Anxiety disorders (PDF) | Anxiety disorders | Guidance | NICE
Anxiety
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Transcript of Anxiety
Stress is the effect of the body releasing heightened levels of adrenaline and cortisol, two hormones made by the adrenal gland.
These hormones trigger the “fight or flight” response and prepare a person for a dangerous situation.
A natural increase in these hormones brings about the same response as injecting the body with a synthetic stimulant such as cocaine or similar powerful drugs.
Hippocampus = required for the formation of long term memories
Hypothalamus = gland that regulates the autonomic nervous system through hormone production
Amygdala = involved in aggression and fear
Amygdala constantly scans surrounding stimuli for danger.
Hippocampus may aid amygdala by associating a current situation to a fearful long-term memory
When amygdala senses danger (real or perceived) it tells the hypothalamus to increase production and distribution of adrenaline and cortisol (stress hormones)
Amygdala sends a message to the brain to shut down all blood flow to the prefrontal cortex of the brain (where logic and creativity centers are located).
Amydala has now single-handedly put the body into “fight or flight” mode – a panic reaction.
Acute Stress
Last relatively short period of time Brought on by specific circumstances Can demand all of our energy Leaves us drained and fatigued Can cause state of shock Can be attributed to a deadline at work, an
accident or unexpected trauma or even adverse reaction to meds
Chronic Stress
Extends for a longer period of time Often present as we perform daily tasks Often, our bodies react to chronic stress slowly,
and we might even become accustomed to a certain level of tension
Can lead to chronic illness (such as ulcers or heart disease)
May show symptoms such as headaches, fatigue, depression, high blood pressure, insomnia, irritability
Anxiety
Response to stress that produces a state of fearfulness an distressing physical symptoms.
Most people suffer form short periods (job interview, exams, etc.)
This type of anxiety does not usually persist. Can be mild, moderate or severe.
Panic
Acute and extreme anxiety accompanied by physiological symptoms
Can be part of acute stress, chronic stress, and anxiety.
Often comes
Generalized Anxiety Disorder (GAD)
Characterized by excessive, unrealistic worry or chronic anxiety that lasts six months or more.
May included trembling, muscle tension, insomnia, abdominal upsets, dizziness, rapid heartbeat, and irritability.
Usually doesn’t have panic attacks or phobias
Obsessive-Compulsive Disorder (OCD)
Persistent, recurring thoughts (obsessions) that reflect exaggerated anxiety or fears.
May cause an individual to perform a ritual or routine in order to prevent whatever they fear from coming to pass (compulsions)
Panic Disorder
Suffer from sudden, recurring panic attacks that come out of the blue
Make them feel like they are going to die or go crazy
May include heart palpitations, chest pain, sweating, trembling, tingling sensations, and difficulty breathing
Agoraphobia
The fear of having panic attacks in situations or places outside of the home
Causes a persona to avoid normal daily activity
Fears having panic attack in a place that would be difficult to leave
Post-Traumatic Stress Disorder (PTSD)
Follows a traumatic event May relive the event (flashback), have
avoidance behaviors, emotional detachment, and physical problems like insomnia and difficulty concentrating
Symptoms last more than one month
Acute Stress Disorder
Lasts less than one month Defined by exposure to a traumatic event in
which a person has been a witness or participant Event is life threatening, could cause serious
injury, or is a threat to the physical integrity of self and others
Intense fear, helplessness, flashbacks, avoidance of the situation, and anxiety that last for two days to four weeks.
Social Anxiety Disorder (SAD)
SAD is when a person has anxiety about being judged by others
Worry their behavior may cause them embarrassment or ridicule
Leads to avoiding social situations
Disease-Related Anxiety Disorders
Caused by a general medical condition (i.e. lupus, thyroid disease, hypertension, or substance abuse)
Specific Phobias
Suffer from an intense reaction to a specific object or situation (i.e. spiders or water)
Typically people know their fear is irrational
Understand What Anxiety Is
Remember what is going on in the brain and body
Remember what kinds of feelings or thoughts may be occurring
Observe and Assess
Find out the cause of the attack or anxiety.
What is in the environment that may be attributing to the situation?
What is the history with this child that may help you asses?
If there is a specific cause for fear, try to remove it or consider taking the person away from
the source of distress.
Discussion: When do we remove kids? When do we approach the situation?
Speak to them in a reassuring but firm manner.
“Narrating Voice” Steady and sure Bring in regulation
Do not dismiss their fears.
Perceptions are REAL (even if they are just perceived).
Validate those fears. Try and understand those fears (Jordan and
the sanitizer)
Stay calm and don’t pressure the person.
Slow and steady wins the race Think of pacing and calm How can you make them safe? Might take all day. What’s more important?
Process over product.
Encourage them to try to control breathing.
Model breathing Breathe FOR them Practice breathing BEFORE hand to help
support in the moment.
Keep them cool. Attend to sensory needs.
Is sensory helping or hindering? MORE input or LESS input? Slow it down? Predictable?
Remember that the feelings are real.
Even if the perceptions are different, the feelings are REAL.
“Don’t be Sorry.” Remember – there may not be any reason for sorry, but they still need to say it. Take the information and use it.
Don’t leave them alone.
May need a moment to calm down, but they need to know that somehow you are still with them.
1. Understand what anxiety is.2. Find out the cause of the attack or anxiety.3. If there is a specific cause for fear, try to remove
it or consider taking the person away from the source of distress.
4. Speak to them in a reassuring but firm manner.5. Do not dismiss their fears.6. Stay calm and don’t pressure the person.7. Encourage them to try to control breathing.8. Keep them cool. Attend to sensory needs.9. Don’t leave them alone.10. Remember that the feelings are real.
You could've bowed out gracefully but you didn't,You knew enough to know to leave well enough alone but you wouldn't.
I drive myself crazy tryin' to stay out of my own way The messes that I make but my secrets are so safe
The only one who gets me, Yeah, you get me, It's amazing to me.
[CHORUS]How every day
Every day, every dayYou save my life
I come around all broken down and crowded out and you're comfortSometimes the place I go is so deep and dark and desperate I don't know, I don't know
[Repeat Chorus]
Sometimes I swear, I don't know if I'm comin' or goin’, but you always say something without even knowin’
That I'm hangin' on to your words with all of my might and it's alrightYeah, I'm alright for one more night- Every day
Every day you save my life