Group 1 Anxiety Disorders PDF

TRIGGER WARNING! Hi..! Nice to meet you, I'm Anxiety. ANXIETY DISORDERS grOUP 1 k for loo Overview Anxiety  OVERVIEW ANXIETY Anxiety is a feeling of nervousness, worry, or unease that is a normal human experience. It is also present in...

TRIGGER WARNING! Hi..! Nice to meet you, I'm Anxiety. ANXIETY DISORDERS grOUP 1 k for loo Overview Anxiety  OVERVIEW ANXIETY Anxiety is a feeling of nervousness, worry, or unease that is a normal human experience. It is also present in a wide range of mental health conditions, including generalized anxiety disorder, panic disorder, and phobias. Although each of these disorders is different, they all feature distress and dysfunction specifically related to anxiety and fear. (Barnhill, 2023)  OVERVIEW ANXIETY According to Chand and Marwaha (2023), Anxiety is linked to fear and manifests as a future-oriented mood state that consists of a complex cognitive, affective, physiological, and behavioral response system associated with preparation for the anticipated events or circumstances perceived as threatening.  ANXIETY DISORDER Include disorders that share features of excessive fear and anxiety and related behavioral disturbances. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes of panic attacks. (particular type of fear response). Fear - often associated with a sudden increase in body reactions, like a fast heartbeat, which prepares us for "fight or flight." It involves feeling an immediate threat and wanting to escape or avoid danger. Anxiety - often associated with muscle tension and vigilance in preparation for future danger and cautious or avoidant behaviors. Many of the anxiety disorders develop in childhood and tend to persist if not treated. Most occur more frequently in females than in males. Common anxiety signs and symptoms includes: Feeling nervous, restless or tense Having a sense of impending danger, panic or doom Having an increased heart rate Breathing rapidly (hyperventilation) Trouble concentrating or thinking about anything other than the present worry Having trouble sleeping etc. SEPARATION ANXIETY  SEPARATION ANXIETY It is a mental health condition that causes excessive fear, distress, and anxiety about losing or being away from home or being separated from an attachment figure  DIAGNOSTIC CRITERIA A. Developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, as evidenced by at least three of the following: 1. Recurrent excessive distress when anticipating or experiencing separation from home or major attachment figures.  DIAGNOSTIC CRITERIA 2. Persistent and excessive worry about losing major attachment figures or about possible harm to them, such as illness, injury, disasters, or death. 3. Persistent and excessive worry about experiencing an untoward event that causes separation from a major attachment figure.  DIAGNOSTIC CRITERIA 4. Persistent reluctance or refusal to go out, away from home, to school, to work, or elsewhere because of fear of separation. 5. Persistent and excessive fear of or reluctance about being alone or without major attachment figures at home or in other settings.  DIAGNOSTIC CRITERIA 6. Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figure. 7. Repeated nightmares involving the theme of separation. 8. Repeated complaints of physical symptoms (e.g., headaches, stomachaches, nausea, vomiting) when separation from major attachment figures occurs or is anticipated.  DIAGNOSTIC CRITERIA CRITERIA B Children and Adolescence (younger than 18) - 4 weeks Adults - 6 or more months CRITERIA C The disturbance causes clinically significant distress or impairment in social, academic, occupational, or other important areas of functioning.  DIAGNOSTIC CRITERIA CRITERIA D The disturbance is not better explained by another mental disorder, such as: (1) refusing to leave home because of excessive resistance to change in autism spectrum disorder, (2) delusions or hallucinations concerning separation in psychotic disorders, (3) refusal to go outside without a trusted companion in agoraphobia, (4) worries about ill health or other harm befalling significant others in generalized anxiety disorder, (5) concerns about having an illness in illness anxiety disorder.  ASSOCIATED FEATURES may exhibit social withdrawal, sadness, apathy, and difficulty concentrating. fears of various dangers (animals, monsters, the dark, and other threats) Children often feel uncomfortable away from home and may refuse to attend school, leading to problems with their studies and social life. may express anger or aggression towards those enforcing separation.  Associated FEATURES Children - very demanding and intrusive Adults - dependent and overly protective DEVELOPMENt AND COURSE It is normal for children around the age of 1 to have separation anxiety Separation anxiety becomes developmentally inappropriate during preschool age (2-6 years old) SELECTIVE MUTISM  SELECTIVE MUTISM Selective mutism is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members.  DIAGNOSTIC CRITERIA A.Consistent failure to speak in specific social situations in which there is an expectation for speaking (e.g., at school) despite speaking in other situations. B.The disturbance interferes with educational or occupational achievement or with social communication. C.The duration of the disturbance is at least 1 month (not limited to the first month of school).  DIAGNOSTIC CRITERIA D.The failure to speak is not attributable to a lack of knowledge of, or comfort with, the spoken language required in the social situation. E.The disturbance is not better explained by: (1) a communication disorder (e.g., childhood- onset fluency disorder), (2) does not occur exclusively during the course of autism spectrum disorder, schizophrenia, or another psychotic disorder.  Associated FEATURES Associated features of selective mutism may include: excessive shyness fear of social embarrassment social isolation and withdrawal clinging compulsive traits negativism temper tantrums mild oppositional behavior  Associated FEATURES Children with selective mutism may be occasionally associated with communication disorder despite having normal language skills. Children with selective mutism are almost always given an additional diagnosis of another anxiety disorder—most commonly, social anxiety disorder (social phobia).  DEVELOPMENt AND COURSE The onset of selective mutism is usually before age 5 years, but the disturbance may not come to clinical attention until entry into school Clinical reports suggest that many individuals “outgrow” selective mutism, the longitudinal course of the disorder is unknown. Particularly in individuals with social anxiety disorder, selective mutism may disappear, but symptoms of social anxiety disorder remain. Specific Phobia  Specific phobia A specific phobia is much more than simple fear, and the afflicted person may attend to everything else other than the phobic object.  DIAGNOSTIC CRITERIA A. Marked fear or anxiety about a specific object or situation (e.g., flying, heights, animals,receiving an injection, seeing blood). -also called phobic stimulus Note: In children, the fear or anxiety may be expressed by crying, tantrums, freezing,or clinging. B. The phobic object or situation almost always provokes immediate fear or anxiety.  DIAGNOSTIC CRITERIA C. The phobic object or situation is actively avoided or endured with intense fear or anxiety. Active avoidance means the individual intentionally behaves in ways that are designed to prevent or minimize contact with phobic objects or situations D. The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context.  DIAGNOSTIC CRITERIA E. The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more. F. The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.  DIAGNOSTIC CRITERIA G. The disturbance is not better explained by the symptoms of another mental disorder: (1) including fear, anxiety, and avoidance of situations associated with panic-like symptoms, (2) objects or situations related to obsessions (as in obsessive-compulsive disorder), (3) reminders of traumatic events (as in posttraumatic stress disorder), (4) separation from home or attachment figures (as in separation anxiety disorder) or social situations (as in social anxiety disorder).  ASSOCIATED FEATURES Individuals with specific phobia typically experience an increase in physiological arousal in anticipation of or during exposure to a phobic object or situation. individuals with situational, natural environment, and animal specific phobias are likely to show sympathetic nervous system arousal individuals with blood-injection-injury specific phobia often demonstrate a vasovagal fainting or near-fainting response  development and course Specific phobias may sometimes develop through the following: due to a traumatic event observation of others going through a traumatic event unexpected panic attack in the to be feared situation informational transmission Specific phobia usually develops in early childhood, with the majority of cases developing prior to age 10 years. EXAMPLES OF SPECIFIC PHOBIAS Animals 1. Arachnophobia - fear of spiders. 2. Entomophobia - a fear of insects. 3. Cynophobia - fear of dogs. Natural environment 1. Acrophobia - fear of heights. 2. Astraphobia - extreme anxiety or debilitating fear when preparing for a thunderstorm. 3. Aquaphobia - fear of water. EXAMPLES OF SPECIFIC PHOBIAS Blood-injection-injury 1. Hemophobia - an irrational and persistent fear of blood. 2. Trypanophobia - extreme fear of needles. 3. Iatrophobia - fear of doctors or medical care, or the medical care system. Social Anxiety Disorder/ Social Phobia  Social Anxiety Disorder/ Social Phobia Social anxiety refers to the general fear and anxiety in social situations This can occur in a milder form and may not require treatment. Social phobia on the other hand is a specific anxiety disorder characterized by an intense fear of social interaction, this condition requires the help of mental health professionals.  DIAGNOSTIC CRITERIA A. Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others. Note: In children, the anxiety must occur in peer settings and not just during interactions with adults. B. The individual fears that he or she will act in a way or show anxiety symptoms that will be negatively evaluated  DIAGNOSTIC CRITERIA C. The social situations almost always provoke fear or anxiety. Note: In children, the fear or anxiety may be expressed by crying, tantrums, freezing, clinging, shrinking, or failing to. speak in social situations. D. The social situations are avoided or endured with intense fear or anxiety. E. The fear or anxiety is out of proportion to the actual threat posed by the social situation and to the sociocultural context.  DIAGNOSTIC CRITERIA F. The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more. G. The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. H. The fear, anxiety, or avoidance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.  DIAGNOSTIC CRITERIA I. The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder such as: (1) panic disorder, (2) body dysmorphic disorder, (3) autism spectrum disorder. J. If another medical condition (e.g., Parkinson’s disease, obesity, disfigurement from burns or injury) is present, the fear, anxiety, or avoidance is unrelated or excessive.  ASSOCIATED FEATURES Individuals with social anxiety disorder may be inadequately assertive or excessively submissive or, less commonly, highly controlling of the conversation. Self-medication with substances is common (e.g., drinking before going to a party). Blushing is a hallmark physical response of social anxiety disorder. development and course The usual onset of social anxiety disorder starts at the age of 13 years old. Onset of social anxiety disorder may follow a stressful or humiliating experience or it may be insidious, developing slowly.  panic disorder  PANIC DISORDER Is a disorder characterized by repeated and unexpected panic attacks. Characterized by sudden episodes of intense fear or discomfort that reach a peak within 10-20 minutes and are usually accompanied by physical and cognitive symptoms.  PANIC DISORDER These attacks can serve as indicators of how serious the disorder is and the possibility that it is linked to other mental health conditions.  DIAGNOSTIC CRITERIA Note: The abrupt surge can occur from a calm state or an anxious state. during a panic attck four (or more) of the following symptoms should occur: 1. Palpitations, pounding heart, or accelerated heart rate.  DIAGNOSTIC CRITERIA 2. Sweating 3. Trembling or shaking 4. Sensations of shortness of breath or smothering 5. Feelings of choking  DIAGNOSTIC CRITERIA 6. Chest pain or discomfort 7. Nausea or abdominal distress 8. Feeling dizzy or light-headed 9. Chills or heat sensations  DIAGNOSTIC CRITERIA 10. Paresthesia (numbness or tingling sensations) 11. Derealization (feelings of unreality) or depersonalization (being detached from oneself) 12. Fear of losing control or “going crazy.” 13. Fear of dying.  DIAGNOSTIC CRITERIA Note: Culture-specific symptoms (e.g., tinnitus, neck soreness, headache, uncontrollable screaming or crying) may be seen. Such symptoms should not count as one of the four required symptoms.  DIAGNOSTIC CRITERIA B. At least one of the attacks has been followed by 1 month (or more) of one or both of the following: 1. Persistent concern or worry about additional panic attacks or their consequences.  DIAGNOSTIC CRITERIA 2. A significant maladaptive change in behavior related to the attacks (e.g., behaviors designed to avoid having panic attacks). C. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug or medication) or another medical condition (e.g., hyperthyroidism, cardiopulmonary disorders).  ASSOCIATED FEATURES Many individuals with panic disorder report constant or intermittent feelings of anxiety that are more broadly related to health and mental health concerns. excessive use of drugs or extreme behaviors aimed at controlling panic attacks development and course Panic disorder frequently occurs alongside other issues such as anxiety, depression, and substance use. While panic disorders are rare to children, they can recall “fearful spells (distressing spells of anxiety that may or may not qualify for criteria of panic attacks)” development and course Panic disorder commonly begins in late adolescence or early adulthood, typically between the ages of 20 and 24. However, its onset can vary, sometimes appearing in childhood or, in rare cases, after the age of 55. AGORAPHOBIA  AGORAPHOBIA Agoraphobia is considered to be an unreasonable fear or avoidance towards a large number of situations where escape might be difficult or where help might not be available if something were to happen.  DIAGNOSTIC CRITERIA A. Pronounced fear or apprehension in at least two out of five situations listed below: 1. The use of public transport (cars, buses, trains, boats, and aeroplanes). 2. Being in open areas (such as parking lots, markets, or bridges).  DIAGNOSTIC CRITERIA 3. Being in enclosed places (stores or entertainment houses like theaters or cinemas). 4. Standing in line or being in a crowd. 5. Being outside the home unaccompanied.  DIAGNOSTIC CRITERIA B. The individual does not wish to or actively avoids these situations due to fears that they would be unable to escape easily or obtain assistance when their panic or humiliating symptoms arise. C. Agoraphobic situations are nearly always associated with fear or anxiety.  DIAGNOSTIC CRITERIA D. Agoraphobic situations are avoided, endured with a accompany, or are tolerated with extreme fear or anxiety. E. Any fear or anxiety experienced owing to agoraphobic situations tends to be exaggerated and also divorced from the sociocultural backdrop.  DIAGNOSTIC CRITERIA F. The fear, anxiety, or avoidance tends to be of a reclaiming nature and lasts up to six months and above. G. The fear, anxiety or avoidance leads to distress or impairment in functioning in social, occupational or other important areas which are clinically significant. H. Even if another medical condition exists (for instance, IBD, Parkinson’s disease,), the fear, anxiety, or avoidance is excessive.  DIAGNOSTIC CRITERIA I. The intense fear, worry, or avoidance is not more adequately accounted for or by the existing symptoms of any other mental disorder. Note: The diagnosis of agoraphobia is made regardless of whether the individual suffers from panic attacks or not. If the individual fulfills the criteria for both, both diagnoses are given.  ASSOCIATED FEATURES Individuals with severe forms of agoraphobia tend to become completely homebound and dependent on others for services and needs.  DEVELOPMENt AND COURSE The average onset of agoraphobia occurs at 17 years whilst the mean is between 25 to 29 years old. The clinical symptoms experienced by patients with agoraphobia remain more or less the same regardless of age there is an increasing risk of developing secondary major depressive disorder, dysthymia and substance use disorders. Generalized Anxiety Disorder  Generalized Anxiety Disorder Is excessive anxiety and worry about a number of events or activities. The intensity, duration, or frequency of the anxiety and worry is out of proportion to the actual likelihood or impact of the anticipated event. The individual finds it difficult to control the worry and to keep worrisome thoughts from interfering with attention to tasks at hand.  DIAGNOSTIC CRITERIA A. Excessive anxiety and worry, occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance). B. The individual finds it difficult to control the worry. C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months);  DIAGNOSTIC CRITERIA Note: Only one item is required for children. 1. Restlessness or feeling keyed up or on edge. 2. Being easily fatigued. 3. Difficulty concentrating or mind going blank. 4. Irritability. 5. Muscle tension. 6. Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep)  DIAGNOSTIC CRITERIA D. The person's anxiety, worry, or physical symptoms are serious enough to disrupt their daily life. It affects how they function socially, at work, or in other important areas of their life. E. These problems aren’t caused by the effects of drugs, medications, or another medical condition (like an overactive thyroid).  DIAGNOSTIC CRITERIA F. The symptoms aren’t better explained by another mental health issue. For example, it’s not just fear of panic attacks (like in panic disorder), fear of judgment (like in social anxiety), obsessive worries (like in OCD), fear of separation, reminders of trauma, weight concerns (like in anorexia), or being overly concerned with appearance, health, or delusional beliefs (like in schizophrenia).  ASSOCIATED FEATURES Many individuals with generalized anxiety disorder also experience somatic symptoms; (sweating, nausea, diarrhea) and an exaggerated startle response.  DEVELOPMENt AND COURSE Many individuals with generalized anxiety disorder report that they have felt anxious and nervous all of their lives. The primary difference across age groups is in the content of the individual's worry. Children and adolescents tend to worry more about school and sporting performance. They may also worry about catastrophic events, such as earthquakes or nuclear war, whereas older adults report greater concern about the well-being of family or their own physical health. Real life case WIL’S AT BIG BANG THEORY WIL’S AT Star Trek: The AGE OF 37 Next Generation AGE OF 15  Wil Wheaton’s Journey of Generalized Anxiety Disorder and Chronic Depression Known for his roles in hit television shows: Star Trek: The Next Generation The Big Bang Theory Despite his success, he has openly struggled with anxiety and depression, showing courage in sharing his mental health journey while continuing to excel in his career. Wil is 45 years old, married, and has two children.  Wil Wheaton’s Childhood with Anxiety and Depression Wheaton started having panic attacks as a young child, but adults didn’t recognize them for what they were and thought they were just nightmares. He would wake up terrified, often with his blanket thrown off the bed, and would sleep on the floor in his sister's room because he was afraid to be alone. By the time he was 13, Wheaton was overwhelmed with anxiety. He worried constantly about everything and felt tired, irritable, and lacked confidence.  Wil Wheaton in His Twenties One night, Wheaton had another panic attack that felt overwhelming, just like when he was a child. Desperate for comfort, he drove to his parents’ house and slept on the floor of his sister's room, just like he used to do as a child. his mother still couldn’t see that her son was struggling with the same issues.  How Anxiety Interfered in Wil Wheaton’s Life? Wheaton would think of all of the “what-if” scenarios that would make him think negatively about every experience. He worried constantly about the world around him. For example: He held his breath while driving under bridges, fearing that it would stop him from crashing his car.  How Anxiety Interfered in Wil Wheaton’s Life? He tapped the side of airplanes, believing it would prevent a crash. Every time he said goodbye to someone, he felt like it might be the last time, adding to his sense of dread.  The Start of Treatment Wheaton experienced a severe panic attack and emotional meltdown at Los Angeles International Airport. His wife, concerned about his well-being, suggested that he seek help. Wheaton finally decided to see a doctor. The doctor compassionately said, “Please let me help you”. Wheaton was prescribed a low dose of antidepressants, which began to shift his perspective.  COMMON TREATMENTS FOR ANXIETY  How is anxiety treated? Anxiety disorders are typically addressed using a combination of psychotherapy approaches and medication interventions or other interventions Psychotherapy Anxiety disorders can also be treated using psychotherapy also known as “talk therapy”. Cognitive behavioral therapy (Exposure therapy) Acceptance and commitment therapy  How is anxiety treated? Medication Anxiety disorders cannot be treated with medication but medication can be used to relieve some of the symptoms. Antidepressants Anti-anxiety medications (Benzodiazepines) Beta-blockers ( alleviate the physical symptoms )  How is anxiety treated? Support groups Discuss their problems and achievements with other people in a self-help group or a support group. Stress-management techniques exercise, mindfulness, meditation, etc. how many? Thank you ! special thanks to, beyonce.