy Anti-anxiety medicine AntidepressantsBeta-blockersTherapyIndividualGroup
8Evolutionary Theory of Anxiety Anxieties are naturalHelp people be aware of potentially harmful situationsHelp prepare people for these situationsWhen anxiety occurs without a stressor, and for long periods of time it harms instead of helps
9PhobiasPho·bia (n.)A persistent, irrational, intense fear of a specific object, activity, or situation
10Types of PhobiasSocial PhobiaSpecific PhobiaAgoraphobia
11Social Phobia A strong fear or being judged and embarrassed Fear gets in the way of everyday life, school, and workRecognize fear is unreasonableCan’t control fear
12Common Symptoms Anxious about being with people Extremely self-consciousAfraid of being embarrassedAfraid of being judgedWorry days or weeks before an eventStay away from social settingsDifficulty making and keeping friends
14Specific Phobias 11.5 million adults suffer from phobias 3 main types Situationalflying, driving, tunnels, enclosed spaces, elevatorsObjectAnimal, natural environment, blood-injection-injuryAnimal – animals/insectsNatural – storms, water, heightsBlood, injury, and injectionOthervomiting, choking, clowns, becoming ill, falling down
15Common Specific Phobias Public speakingMiceSnakes and other reptilesSpiders and insectsHeightsDeathClinically, animal fears are found to be most common
16Agoraphobia Fear of unfamiliar places Includes wide open spaces, crowds, traveling, and anywhere from which escape may be difficultSuffer from panic attacks when they feel they aren’t in controlAbout 3.2 million Americans have agoraphobia
17Treatment of Phobias Medications Therapy Anti-anxiety medicine AntidepressantsBeta-blockersTherapyIndividualGroupBehaviorVirtual
18Evolutionary Theory of Phobias Fear alerts people to danger and prepares their bodies to handle the situation, hopefully keeping them safeFear which occurs without a stimulus impedes life without being helpfulConstant fear interrupts people’s normal lives
19PTSDPosttraumatic Stress Disorder is an anxiety disorder that develops after exposure to a terrifying or traumatic event where severe physical harm was inflicted or threatenedTraumatic events include: assault, rape, car accidents, child abuse, kidnapping, bombing, natural disasters, military combat, etc.One can suffer from PTSD after witnessing, being the victim, or being close to the victim
20Symptoms of PTSD Startle easy Become emotionally numb, with family and friendsIrritableBecome aggressive or violentHave trouble being affectionateAvoid situations that may remind them of the traumatic incidentReliving the trauma in flashbacks, during the day or in nightmares
21PTSDOnset of symptoms is usually within three months of the trauma, but it can be as late as a year after the traumaThe symptoms must last at least a month to be diagnosed as PTSDRecovery can happen in six months with proper treatment but can last a lot longer, or even become chronic7.7 million Americans suffer from PTSDPTSD can affect children and adultsPTSD patients may also suffer from depression, substance abuse, or another anxiety disorder
22Treatment of PTSD Medications Psychotherapy Exposure therapy – exposed to the trigger and desensitize the patientVirtual reality treatments – similar to the technology used with phobias
23Evolutionary Theory of PTSD Flight is a common symptom in PTSDleaving a situation that is thought to be threateningthis is an adaptation– predator avoidance is less dangerous than predator confrontationVigilance is one of the symptoms of PTSDthis is just being wary and watchful of different situations and their potential threatsRe-experiencing the memory is going to promote the flight reflex to avoid the previously traumatic experienceAlthough memories may intensify over time, the phenomenon of re-experiencing events seems to fade once the avoidance/defense behavior is reinforcedPTSD is based on fear, rather than emotion – thus motivates action
24How can PTSD be adaptive A small dose of vigilance, avoidance, flight, etc. is always going to promote survivalthere are varying degrees of PTSDMaladaptations are always adaptations at some pointfor example aggression is favorable during wartime but not so much during peacetimePTSD and being overly cautious is favorable in times of high risk and dangerIn war-time or during a natural disaster your kin will be safer by keeping them more protectedusing avoidance, flight, etc.
26Video Clip of OCDOCD – As OCD As It Gets – 1:06 minutesOCD
27Obsessive-Compulsive Disorder Obsessive-Compulsive Disorder or OCD is an anxiety disorder characterized by frequent, unwanted thoughts, obsessions, and/or repeating specific behaviors, compulsionsRepeated behaviors can include: hand washing, counting, checking, cleaning, etc.These behaviors are performed with the hope of relieving or alleviating the obsessive thoughtsNot performing these rituals causes intense anxiety
28Obsessive-Compulsive Disorder It affects approximately 2.2 million American adultsCan and frequently is coupled with another mental disordersuch as an eating disorder, another anxiety disorder, or depressionOnset during adolescence or early adulthoodThe disease can come and go over timeIt can get better or worsen as a person gets olderSevere OCD can keep people from functioning in their daily livesResearch indicates that OCD runs in families
29Symptoms of OCD Symptoms are Obsessions – frequent, unwelcome thoughts that will not go awayObsession: germs or dirtObsession: securityCompulsions – repetitive behavior that is thought to relieve the anxiety and/or obsessionsCompulsion: excessive and repetitive hand washingCompulsion: checking many times to make sure the door is locked
30Treatment of OCD Personal treatments Clinical treatments People with OCD are likely to try to self-medicate with drugs or alcoholThey will try to avoid situations that trigger their obsession or compulsionsClinical treatmentsMedicationExposure-based psychotherapy – desensitizing them to the anxiety-producing situationNew treatments – deep brain stimulation
31Evolutionary Theory of OCD Most symptoms of OCD revolve around safety, security, and/or preservation of self and/or othersOCD as a symptom of a security motivational system – although security is not officially recognized as one of the five motivations it is an intrinsic needSecurity is a “special motivation” – motivation based on a biologically primitive need
32Evolutionary Theory of OCD OCD sufferers are constantly assessing and processing potential danger – with a slight threat the defense system is activated and is slow to deactivateFavors action – being proactive to avoid the predator – predators rely on the element of surprise – so gathering information and being constantly alert diminishes or eliminates this elementPrevention – being prepared and avoiding the threatening situationsMost of the symptoms of OCD are security behaviors – like cleansing, checking, or hoardingCleansing – teratogens, spice hypothesis, germs, etc.Checking – security, safety of kinHoarding – in case of food shortage, famine, or natural disaster
33Evolutionary Theory of OCD Overexposure and ProtectionChildhood – two extremesHighly protected during their childhood, seen the world from a distance, hold onto their parents, fear, a lot of restrictionsTaught to fear the outside world and thus they do not feel like they are in a safe environment, OCD developsVery permissive experience – parents allowed them to do a lot of things very early in life, over stimulated, were not equipped to handle all their experiencesLack of a safe and secure environment – thus the obsessive and compulsive behavior creates a sense of security
37Signs and SymptomsMemory loss (amnesia) of certain time periods, events and peopleMental health problems, including depression and anxietyA sense of being detached from yourself (depersonalization)A perception of the people and things around you as distorted and unreal (derealization)A blurred sense of identity
38Dissociative AmnesiaMemory loss that's more extensive than normal forgetfulness and can't be explained by a physical or neurological condition.Sudden-onset amnesia following a traumatic event, such as a car accident, happens infrequently.More commonly, conscious recall of traumatic periods, events or people in your life — especially from childhood — is simply absent from your memory.
39Dissociative Identity Disorder Formerly known as multiple personality disorder, is characterized by "switching" to alternate identities when you're under stress.You may feel the presence of one or more other people talking or living inside your head.Each of these identities may have their own name, personal history and characteristics, including marked differences in manner, voice, gender and even such physical qualities as the need for corrective eyewear.
40Dissociative Identity Disorder Considerable variation in each alternate personality's familiarity with the others.People with DID typically also have dissociative amnesia.Edward Norton in Primal FearMartin meets Roy (DID)
41Dissociative FuguePeople with this condition dissociate by putting real distance between themselves and their identity.For example, you may abruptly leave home or work and travel away, forgetting who you are and possibly adopting a new identity in a new location.Typically retain all their faculties and may be very capable of blending in wherever they end up.
42Dissociative FugueA fugue episode may last only a few hours or, rarely, as long as many months.Ends as abruptly as it begins.May feel intensely disoriented, depressed and angry, with no recollection of what happened
43Depersonalization Disorder Characterized by a sudden sense of being outside yourself, observing your actions from a distance as though watching a movie.Distortion of the size and shape of your body or of other people and objects around you.Time may seem to slow down, and the world may seem unreal.Symptoms may last only a few moments or may last over many years.
44Causes Develop as a mechanism for coping with trauma. Often form in children subjected to chronic physical, sexual or emotional abuse or a home environment that is otherwise frightening or highly unpredictable.A child is more able than is an adult to step outside herself or himself and observe trauma as though it's happening to a different person.
45More CausesA child who learns to dissociate in order to endure an extended period of his or her youth may reflexively use this coping mechanism in response to stressful situations throughout life.Adults rarely develop dissociative disorders in response to severe trauma
46RisksPeople who experience chronic physical, sexual or emotional abuse during childhood are at greatest risk of developing dissociative disorders.Children and adults who experience other traumatic events, including war, natural disasters, kidnapping, torture and invasive medical procedures also may develop these conditions.
47PreventionIf stress or other personal issues are affecting the way you treat your child, seek help.Talk to a trusted person such as a friend, your doctor or a leader in your faith community.Ask for help locating resources such as parenting support groups and family therapists.Parenting classes may help you learn a healthier parenting style.If your child has been abused or has experienced another traumatic event, see a doctor immediately.Your doctor can refer you to mental health professionals who can help your child recover and adopt healthy coping skills.
48DiagnosisDoctors diagnose dissociative disorders based on a review of your symptoms and your personal history.Perform tests to rule out physical conditions that can cause symptoms such as memory loss and a sense of unreality.If your doctor rules out physical causes, he or she will likely refer you to a mental health professional for an in-depth interview.To help diagnose dissociative identity disorder, some doctors use medication or hypnosis.Helps identify alternate personalities or may help you describe repressed memories
49TreatmentPsychotherapy is the primary treatment for dissociative disorders.Involves talking about your disorder and related issues with a mental health professional.Your therapist will work to help you understand the cause of your condition and to form new ways of coping with stressful circumstances.Psychotherapy often involves techniques, such as hypnosis, that help you remember and work through the traumaThe course of your psychotherapy may be long and painful, but this treatment approach often is very effective in treating dissociative disorders.
50More Treatment Creative art therapy. Cognitive therapy. Medication. Uses the creative process to help people who might have difficulty expressing their thoughts and feelings.Helps you increase self-awareness, cope with symptoms and traumatic experiences, and foster positive changes.Includes art, dance and movement, drama, music and poetry.Cognitive therapy.Helps you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones.It's based on the idea that your own thoughts — not other people or situations — determine how you behave.Even if an unwanted situation has not changed, you can change the way you think and behave in a positive way.Medication.Your doctor may prescribe antidepressants, anti-anxiety medications or tranquilizers to help control the mental health symptoms