Introduction to Anxiety Disorders Professor Craig A. Jackson Head of Psychology

Overview Diagnostics Classification Causes Treatment

Diagnostics 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

Diagnostics 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 Types General anxiety disorder Panic disorder Panic disorder & agoraphobia Phobias OCDs PTSD Separation anxiety Childhood anxiety disorder

Generalised 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 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 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 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 & 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

Phobias 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 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 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 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 Cause Neurotransmitter theories GABA depletion Solvents Amygdala theory Stress theories

Treatments SSRIs Benzodiazepines CBT Psychotherapy Alternative remedies Exercise Sleep hygiene Lifestyle

Medicalisation Necessity of anxiousness? Modern society Increased hazards Amygdalian evolution

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