1. ANXIETY DISORDERS

2. Definition  filled with exaggerated worry and tension even though there is little or nothing to provoke it.  Anticipate disaster  Overly concerned about health issues, money, family, difficulties at work  Getting through the day causes anxiety

3. 4 Types of Anxiety Disorders:  Phobia-intense, irrational fear of an object or situation that is not likely to be dangerous  Specific Phobia-fear and avoidance of heights, blood, animals, automobile or air travel  Social Phobias-anxiety about being negatively evaluated by others (fear of eating in front of others)  Agoraphobia-strong fear of being away from a safe place

4. Diagnosis  Worries excessively about a variety of everyday problems for at least 6 months  Can’t relax, startles easily, difficulty concentrating  Anxiety is more intense than the situation warrants  Trouble falling asleep

5. Physical Symptoms  Fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritable, sweaty, nausea, light headedness, frequent trips to the bathroom, feeling out of breath, hot flashes  The level of anxiety determines functionality

6. Social Phobia (Social Anxiety Disorder)  overwhelmingly anxious and excessively self conscious in everyday social situations.  Intense, persistent, and chronic fear of being watched and judged by others and of doing things that will embarrass them.

7.  A student won’t attend her university classes on the first day because she knows that in some classes the professor will instruct them to go around the room and introduce themselves. Just thinking about sitting there, waiting to introduce herself to a roomful of strangers who will be staring at her makes her feel nauseous…..The anxiety is just too much to bear -- so she skips the first day of class to avoid the possibility of having to introduce herself in public.  To the person with social anxiety, going to a job interview is pure torture…..You’ll look funny, you’ll be hesitant, maybe you’ll even blush, and you won’t be able to find the right words to answer all the questions. It is especially frustrating because you know you could do the job well if you could just get past this terrifying and intimidating interview.  A man hates to go to work because a meeting is scheduled the next day…. Just the thought of speaking in front of co-workers raises his anxiety. Sometimes he can’t sleep the night before because of the anticipatory anxiety that builds up. Finally, the meeting is over. A big wave of relief spills over him as he begins to relax. But the memory of the meeting is still uppermost in his mind. He is convinced he made a fool of himself and that everyone in the room saw how afraid he was when he spoke and how stupid he acted in their presence.

8. info  Social Phobia affects about 15 million American adults.  Women and men are equally likely to develop the disorder which usually begins in childhood or early adolescence.  There is some evidence that genetic factors are involved.  Social Phobia is often accompanied by other anxiety disorders or depression and substance abuse may develop if people try to self medicate their anxiety.

9. Info  Social Phobia can be limited to one situation ( such as talking to people, eating or drinking, or writing on a blackboard in front of others) or may be so broad (such as in generalized social phobia) that the person experiences anxiety around almost anyone other than family.  Physical symptoms: blushing, profuse sweating, trembling, nausea, and difficulty talking.

10. Other Facts  Affects 6.8 million adults, twice as many women than men  Disorder comes on gradually, risk is highest between childhood and middle age  Must spend 6 months worrying excessively about a number of everyday problems  Genes could play a role  GAD could be accompanied by other anxiety disorders, depression or substance abuse  Gad rarely occurs alone  Medication or Cognitive Behavior Therapy most affective

12. Panic Disorder  Sudden attacks of terror, accompanied by a pounding heart, sweatiness, weakness, faintness or dizziness  During an attack: flushed or feel chilled, hands tingle or feel numb, nausea or chest pain or a smothering sensation  Creates a sense of unreality impending doom, or a fear of losing control

13. Info  Believe they are having a heart attack, losing their mind, or on the verge of death  May worry intensely and dread the next attack  Occurs at anytime, even sleep  Peaks after 10 minutes, symptoms may last much longer

14. Other Facts  Affects about 6 million American adults twice as common in women than men  Begins in late adolescence or early adulthood  Not all who experience panic attacks will develop Panic Disorder  Appears to be inherited  People who have full blown attacks should seek help before they start avoiding places or situations where attacks may occur.  Example: panic attack in elevator, what would it affect?

15. Other facts  A third of the people who have panic disorder become homebound unless they are able to confront a fear with a trusted person, if the disease progresses it becomes agoraphobia or a fear of open spaces  Early treatment can often prevent agoraphobia, but sometimes people are bounced around so much that they are diagnosed too late to seek treatment  Considered one of the most treatable anxiety disorders  Also accompanied by other serious problems: depression and substance abuse (drugs and alcohol)

17. Obsessive-Compulsive Disorder  People with OCD have persistent, upsetting thoughts (obsessions) and use rituals (compulsions) to control the anxiety these thoughts produce. Most of the time the rituals end up controlling them.  Example: obsessed with germs, compulsion is washing their hands over and over again, performing a ritual like this is not pleasurable, at best, it produces temporary relief from the anxiety created by obsessing thoughts.

19. Info  Rituals: Need to repeatedly check things, touch things, or count things.  Common Obsessions: frequent thoughts of violence and harming loved ones, persistently thinking about performing sexual acts the person dislikes, or having thoughts that are prohibited by religious belief.  Preoccupied with order and symmetry, have difficulty throwing things out or hoard unneeded items.

20. info  Healthy people also have rituals, the difference is people with OCD perform their rituals even though doing so interferes with daily life and they find the repetition distressing.  Most adults with OCD recognize what they are doing is senseless, some adults and most children may not realize that their behavior is out of the ordinary.

21. info  OCD affects about 2.2 million American adults. Problem can be accompanied by: eating disorders, other anxiety disorders, or depression.  Affects both men and women equally and usually surfaces in childhood, adolescence, or early adulthood.  One third of adults with OCD develop symptoms as children, and research indicates that OCD might run in families  Symptoms may come or go, ease over time, or get worse  If OCD become severe it may keep a person from working or carrying out normal responsibilities at home.  People with OCD may avoid situations that cause the obsessions or they may use drugs or alcohol to calm themselves  OCD usually responds well to treatment with certain medications, or exposure –based psychotherapy, in which people face situations that cause fear or anxiety and become less sensitive to them.

22. Post-Traumatic Stress Disorder (PTSD)  Develops after a terrifying ordeal that involved physical harm or the threat of physical harm. The person who develops PTSD may have been the one who was harmed, the harm may have happened to a loved one, or the person may have witnesses a harmful event that happened to loved ones or strangers.

23. 2004 New England Journal of Medicine

24. info  They can worry for days or weeks before a dreaded situation, this fear may become so severe that it interferes with work, school, and other ordinary activities, can become hard to make and keep friends.  Many people with Social phobia realize their fears to be excessive and unreasonable that are unable to overcome the fear.  Even if they manage to confront their fears and be around others they are usually very anxious beforehand, and intensely uncomfortable throughout the encounter, and worry about how they were judged for hours afterwards.

25. Info  PTSD was first brought to public attention in relation to war veterans, but it can result from a variety of traumatic events, such as a mugging, rape, torture, kidnapping, or being held captive, child abuse, car accidents, train wrecks, plane crashes, etc.  Symptoms: startle easy, become emotionally numb, and lose interest in things they used to enjoy, be irritable, and become more aggressive or even violent.  PTSD symptoms seem to be worse if the event that triggered them was deliberately initiated by another person, as in a mugging or kidnapping.  Most people with PTSD relive the trauma during the day and in nightmare when they sleep

26. info  Known as flashbacks (images, sounds, smells, or feelings) the person may lose touch with reality and believe that the traumatic event is happening all over again.  Not every traumatized person develops the disorder or even minor PTSD, symptoms usually begin within 3 months of the event but occasionally emerge years after.  They must last more than a month to be considered PTSD.  The course of the illness varies, some people recover within 6 months, while others have symptoms that last much longer, in some the condition becomes chronic  PTSD affects about 7.7 million American adults, but it can occur at any age, including childhood.

27. Info  Women are more likely to develop PTSD than men, and there is some evidence that susceptibility to the disorder may run in families.  PTSD is often accompanied by depression, substance abuse, or one or more of the other anxiety disorders.  Medications and psychotherapy are preferred treatments.