ANXIETY

Definition of Anxiety

• Anxiety is a feeling of apprehension or fear. The source of this uneasiness is not always known or recognized, which can add to the distress you feel.

Anxiety Facts• Most common mental illness in the U.S. with 19 million of the adult

(ages 18-54) U.S. population affected.

• Anxiety disorders cost more than $42 billion a year.

• More than $22 billion are associated with the repeated use of healthcare services, as those with anxiety disorders seek relief for symptoms that mimic physical illnesses.

• Anxiety is highly treatable (up to 90% of cases), but only one-third of those who suffer from it receive treatment

• People with an anxiety disorder are three-to-five times more likely to go to the doctor and six times more likely to be hospitalized for psychiatric disorders than non-sufferers.

• Depression often accompanies anxiety disorders

Types of Anxiety Disorders

• Panic Disorder

• Obsessive-Compulsive Disorder

• Post-Traumatic Stress Disorder

• Phobias

• Generalized Anxiety Disorder

Panic Disorder• The abrupt onset of an episode of intense fear or

discomfort, which peaks in approximately 10 minutes, and includes at least four of the following symptoms:

• A feeling of imminent danger or doom• The need to escape• Palpitations• Sweating• Trembling• Shortness of breath or a smothering feeling • Chest pain or discomfort

• Nausea or abdominal discomfort• Dizziness or lightheadedness•A fear of losing control or "going crazy" • A fear of dying • Tingling sensations • Chills or hot flushes

Panic Disorder

There are three types of Panic Attacks:

1. Unexpected - the attack "comes out of the blue" without warning and for no discernable reason.

2. Situational - situations in which an individual always has an attack, for example, upon entering a tunnel.

3. Situationally Predisposed - situations in which an individual is likely to have a Panic Attack, but does not always have one. An example of this would be an individual who sometimes has attacks while driving.

Obsessive-Compulsive Disorder

Characterized by uncontrollable obsessions and compulsions which the sufferer usually recognizes as being excessive or unreasonable.

• Obsessions are recurring thoughts or impulses that are intrusive or inappropriate and cause the sufferer anxiety: – Thoughts about contamination, for example, when an individual

fears coming into contact with dirt, germs or "unclean" objects; – Persistent doubts, for example, whether or not one has turned off

the iron or stove, locked the door or turned on the answering machine;

– Extreme need for orderliness; – Aggressive impulses or thoughts, for example, being overcome

with the urge to yell 'fire' in a crowded theater

Obsessive-Compulsive Disorder• Compulsions are repetitive behaviors or rituals performed by the

OCD sufferer, performance of these rituals neutralize the anxiety caused by obsessive thoughts, relief is only temporary.

– Cleaning. Repeatedly washing their hands, showering, or constantly cleaning their home;

– Checking. Individuals may check several or even hundreds of times to make sure that stoves are turned off and doors are locked;

– Repeating. Some repeat a name, phrase or action over and over; – Slowness. Some individuals may take an excessively slow and

methodical approach to daily activities, they may spend hours organizing and arranging objects;

– Hoarding. Hoarders are unable to throw away useless items, such as old newspapers, junk mail, even broken appliances

• In order for OCD to be diagnosed, the obsessions and/or compulsions must take up a considerable amount of the sufferers time, at least one hour every day, and interfere with normal routines .

Post-Traumatic Stress Disorder

• Exposure to traumas such as a serious accident, a natural disaster, or criminal assault can result in PTSD. When the aftermath of a traumatic experience interferes with normal functioning, the person may be suffering from PTSD.

• Symptoms of PTSD are:– Reexperiencing the event, which can take the form of intrusive thoughts

and recollections, or recurrent dreams; – Avoidance behavior in which the sufferer avoids activities, situations,

people,and/or conversations which he/she associates with the trauma; – A general numbness and loss of interest in surroundings; – Hypersensitivity, including: inability to sleep, anxious feelings, overactive

startle response, hypervigilance, irritability and outbursts of anger.

Social Phobia/Anxiety• Social anxiety disorder, also known as social phobia, is an

intense fear of social situations. This fear arises when the individual believes that they may be judged, scrutinized or humiliated by others.

• Individuals with the disorder are acutely aware of the physical signs of their anxiety and fear that others will notice, judge them, and think poorly of them.

• In extreme cases this intense uneasiness can progress into a full blown panic attack.

Social Phobia/Anxiety• Common anxiety provoking social situations include:

– public speaking – talking with people in authority – dating and developing close relationships – making a phone call or answering the phone – interviewing – attending and participating in class – speaking with strangers – meeting new people – eating, drinking, or writing in public – using public bathrooms – driving – shopping

Generalized Anxiety Disorder• Excessive uncontrollable worry about

everyday things. This constant worry affects daily functioning and can cause physical symptoms.

• GAD can occur with other anxiety disorders, depressive disorders, or substance abuse.

Generalized Anxiety Disorder• The focus of GAD worry can shift, usually

focusing on issues like job, finances, health of both self and family; but it can also include more mundane issues such as, chores, car repairs and being late for appointments.

• The intensity, duration and frequency of the worry are disproportionate to the issue

Specific Disorder Facts• Generalized Anxiety Disorder

– Women are twice as likely to be afflicted than men. – Very likely to exist along with other disorders.

• Obsessive Compulsive Disorder– It is equally common among men and women. – One third of afflicted adults had their first symptoms in childhood.

• Panic Disorder– Women are twice as likely to be afflicted than men. – Occurs with major depression in very high rates.

2003 Anxiety Disorders Association of America

Specific Disorder Facts• Posttraumatic Stress Disorder

– Women are more likely to be afflicted than men. – Rape is the most likely trigger of PTSD, 65% of men and 45.9% of

women who are raped will develop the disorder. – Childhood sexual abuse is a strong predictor of lifetime likelihood

for developing PTSD.

• Social Anxiety Disorder– It is equally common among men and women.

• Specific Phobia affects– Women are twice as likely to be afflicted as men

2003 Anxiety Disorders Association of America

Common Causes• There is no one cause for anxiety disorders. Several

factors can play a role – Genetics– Brain biochemistry – Overactive "fight or flight" response

• Can be caused by too much stress– Life circumstances– Personality

• People who have low self-esteem and poor coping skills may be more prone

• Certain drugs, both recreational and medicinal, can lead to symptoms of anxiety due to either side effects or withdrawal from the drug.

• In very rare cases, a tumor of the adrenal gland (pheochromocytoma) may be the cause of anxiety.

Symptoms of Anxiety

Anxiety is an emotion often accompanied by various physical symptoms, including:

• Twitching or trembling • Muscle tension • Headaches • Sweating • Dry mouth • Difficulty swallowing • Abdominal pain (may be the only symptom of stress

especially in a child)

Additional Symptoms of Anxiety

Sometimes other symptoms accompany anxiety: • Dizziness • Rapid or irregular heart rate• Rapid breathing • Diarrhea or frequent need to urinate• Fatigue • Irritability, including loss of your temper • Sleeping difficulties and nightmares • Decreased concentration • Sexual problems

Physical Reaction to AnxietyAuditory and Visual Stimuli:sights and sounds are processedfirst by the thalamus, which filtersthe incoming cues and shunts them either directly to the amygdala or to the other parts ofthe cortex.

Olfactory and tactile stimuli:Smells and touch sensations Bypass the thalamus altogether,Taking a shortcut directly to theAmygdala. Smells, therefore, Often evoke stronger memoriesOr feelings than do sights or Sounds.

Physical Reaction to AnxietyThalamus:The hub for sights and sounds,The thalamus breaks down Incoming visual cues by size, Shape and color, and auditoryCues, by volume and Dissonance, and then signalsThe appropriate part of the Cortex.

Cortex:It gives raw sights and sounds meanings, enabling the brainto become conscious of what itIs seeing or hearing. One region, the prefrontal cortex, may be vital to turning off theanxiety response once a threathas passed.

Physical Reaction to AnxietyAmygdala:emotional core of the brain, theamygdala has the primary roleof triggering the fear response.information that passes throughthe amygdala is tagged with emotional significance.

Bed Nucleus of Stria Terminalis:unlike the Amygdala, which sets off an immediate burst of fear, the BNST perpetuates the fear response, causing the longer term unease typical ofanxiety.

Physical Reaction to AnxietyLocus Ceruleus:It receives signals from the amygdala and is responsiblefor initiating many of the classic anxiety responses: rapid heartbeat, increasedblood pressure, sweating and pupil dilation.

Hippocampus:This is the memory center,vital to storing the raw information coming in from the senses along with the emotional baggage attached to the data during their trip through the amygdala.

The End