Introduction to Anxiety Introduction to Anxiety DisordersDisorders

Professor Craig A. JacksonProfessor Craig A. JacksonHead of PsychologyHead of Psychology

OverviewOverview

Diagnostics

Classification

Causes

Treatment

DiagnosticsDiagnostics

debilitating & chronic

can be present from an early age

or begin suddenly after a triggering event

flare up at times of high stress

frequently accompanied by physiological symptoms e.g. headache, sweating, muscle spasms, palpitations, hypertension

often comorbid with other mental disorders

29% lifetime prevalence

DiagnosticsDiagnostics

particularly clinical depression (60% of anxiety sufferers)

considerable overlap between symptoms of anxiety and depression

same environmental triggers

anxiety disorders more likely among those with family history of anxiety disorders

Sexual dysfunction often accompanies anxiety e.g. avoidance of intercourse, premature ejaculation or erectile dysfunction, painful intercourse

Anxiety Disorder TypesAnxiety Disorder Types

General anxiety disorder

Panic disorder

Panic disorder & agoraphobia

Phobias

OCDs

PTSD

Separation anxiety

Childhood anxiety disorderChildhood anxiety disorder

Generalised Anxiety DisorderGeneralised Anxiety Disorder

common chronic disorder

long-lasting anxiety not focused on anything

non-specific persistent fear and worry

overly concerned with everyday matters

most common anxiety disorder to affect older adults

can be a symptom of a medical problem or drug abuse

Generalised Anxiety DisorderGeneralised Anxiety Disorder

diagnosis made after six months or more

problems making daily decisions and appointments

appearance looks strained, skin is pale

increased sweating from hands, feet and axillae

may be tearful which can suggest depression

Panic DisorderPanic Disorder

fear or discomfort that abruptly arises and peaks

brief (10 mins) attacks of intense terror and apprehension

trembling, shaking, confusion, dizziness, nausea, difficulty breathing

can last for hours and can be triggered by stress or fear

specific cause is not always apparent

Panic DisorderPanic Disorder

diagnosis of PD requires attacks have chronic consequences

worry over potential implications

persistent fear of future attacks

significant changes in behaviour

hyper-vigilant to bodily sensations

catastrophic

Panic Disorder & AgoraphobiaPanic Disorder & Agoraphobia

specific anxiety about being in a situation

escape is difficult or embarrassing

or where help may be unavailable

strongly linked with panic disorder

often precipitated by the fear of having a panic attack

need to be in constant view of door or other escape route

develop secondary avoidance behaviours

PhobiasPhobias

e.g. agoraphobia, social anxiety

single largest category of anxiety disorders

fear and anxiety triggered by a specific stimulus / place

5% - 12% of global population suffer from phobic disorders

anticipate terror from encountering the object

understand their fear is not proportional to the actual potential danger

Obsessive Compulsive DisordersObsessive Compulsive Disorders

type of anxiety characterized by repetitive obsession

distressing, persistent, and intrusive thoughts or images

compulsions / urges to perform specific acts or rituals

affects 3% of the global population

superstitions? e.g. causation

insight into illogical nature

often no aetiological explanation

Post Traumatic Stress DisorderPost Traumatic Stress Disorder

anxiety disorder resulting from a traumatic experience

can result from an extreme situation e.g. combat

can result from chronic exposure to a severe stressor

symptoms include hypervigilance, flashbacks, avoidant behaviours, anxiety, anger and depression

Separation AnxietySeparation Anxiety

excessive & inappropriate levels of anxiety

from being separated from a person or place

normal part of development in babies or children

affects roughly 7% of adults and 4% of children

childhood cases tend to be more severe

Theories of CauseTheories of Cause

Neurotransmitter theories

GABA depletion

Solvents

Amygdala theory

Stress theories

TreatmentsTreatments

SSRIs

Benzodiazepines

CBT

Psychotherapy

Alternative remedies

Exercise

Sleep hygiene

Lifestyle

MedicalisationMedicalisation

Necessity of anxiousness?

Modern society

Increased hazards

Amygdalian evolution

ReferencesReferences

Berrios GE (1999) Anxiety Disorders: a conceptual history. J. Affect Disord 56(2-3):617-27

Dunlop BW, Davis PG (2008) Combination treatment with benzodiazepines and SSRIs for comorbid anxiety and depression: a review. Prim Care Companion J. Clin Psychiatry 10:22-8

Lindsay SJE, Powell GE, (1998) The Handbook of Clinical Adult Psychology. 2nd edition. New York. Routelidge

Lydiard RB (2003) The role of GABA in anxiety disorders. J. Clin Psychiatry 64(3):21-7