MANAGING ANXIETY DISORDERS
Transcript of MANAGING ANXIETY DISORDERS
MANAGING ANXIETY DISORDERS –
DR. ANGELA LYKINS, PH.D., HSPP
LICENSED CLINICAL PSYCHOLOGIST
HEALTH SERVICE PROVIDER IN PSYCHOLOGY
OBJECTIVES
• LIST POTENTIAL CAUSES OF ANXIETY
• ADDRESS SYMPTOMS AND CHARACTERISTICS
• UNDERSTAND PREVALENCE RATES
• DISCUSS POTENTIAL TECHNIQUES
• IDENTIFY ASSESSMENTS AND RESOURCES
WHAT IS AN ANXIETY DISORDER? DIAGNOSTIC AND STATISTICAL MANUAL, 5TH EDITION
A) PERSISTENT FEARB) EXPOSURE TO THE FEAR PROVOKES ANXIETYC) THE PERSON KNOWS THE FEAR IS UNREASONABLED) THE FEARED SITUATIONS ARE AVOIDEDE) ANXIETY INTERFERES SIGNIFICANTLY WITH DAILY LIFE F) THE FEAR, ANXIETY, OR AVOIDANCE IS PERSISTENT, TYPICALLY LASTING 6 OR MORE MONTHS G) THE FEAR OR ANXIETY IS NOT DUE TO DIRECT PHYSIOLOGICAL EFFECTS
MANY COMPLICATED
TERMS
WHERE DO WE BEGIN?
CAUSES OF ANXIETY DISORDERS: NEUROBIOLOGICAL
DYSREGULATION OF AUTONOMIC NERVOUS SYSTEM
SENSORY INTEGRATION
ABNORMAL CARDIOVASCULAR AND ELECTRODERMAL RESPONSES
GENETIC TEMPERAMENT OF FAMILY
CAUSES OF ANXIETY DISORDERS: STRUCTURAL ABNORMALITIES
ABNORMALITIES OF SEROTONIN AND DOPAMINE
METABOLIC DEFICITS IN FRONT CORTEX
STRUCTURE ABNORMALITIES IN AMYGDALA AND HIPPOCAMPUS; LIMBIC SYSTEM AS A WHOLE
LIMBIC SYSTEM: PREFRONTAL CORTEX
CAUSES OF ANXIETY DISORDERS: ENVIRONMENTAL
TRAUMA/BULLYING
MULTIPLE HOMES TRANSITIONS
STRESSFUL WORK AND
SOCIAL SITUATIONS
ILLNESSSTRICT
ROUTINES AND LACK OF CHOICE
SERVICE PROVIDERS
FROM DIFFERENT
DISCIPLINES AND AGENCIES
COMMON TYPES OF ANXIETY DISORDERS
GENERALIZED ANXIETY DISORDER (GAD)
COMMON TYPES OF ANXIETY DISORDERS
PANIC DISORDER
COMMON TYPES OF ANXIETY DISORDERS
OBSESSIVE COMPULSIVE DISORDER
COMMON TYPES OF ANXIETY DISORDERS
PHOBIA
COMMON TYPES OF ANXIETY DISORDERS
SOCIAL ANXIETY DISORDER
COMMON TYPES OF ANXIETY DISORDERS
POSTTRAUMATIC STRESS DISORDER
COMMON TYPES OF ANXIETY DISORDERS
GENERALIZED ANXIETY DISORDER (GAD)PANIC DISORDEROBSESSIVE COMPULSIVE DISORDER
PHOBIASOCIAL ANXIETY DISORDERPOSTTRAUMATIC STRESS DISORDER (PTSD)
SYMPTOMSEXCESSIVE WORRY
RESTLESSNESS FATIGUE
DIFFICULTY CONCENTR
ATINGIRRITABI
LITY
MUSCLE TENSIO
N
HEART PALPITATIO
NS
ACCELERATED HEART
RATESWEATI
NG TREMBLI
NGPHOBIA
SHYPERVIGILAN
CE
PANIC ATTACK
S
OBSESSIVE
THOUGHTS
COMPULSIVE
BEHAVIORS
SCREAMING YELLING FLAPPING
ROCKING
SLEEP DISTURBAN
CESWITHDRA
WAL
AGGRESSION
INTERRUPTING
REPETITIVE
QUESTIONS
SELF-INJURIO
US BEHAVIO
RS
????
HOW DO WE RECOGNIZE SYMPTOMS IN
OURSELVES AND WITH OTHERS?
PREVALENCE• STATISTICS: MOST COMMON MENTAL HEALTH
DIAGNOSIS IN THE U.S. (PER NATIONAL INSTITUTE OF MENTAL HEALTH-NIMH).
• OF THE 40 MILLION PEOPLE DIAGNOSED WITH ANXIETY DISORDER
A) ALMOST 7 MILLION SUFFER FROM GAD
B) ALMOST 14 MILLION SUFFER FROM SOCIAL ANXIETY DIOSRDER
C) ALMOST 7 MILLION AFFECTED BY PTSD
D) ALMOST 13 MILLION EXPERIENCE COMORBID DX OF DEPRESSION
COMORBIDITY
POTENTIAL TECHNIQUES• PSYCHOTHERAPY: COGNITIVE BEHAVIORAL THERAPY
• TELL YOURSELF: “IT’S OK TO FEEL ANXIOUS”
• WILLINGNESS: CHOOSING AND ACCEPTING TO FEEL WHAT YOU ARE EXPERIENCING IN THE MOMENT
• WHY DO YOU WANT TO BEAT ANXIETY? TALK OUT LOUD
• MINDFULNESS: PRESENT MOMENT HEADSPACE OR STOP, BREATHE & THINK – 10 MINUTES A DAY
• ACCEPTANCE AND COMMITMENT THERAPY (ACT)
• GROUNDING (ANXIETY, FLASHBACKS, PTSD, IMPROVING MENTAL HEALTH) – PARASYMPATHETIC RESPONSE COUNTERACTS THE FEAR RESPONSE
• SELF-REGULATION ACTIVITIES (BREATHING TECHNIQUES)
• SHARING DAILY A MISTAKE YOU MADE (AT DINNER TABLE, JOURNAL, SOCIAL MEDIA)
COGNITIVEBEHAVIORAL THERAPY
POTENTIAL TECHNIQUES: BEHAVIORAL• LIFE STYLE
• REDUCE STIMULI (LIGHTING, CLUTTER, NOISE, TEMPERATURE)
• REDUCE TRANSITIONS
• SKILL BUILDING
• PROVIDE ACTIVITIES TO ENGAGE WITH OTHERS
• TEACH CAREGIVERS TECHNIQUES TO IMPROVE COMMUNICATION SKILLS
• REDIRECTION
• POSITIVELY REINFORCE FOR DESIRED BEHAVIORS
POTENTIAL TECHNIQUES : PHARMACOTHERAPY
SELECTIVE SEROTONIN REUPTAKE INHIBITORS
(SSRI): PROZAC, CELEXA,
LEXAPRO, ZOLOFT, PAXIL,
LUVOX
SEROTONIN NOREPINEPHRIN
E REUPTAKE INHIBITORS
(SNRI): PRISTIQ, CYMBALTA, EFFEXOR
BENZODIAZEPINE: XANAX,
KLONOPIN, VALIUM
POSSIBLE SIDE
EFFECTS
ASSESSMENTS/RESOURCES• SELF-REPORT & INFORMANT REPORT: GLASGOW
ANXIETY SCALE
• PHQ-9 (PATIENT HEALTH QUESTIONNAIRE) – USED BY HEALTH CARE PROFESSIONALS
• MASS (MOOD AND ANXIETY SEMI-STRUCTURED INTERVIEW) –USED BY HEALTH CARE PROFESSIONALS
• ADAMS (ANXIETY, DEPRESSION, AND MOOD SCALE) – USED BY HEALTH CARE PROFESSIONALS
• THE FEAR SURVEY
LOTS OF WORK TO BE DONE
REFERENCES• ADDRESSING ANXIETY IN INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES, DR. JULIE STECK, CRG, JUNE 2016
• ANXIETY AND INTELLECTUAL DISABILITY, MOLLY FAULKNER, PH.D., CNP, LISW UNIVERSITY OF NEW MEXICO, MARCH 2015
• ANXIETY, DEPRESSION AND MOOD SCALE, AJ ESBENSEN , J ROJAHN , MG AMAN,S RUEDRICH , 2003
• THE DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS; 5TH EDITION, PUBLISHED BY AMERICAN PSYCHIATRIC ASSOCIATION, 2013
• GLASGOW ANXIETY SCALE FOR PEOPLE WITH AN INTELLECTUAL DISABILITY (GAS-ID), BLACKWELL PUBLISHING 2003
• INDIANA FAMILY & SOCIAL SERVICES ADMINISTRATION
• MENTAL HEALTH ISSUES FOR INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES, KAREN TOTO, LMFT, JANUARY 2017
• THE MOOD AND ANXIETY SEMI-STRUCTURED INTERVIEW, CHARLOT, DEUTSCH, HUNT, FLETCHER, & MCILVANE, 2007
• PATIENT HEALTH QUESTIONNAIRE-9, EDUCATIONAL GRANTS FOR DRS SPITZER, WILLIAMS AND KROENKE
CONTACT INFORMATION
DR. ANGELA LYKINS
LYKINS COUNSELING CLINIC
4221 N BROADWAY AVENUE
MUNCIE, IN 47303
765-282-7150