1. Anxiety Disorders Panic Disorder Phobia Disorders
Generalized Anxiety Disorder
Obsessive-Compulsive Disorder
Anxiety Caused by Medical Conditions or Substances
Normal Anxiety

2. Essential Features Clinically significant anxiety
Including avoidance behavior
Not fear
Fear involves intellectual appraisal of threatening stimulus
Anxiety involves emotional response to appraisal of threatening stimulus

3. Who Experiences Anxiety Disorders?
25% of population (1 in 4 persons in US)
More than 1/3 of all persons who consult mental health
Anxiety Disorders Association of America – More learned in last 10 yrs than past 100 yrs.
Breakthroughs include:
Some AD, such as panic disorder are primarily biological illnesses, associated with underlying genetic vulnerability & alterations in brain chemistry
Stress & conflict can worsen AD but don’t necessarily cause them
Mostly, interplay of biological, psychosocial (including stress), and behavioral determines nature & severity of disorder

4. New Treatment Options
New insights into anxiety  major treatment advances
Cognitive-behavioral therapy proven effective for phobias
Medications in combo with CBT provide relief for panic disorders
Remember self-medication with legal/illegal substances common
Self-help techniques helpful with other AD
Avoid caffeine
Exercise regularly
Controlled breathing

5. Panic Disorder Most common AD among those who seek help
About 1/3 all young adults experience at least 1 panic attack bet years
Panic attacks reach intensity within 10 min.
Panic attacks not codable disorder
No impetus for panic that overwhelms
Attacks strike during normal everyday activities
Diagnosed as with or without Agoraphobia
Agoraphobia
fear & avoidance of places/situations in which escape/getting help, if needed, not easy—5.6% of adults at some pt. in lives
Biological root is misfiring of brain’s alarm center which triggers fight-or-flight stress response; brain signals distress even when none exists

6. Specific Phobias Most common anxiety disorder yet rarely seeking help
11% of all men & women at some point in lives
Intense, unfounded, & persistent fear of a particular object, activity, or situation
Anticipatory anxiety also
Genetic predisposition, environmental & developmental factors such as childhood trauma (Freud’s “Little Albert”)
Common types:
Animal (most often dogs, snakes, mice, or insects)
Blood-injection-injury phobia
Situational phobia (closed places)
Natural environmental phobia (fear of storms, heights, or water)
Situational phobias occur most frequently in adults

7. Social Phobia Clinically significant anxiety
Exposure to certain types of social or performance situations lead to avoidance behaviors
Centers on fear of public humiliation
Physical symptoms usually also occur
Usually fear is general rather than specific
13.3% of Americans may experience
Men appear to be as vulnerable as women
Those seeking help usually present with fear of more than 1 type of situation
CBT with exposure techniques, imagined or direct

8. Obsessive-Compulsive Disorder
Check if:
Senseless, upsetting, bizarre thoughts/images
Repeatedly trying but failing to ignore/block troubling thoughts
Worry excessively about dirt, germs, or contamination
Afraid of losing/giving away something important
Feeling compelled to think certain thoughts or perform certain acts repeatedly
Wash or clean excessively
Check thing repeatedly to make sure done
Do same thing over & over again
Keep useless things because may need them someday
Spend more than 1 hour a day on odd thoughts/behaviors
Feel upset or embarrassed due to thoughts/behaviors
Find difficulty carrying on normal daily routines due to intrusive thoughts or need to perform certain acts repeatedly

9. Acute Stress Disorder Can simulate PTSD
Set off by trauma of unusually frightening experience or event but more severe than adjustment disorder would cover
Symptoms
Some symptoms of anxiety disorder
Some symptoms of “dissociation” involving altered sense of identity, memory, or perception
Must occur within 1 month of stressor
Last for at least 2 days
Resolve within 4 weeks
1st classification is in DSM-IV
¼ to 1/3 involved in disasters have emotional numbing & inability to feel deeply about anything

10. Generalized Anxiety Disorder
6 months persistent excessive anxiety & worry
Chronic, unrealistic worry about several events or activities so intense as to produce physical & psychological symptoms
Constant apprehension, always expecting worst
Physical tension
Physiological changes similar to real fear
Increased arousal or hypervigilance, causing irritability, impatience, concentration & insomnia
3% experience in a 1 year period
Genetic factors, stressful events, predisposition may keep from bouncing back, unconscious conflicts

11. Normal Anxiety
So what is the difference between GAD, Acute Anxiety Disorder and Normal Anxiety?
What are your anxieties?

12. Post Traumatic Stress Disorder
Intense, persistent, extremely distressing response to event that threatened life/safety
Gained attention after Viet Nam
yet combat not only experience to forever change way in which people view themselves & world
Reaction goes beyond normal responses
include intrusive thoughts & feelings & denial or avoidance of upsetting emotions
Fears & helplessness re-experienced in thoughts or dreams

13. Anxiety Caused by Medical Problem or Substance
Cardiovascular Disorders
arrhythmias, congestive heart failure, coronary artery disease, & mitral valve prolapse
Respiratory diseases
asthma, chronic obstructive pulmonary disease etc
Hormonal imbalance disorders
hyperthyroidism, menopause & premenstrual
Metabolic conditions
anemia, hypoglycemia
Neurological disorders
encephalpathy, temporal lobe epilepsy etc