Anxiety Disorders

What is anxiety?

 Generalized Anxiety Disorder  Panic Disorder  Social Anxiety Disorder  Agoraphobia  Specific Phobias – Fear vs. Phobia  Obsessive-Compulsive Disorder  Post-Traumatic Stress Disorder

Did You Know?  Anxiety disorders are the most common mental illness in the U.S.  1/3 of our country's total mental health bill goes towards the treatment of anxiety disorders (= $42 billion a year)  Anxiety disorders are highly treatable, yet only about 1/3 of those suffering receive treatment  People with anxiety disorders often seek relief for symptoms that mimic physical illnesses, not realizing that anxiety is the underlying cause

Generalized Anxiety Disorder What’s the difference between worrying and GAD?

“I always thought I was just a worrier. I’d feel nervous and unable to relax. At times it would come and go, and at times it would be constant. I was worried all the time about everything. It didn't matter that there were no signs of problems, I just got upset. I was having trouble falling asleep at night, and I couldn't keep my mind focused at school. I just couldn’t let something go.”

“I’d have terrible sleeping problems. There were times I’d wake up wired in the middle of the night. I had trouble concentrating, even reading a book or newspaper article. Sometimes I’d feel a little lightheaded. My heart would race or pound - and that would make me worry even more. I was always imagining things were worse than they really were.”

Signs & Symptoms  Can’t stop or control worries or concerns  Inability to relax  Easily startled/difficulty concentrating  Difficulty falling asleep or staying asleep  Fatigue  Headaches  Muscle tension and aches  Difficulty swallowing  Trembling or twitching  Irritability  Sweating, nausea, and lightheadedness  Severe GAD can be debilitating

Think about your life… On a scale from 1 – 10 (1 being never and 10 being always), how anxious would you say you are? What are your top 3 triggers of anxiety? What worries you or makes you nervous? What are some strategies you could use to manage anxiety?

Who Gets GAD?  GAD affects about 18% of American adults (40 million people)  The average age of onset is 31 years old, although worrying/ habits may begin in teenage years and gradually get worse over time  Women are 2 x more likely to experience GAD than men  GAD is diagnosed when a person worries excessively about a variety of everyday problems for at least 6 months

Panic Disorder Panic disorder is diagnosed in people who experience spontaneous seemingly out-of-the-blue panic attacks and are preoccupied with the fear of a recurring attack. Panic attacks occur unexpectedly, sometimes even during sleep.

"One day, without any warning or reason, I felt terrified. I was so afraid, I thought I was going to die. My heart was pounding and my head was spinning. I would get these feelings every couple of weeks. I thought I was losing my mind.“

"The more attacks I had, the more afraid I got. I was always living in fear. I didn't know when I might have another attack. I became so afraid that I didn't want to leave my house."

Signs & Symptoms  Sudden and repeated attacks of fear  A feeling of being out of control during a panic attack  An intense worry about when the next attack will happen  A fear or avoidance of places where panic attacks have occurred in the past  Physical symptoms during an attack:  pounding or racing heart  sweating  breathing problems/ hyperventilation  weakness or dizziness  feeling hot or a cold chill  tingly or numb hands  chest pain or stomach pain

Who Gets Panic Disorders?  Panic disorders affects about 6 million American adults  Women are 2 x more likely to experience PD than men  Panic attacks often begin in late adolescence or early adulthood, but not everyone who experiences panic attacks will develop panic disorder  Many people have just one attack and never have another  The tendency to develop panic attacks appears to be inherited

People with panic disorder may sometimes go from doctor to doctor for years and visit the emergency room repeatedly before someone correctly diagnoses their condition. This is unfortunate, because panic disorder is one of the most treatable of all the anxiety disorders.

Panic disorder is often accompanied by other serious problems, such as depression, drug abuse, or alcoholism. These conditions need to be treated separately.

Social Anxiety Disorder (Social Phobia) Social phobia can be limited to one situation (such as talking to people or writing on a blackboard in front of others) or may be so broad that the person experiences anxiety around almost anyone other than family.

Signs & Symptoms  Anxious about being around other people  Have a hard time talking to others, even though they wish they could  Very self-conscious in front of other people and often feel embarrassed  Always afraid that other people will judge them  Worry for days or weeks before a social event

 Avoid places where there are other people  Have a hard time making friends and keeping friends  Blush, sweat, or tremble around other people  Feel nauseous or sick to their stomach when with other people

Who Gets SAD?  Social phobia affects about 15 million American adults  Women and men are equally likely to develop the disorder

Agoraphobia Agoraphobia is the fear of public or open SPACES, in the company or absence of other people. People having agoraphobia conditions try to avoid crowds or situations where they fear having a panic attack and getting embarrassed.

Unlike people with social phobia, people having agoraphobia are afraid of being or walking alone because of the fear of not getting any help if they begin to panic. For example: airports, malls

Signs & Symptoms  Fear of being alone in any situation  Fear of being in crowded places  Fear of losing control in a public place  Fear of being in places where it may be hard to leave, such as an elevator or train  Inability to leave your home or only able to leave it if someone else goes with you  Sense of helplessness  Overdependence on others

So what’s the difference between social phobia and agoraphobia?

Fear vs. Phobia Phobias involve the experience of persistent fear that is excessive and unreasonable. Phobias are cued when a person approaches a particular situation or object, or even anticipates the approach of it, and they understand the fear they will experience as a result of that situation will be unreasonable and excessive.

The key to distinguishing a fear from a phobia is that that while most people get the jitters if a spider crawls on their arm, people suffering from arachnophobia -- the fear of spiders -- are physically and/or psychologically impaired by it.

Obsessive Compulsive Disorder (OCD) Obsessive-compulsive disorder is characterized by unreasonable thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). It's also possible to have only obsessions or only compulsions and still have OCD.

With OCD, you may or may not realize that your obsessions aren't reasonable, and you may try to ignore them or stop them. But that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts in an effort to ease your stressful feelings.

OCD obsessions are repeated, persistent and unwanted urges or images that cause distress or anxiety. You might try to get rid of them by performing a compulsion or ritual. These obsessions typically intrude when you're trying to think of or do other things. Obsessions often have themes to them. They are…

Obsessive Compulsive Themes  Washing and cleaning  Counting  Checking  Demanding reassurances  Following a strict routine  Orderliness or arranging objects  Counting in certain patterns  Silently repeating a word or phrase

Symptoms usually begin gradually and tend to vary in severity throughout your life. Symptoms generally worsen when you're experiencing more stress. OCD, considered a lifelong disorder, can be so severe and time-consuming that it becomes disabling. Most adults recognize that their obsessions and compulsions don't make sense, but that's not always the case. Children may not understand what's wrong.

When to Seek Help There's a difference between being a perfectionist and having OCD. OCD thoughts aren't simply excessive worries about real problems in your life. Perhaps you keep the floors in your house so clean that you could eat off them. Or you like your knickknacks arranged just so. That doesn't necessarily mean that you have OCD. If your obsessions and compulsions are affecting your quality of life, see your doctor or mental health provider. People with OCD may be ashamed and embarrassed about the condition, but treatment can help.

Post-Traumatic Stress Disorder (PTSD) Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.

Possible Traumatic Events  Combat exposure  Childhood neglect and physical abuse  Sexual assault  Physical attack  Being threatened with a weapon

Post-traumatic stress disorder symptoms may start within 3 months of a traumatic event, but sometimes symptoms may not appear until years after the event. These symptoms cause significant problems in social or work situations and in relationships. PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, or changes in emotional reactions.

Intrusive Memories  Recurrent, unwanted distressing memories of the traumatic event  Reliving the traumatic event as if it were happening again (flashbacks)  Upsetting dreams about the traumatic event  Severe emotional distress or physical reactions to something that reminds you of the event

Avoidance  Trying to avoid thinking or talking about the traumatic event  Avoiding places, activities or people that remind you of the traumatic event

Negative Changes in Thinking & Mood  Negative feelings about yourself or other people  Inability to experience positive emotions  Feeling emotionally numb  Lack of interest in activities you once enjoyed  Hopelessness about the future  Memory problems, including not remembering important aspects of the traumatic event  Difficulty maintaining close relationships

Changes in Emotional Reactions  Irritability, angry outbursts or aggressive behavior  Always being on guard for danger  Overwhelming guilt or shame  Self-destructive behavior, such as drinking too much or driving too fast  Trouble concentrating  Trouble sleeping  Being easily startled or frightened

When to See a Doctor If you have disturbing thoughts and feelings about a traumatic event for more than a month, if they're severe, or if you feel you're having trouble getting your life back under control, talk to your health care professional. Get treatment as soon as possible to help prevent PTSD symptoms from getting worse.