ANXIETY DISORDERS PDF
Anxiety disorders: an information guide: a guide for people with anxiety and their families / Neil A. isbn: (pdf) isbn: anxiety disorder? Anxiety is a term used to describe a normal feeling people experience when faced with threat, danger, or when stressed. When people. What Are Anxiety Disorders? Individuals with anxiety disorders experience excessive anxiety, fear or worry, causing them either to avoid situations that might .
|Language:||English, Spanish, Indonesian|
|ePub File Size:||20.77 MB|
|PDF File Size:||11.41 MB|
|Distribution:||Free* [*Regsitration Required]|
Anxiety disorders - your guide. Key facts. • It's normal and healthy to feel anxious sometimes. Anxiety actually helps us. It makes us alert and helps us do things. anxiety disorders info sheets ppti.info Suddenly your heart is racing, palms are sweaty, stomach's churning. Your muscles are tense and. Anxiety Disorders. Everyone experiences anxiety. However, when feelings of intense fear and distress are overwhelming and prevent us from doing everyday .
What is anxiety? Disproportionate reactions of tension and worry characterize anxiety. The American Psychological Association APA defines anxiety as "an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure.
In this article, we look at the differences between anxiety and anxiety disorder, the different types of anxiety, and the available treatment options. When does anxiety need treatment?
While anxiety can cause distress, it is not always a medical condition.
Anxiety When an individual faces potentially harmful or worrying triggers, feelings of anxiety are not only normal but necessary for survival. Since the earliest days of humanity, the approach of predators and incoming danger sets off alarms in the body and allows evasive action. These alarms become noticeable in the form of a raised heartbeat, sweating, and increased sensitivity to surroundings.
The danger causes a rush of adrenalin, a hormone and chemical messenger in the brain, which in turn triggers these anxious reactions in a process called the "fight-or-flight' response.
This prepares humans to physically confront or flee any potential threats to safety. For many people, running from larger animals and imminent danger is a less pressing concern than it would have been for early humans. Anxieties now revolve around work, money, family life, health, and other crucial issues that demand a person's attention without necessarily requiring the 'fight-or-flight' reaction.
The nervous feeling before an important life event or during a difficult situation is a natural echo of the original 'fight-or-flight' reaction. It can still be essential to survival — anxiety about being hit by a car when crossing the street, for example, means that a person will instinctively look both ways to avoid danger.
Anxiety disorders The duration or severity of an anxious feeling can sometimes be out of proportion to the original trigger, or stressor. Physical symptoms, such as increased blood pressure and nausea, may also develop.
These responses move beyond anxiety into an anxiety disorder. The APA describes a person with anxiety disorder as "having recurring intrusive thoughts or concerns. Symptoms While a number of different diagnoses constitute anxiety disorders, the symptoms of generalized anxiety disorder GAD will often include the following: restlessness, and a feeling of being "on-edge" uncontrollable feelings of worry concentration difficulties sleep difficulties, such as problems in falling or staying asleep While these symptoms might be normal to experience in daily life, people with GAD will experience them to persistent or extreme levels.
GAD may present as vague, unsettling worry or a more severe anxiety that disrupts day-to-day living. For information on the symptoms of other diagnoses under the umbrella of anxiety disorders, follow the links in the "Types" section below. Types Panic disorder is a type of anxiety disorder.
However, the manual now no longer groups these mental health difficulties under anxiety. Anxiety disorders now include the following diagnoses.
Generalized anxiety disorder: This is a chronic disorder involving excessive, long-lasting anxiety and worries about nonspecific life events, objects, and situations. GAD is the most common anxiety disorder, and people with the disorder are not always able to identify the cause of their anxiety. Panic disorder: Brief or sudden attacks of intense terror and apprehension characterize panic disorder. These attacks can lead to shaking, confusion, dizziness, nausea, and breathing difficulties.
Panic attacks tend to occur and escalate rapidly, peaking after 10 minutes. However, a panic attack might last for hours. Panic disorders usually occur after frightening experiences or prolonged stress but may also occur without a trigger. An individual experiencing a panic attack may misinterpret it as a life-threatening illness, and may make drastic changes in behavior to avoid future attacks.
Click here to learn more about panic disorder and panic attacks. Specific phobia: This is an irrational fear and avoidance of a particular object or situation. Phobias are not like other anxiety disorders, as they relate to a specific cause.
A person with a phobia might acknowledge a fear as illogical or extreme but remain unable to control feelings anxiety around the trigger.
Triggers for a phobia range from situations and animals to everyday objects. Click here to learn more about phobias and how they develop. Agoraphobia: This is a fear and avoidance of places, events, or situations from which it may be difficult to escape or in which help would not be available if a person becomes trapped. People often misunderstand this condition as a phobia of open spaces and the outdoors, but it is not so simple.
A person with agoraphobia may have a fear of leaving home or using elevators and public transport. Click here to learn about agoraphobia, an often-misunderstood psychological disorder. Selective mutism: This is a form of anxiety that some children experience, in which they are not able to speak in certain places or contexts, such as school, even though they may have excellent verbal communication skills around familiar people.
It may be an extreme form of social phobia. Social anxiety disorder, or social phobia: This is a fear of negative judgment from others in social situations or of public embarrassment. Social anxiety disorder includes a range of feelings, such as stage fright, a fear of intimacy, and anxiety around humiliation and rejection.
Anxiety disorders can arise in response to life stresses such as financial worries or chronic physical illness. Anxiety among adolescents and young adults is common due to the stresses of social interaction, evaluation, and body image. Anxiety is also common among older people who have dementia. On the other hand, anxiety disorder is sometimes misdiagnosed among older adults when doctors misinterpret symptoms of a physical ailment for instance, racing heartbeat due to cardiac arrhythmia as signs of anxiety.
GAD runs in families and is six times more common in the children of someone with the condition. While anxiety arose as an adaptation, in modern times it is almost always thought of negatively in the context of anxiety disorders. People with these disorders have highly sensitive systems; hence, their systems tend to overreact to seemingly harmless stimuli.
Sometimes anxiety disorders occur in those who have had traumatic youths, demonstrating an increased prevalence of anxiety when it appears a child will have a difficult future. At a low level, anxiety is not a bad thing.
In fact, the hormonal response to anxiety has evolved as a benefit, as it helps humans react to dangers. Researchers in evolutionary medicine believe this adaptation allows humans to realize there is a potential threat and to act accordingly in order to ensure greatest possibility of protection.
It has actually been shown that those with low levels of anxiety have a greater risk of death than those with average levels. This is because the absence of fear can lead to injury or death. It has been theorized that high rates of anxiety are a reaction to how the social environment has changed from the Paleolithic era.
For example, in the Stone Age there was greater skin-to-skin contact and more handling of babies by their mothers, both of which are strategies that reduce anxiety.
Researchers posit that the lack of constant social interaction, especially in the formative years, is a driving cause of high rates of anxiety. Many current cases are likely to have resulted from an evolutionary mismatch , which has been specifically termed a "psychopathogical mismatch".
In evolutionary terms, a mismatch occurs when an individual possesses traits that were adapted for an environment that differs from the individual's current environment. For example, even though an anxiety reaction may have been evolved to help with life-threatening situations, for highly sensitized individuals in Westernized cultures simply hearing bad news can elicit a strong reaction.
An evolutionary perspective may provide insight into alternatives to current clinical treatment methods for anxiety disorders. Simply knowing some anxiety is beneficial may alleviate some of the panic associated with mild conditions.
Some researchers believe that, in theory, anxiety can be mediated by reducing a patient's feeling of vulnerability and then changing their appraisal of the situation. Low levels of GABA , a neurotransmitter that reduces activity in the central nervous system, contribute to anxiety.
A number of anxiolytics achieve their effect by modulating the GABA receptors. Selective serotonin reuptake inhibitors , the drugs most commonly used to treat depression, are frequently considered as a first line treatment for anxiety disorders. The amygdala is central to the processing of fear and anxiety, and its function may be disrupted in anxiety disorders.
The basolateral complex processes sensory-related fear memories and communicates their threat importance to memory and sensory processing elsewhere in the brain, such as the medial prefrontal cortex and sensory cortices. Another important area is the adjacent central nucleus of the amygdala, which controls species-specific fear responses, via connections to the brainstem , hypothalamus , and cerebellum areas.
In those with general anxiety disorder, these connections functionally seem to be less distinct, with greater gray matter in the central nucleus. Another difference is that the amygdala areas have decreased connectivity with the insula and cingulate areas that control general stimulus salience, while having greater connectivity with the parietal cortex and prefrontal cortex circuits that underlie executive functions. The latter suggests a compensation strategy for dysfunctional amygdala processing of anxiety.
Researchers have noted "Amygdalofrontoparietal coupling in generalized anxiety disorder patients may Clinical and animal studies suggest a correlation between anxiety disorders and difficulty in maintaining balance.
Anxiety processing in the basolateral amygdala has been implicated with dendritic arborization of the amygdaloid neurons. SK2 potassium channels mediate inhibitory influence on action potentials and reduce arborization. By overexpressing SK2 in the basolateral amygdala, anxiety in experimental animals can be reduced together with general levels of stress-induced corticosterone secretion.
Joseph E. LeDoux and Lisa Feldman Barrett have both sought to separate automatic threat responses from additional associated cognitive activity within anxiety. Anxiety disorders are often severe chronic conditions, which can be present from an early age or begin suddenly after a triggering event. They are prone to flare up at times of high stress and are frequently accompanied by physiological symptoms such as headache , sweating , muscle spasms , tachycardia , palpitations , and hypertension , which in some cases lead to fatigue.
In casual discourse the words "anxiety" and "fear" are often used interchangeably; in clinical usage, they have distinct meanings: The diagnosis of anxiety disorders is difficult because there are no objective biomarkers , it is based on symptoms,  which typically need to be present at least six months, be more than would be expected for the situation, and decrease functioning. The fact that there is considerable overlap between symptoms of anxiety and depression, and that the same environmental triggers can provoke symptoms in either condition, may help to explain this high rate of comorbidity.
Studies have also indicated that anxiety disorders are more likely among those with family history of anxiety disorders, especially certain types. Sexual dysfunction often accompanies anxiety disorders, although it is difficult to determine whether anxiety causes the sexual dysfunction or whether they arise from a common cause. The most common manifestations in individuals with anxiety disorder are avoidance of intercourse, premature ejaculation or erectile dysfunction among men and pain during intercourse among women.
Sexual dysfunction is particularly common among people affected by panic disorder who may fear that a panic attack will occur during sexual arousal and posttraumatic stress disorder. The diagnosis of an anxiety disorder requires first ruling out an underlying medical cause. Also, several drugs can cause or worsen anxiety, whether in intoxication, withdrawal, or from chronic use.
These include alcohol , tobacco , cannabis , sedatives including prescription benzodiazepines , opioids including prescription pain killers and illicit drugs like heroin , stimulants such as caffeine, cocaine and amphetamines , hallucinogens , and inhalants. Focus is increasing on prevention of anxiety disorders. Treatment options include lifestyle changes, therapy , and medications.
There is no clear evidence as to whether therapy or medication is more effective; the choice of which is up to the person with the anxiety disorder and most choose therapy first. Lifestyle changes include exercise, for which there is moderate evidence for some improvement, regularizing sleep patterns, reducing caffeine intake, and stopping smoking.
Cognitive behavioral therapy CBT is effective for anxiety disorders and is a first line treatment. Self-help books can contribute to the treatment of people with anxiety disorders. Mindfulness based programs also appear to be effective for managing anxiety disorders.
Buspirone , quetiapine and pregabalin are second line treatments for people who do not respond to SSRIs or SNRIs; there is also evidence that benzodiazepines including diazepam and clonazepam are effective but have fallen out of favor due to the risk of dependence and abuse. Medications need to be used with care among older adults, who are more likely to have side effects because of coexisting physical disorders.
Adherence problems are more likely among older people, who may have difficulty understanding, seeing, or remembering instructions. In general medications are not seen as helpful in specific phobia but a benzodiazepine is sometimes used to help resolve acute episodes; as data were sparse for efficacy of any drug. Many other remedies have been used for anxiety disorder. These include kava , where the potential for benefit seems greater than that for harm with short-term use in those with mild to moderate anxiety.
Inositol has been found to have modest effects in people with panic disorder or obsessive-compulsive disorder. John's wort , valerian or passionflower. Aromatherapy has shown some tentative benefits for anxiety reduction in people with cancer when done with massages, although it not clear whether it could just enhance the effect of massage itself.
What to know about anxiety
Both therapy and a number of medications have been found to be useful for treating childhood anxiety disorders. Cognitive behavioral therapy CBT is a good first therapy approach. Family therapy is a form of treatment in which the child meets with a therapist together with the primary guardians and siblings. Art and play therapy are also used. Art therapy is most commonly used when the child will not or cannot verbally communicate, due to trauma or a disability in which they are nonverbal.
Participating in art activities allows the child to express what they otherwise may not be able to communicate to others. The therapist may intercede from time to time with a question, comment, or suggestion. This is often most effective when the family of the child plays a role in the treatment. The prognosis varies on the severity of each case and utilization of treatment for each individual.
If these children are left untreated, they face risks such as poor results at school, avoidance of important social activities, and substance abuse.
Children who have an anxiety disorder are likely to have other disorders such as depression , eating disorders , attention deficit disorders both hyperactive and inattentive. Like adults, children can experience anxiety disorders; between 10 and 20 percent of all children will develop a full-fledged anxiety disorder prior to the age of 18,  making anxiety the most common mental health issue in young people.
Anxiety disorders in children are often more challenging to identify than their adult counterparts owing to the difficulty many parents face in discerning them from normal childhood fears.
Likewise, anxiety in children is sometimes misdiagnosed as an attention deficit disorder or, due to the tendency of children to interpret their emotions physically as stomach aches, head aches, etc. Anxiety in children has a variety of causes; sometimes anxiety is rooted in biology, and may be a product of another existing condition, such as autism or Asperger's disorder.
Anxiety in children tends to manifest along age-appropriate themes, such as fear of going to school not related to bullying or not performing well enough at school, fear of social rejection, fear of something happening to loved ones, etc. What separates disordered anxiety from normal childhood anxiety is the duration and intensity of the fears involved.
From Wikipedia, the free encyclopedia. Anxiety disorder The Scream Norwegian: Main article: Generalized anxiety disorder. Specific phobia. Panic disorder. Social anxiety disorder. Post-traumatic stress disorder.
Separation anxiety disorder. Obsessive—compulsive disorder. Selective mutism. Financial Times. Archived from the original on 14 October American Psychiatric Publishing. March Archived from the original on 27 July Retrieved 14 August Archived PDF from the original on 10 March World Psychiatry. Second Edition. New York, NY: Differentiated Diagnosis and Treatment Strategies". Psychiatric Times. Archived from the original on 4 September Psychiatric and mental health nursing: Archived from the original on 27 May Retrieved 17 December McGrath Hill Companies Inc.
From Causes to Treatment and Prevention". Archived from the original on 17 February Retrieved 18 February Oxford; New York: Oxford University Press, c p.
E Manual of Psychiatric Nursing Care Planning: Assessment Guides, Diagnoses and Psychopharmacology. New York: Saunders Elsevier. Paediatric Drugs. Retrieved McGrath Hill companies Inc. Fisher; William T. O'Donohue 27 July Practitioner's Guide to Evidence-Based Psychotherapy. Oxford University Press. Veterans Affairs Canada. Archived from the original on 14 February New England Journal of Medicine.
Posttraumatic Stress Disorder. Washington, D. American Psychiatric Press Inc. Worth Publishers. Psychiatric News. June Am J Psychiatry. American Journal of Psychiatry. Retrieved from "Situational Panic Attacks". Archived from the original on 10 June Retrieved 28 March Obsessive-Compulsive Disorder: Archived from the original on 29 May Retrieved 21 November BMJ Clinical Evidence.
PubMed Health. A review and integration of the last 15 years". Clinical Psychology Review. Dual Diagnosis: Counseling the Mentally Ill Substance Abuser 2nd ed. Guilford Press. The Handbook of Clinical Adult Psychology 2nd ed. Addiction medicine: Archived from the original on 1 December J R Soc Med.
Psychosom Med. Archived from the original on 7 February The Antianxiety Food Solution: New Harbinger Publications. Retrieved 7 October Advances in Psychiatric Treatment. New Zealand Journal of Psychology.
Archived from the original on 9 February Expert Rev Neurother. A systematic literature review". Expert Review of Neurotherapeutics. Archives of General Psychiatry. Comprehensive Psychiatry. BMC Psychiatry. Human Psychopharmacology: Clinical and Experimental. Archived from the original on 8 May Retrieved 28 April CS1 maint: Generalized anxiety disorder".
Annals of Internal Medicine. Preventive Medicine. Archived PDF from the original on 19 October A person with OCD knows that the symptoms are unreasonable and struggles against both the thoughts and the behavior.
Focus is increasing on prevention of anxiety disorders. Support network: Talk with familiar people who are supportive, such as a family member or friend.
J Affect Disord Systematic Review. The amygdala is central to the processing of fear and anxiety, and its function may be disrupted in anxiety disorders. Schizophrenia , schizotypal and delusional. Family therapy is a form of treatment in which the child meets with a therapist together with the primary guardians and siblings.
Treatment options include lifestyle changes, therapy , and medications. Cochrane Database of Systematic Reviews 1: John's wort , valerian or passionflower.