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