Information Thread: Anxiety Disorders

by **Butterfly Faerie** » Wed May 17, 2006 4:23 pm

Here you can find information on Anxiety Disorders including OCD, Panic Disorder, Generalized Anxiety Disorder, Social Phobia etc.

1. Symptoms of GAD
2. Generalized Anxiety Disorder: From the book Don't Panic.
3. Common Symptoms of Anxiety
4. Social Phobia
5. Panic Attacks
6. Anxiety Attacks
7. Agoraphobia
8. Obessive-Compulsive Disorder
9. Specific Phobia
10. Causes of Anxiety Disorders
11. Long-term predisposing causes: Heredity
12. Long-term predisposing causes: Childhood circumstances
13. Biological causes: Physiology of panic
14. Biological causes: Medical conditions that can cause anxiety
15. Short-term triggering causes: Stressors that precipitate panic attacks

Page 2

16. Conditioning and the origan of phobias
17. Trauma, simple phobias & PTSD
18. Maintaining causes: avoidance of phobic situations, anxious self-talk & mistaken beliefs
19. Maintaining causes: Withheld feelings, lack of assertiveness & lack of nurturing skills
20. Maintaining causes: Muscle tension, stimulants & or other dietary factors & high stress lifestyle.
21. What is the difference between fear and anxiety?
22. Panicking
23. Information on Agoraphobia
24. Information on Phobias
25. Post-Traumatic Stress Disorder
26. Hyperventilation & Panic
27. Six types of Anxiety

SYMPTOMS

Generalized anxiety disorder (GAD) is much more than the normal anxiety people experience day to day. It's chronic and exaggerated worry and tension, even though nothing seems to provoke it. Having this disorder means always anticipating disaster, often worrying excessively about health, money, family, or work. Sometimes, though, the source of the worry is hard to pinpoint. Simply the thought of getting through the day provokes anxiety.
People with GAD can't seem to shake their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. People with GAD also seem unable to relax. They often have trouble falling or staying asleep. Their worries are accompanied by physical symptoms, especially trembling, twitching, muscle tension, headaches, irritability, sweating, or hot flashes. They may feel lightheaded or out of breath. They may feel nauseated or have to go to the bathroom frequently. Or they might feel as though they have a lump in the throat.

Many individuals with GAD startle more easily than other people. They tend to feel tired, have trouble concentrating, and sometimes suffer depression, too.

Usually the impairment associated with GAD is mild and people with the disorder don't feel too restricted in social settings or on the job. Unlike many other anxiety disorders, people with GAD don't characteristically avoid certain situations as a result of their disorder. However, if severe, GAD can be very debilitating, making it difficult to carry out even the most ordinary daily activities.

GAD comes on gradually and most often hits people in childhood or adolescence, but can begin in adulthood, too. It's more common in women than in men and often occurs in relatives of affected persons. It's diagnosed when someone spends at least 6 months worried excessively about a number of everyday problems.

Specific Symptoms of this Disorder:
Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).

The person finds it difficult to control the worry.

The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months; children don't need to meet as many criteria).

restlessness or feeling keyed up or on edge
being easily fatigued
difficulty concentrating or mind going blank
irritability
muscle tension
sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)
Additionally, the anxiety or worry is not about having a Panic Attack, being embarrassed in public (as in Social Phobia), being contaminated (as in Obsessive-Compulsive Disorder), being away from home or close relatives (as in Separation Anxiety Disorder), gaining weight (as in Anorexia Nervosa), having multiple physical complaints (as in Somatization Disorder), or having a serious illness (as in Hypochondriasis), and the anxiety and worry do not occur exclusively during Posttraumatic Stress Disorder (PTSD).

The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism) and does not occur exclusively during a Mood Disorder, a Psychotic Disorder, or a Pervasive Developmental Disorder.

Treatments

by **Butterfly Faerie** » Wed May 17, 2006 4:25 pm

Generalized Anxiety Disorder

With generalized anxiety disorder, panic is not the predominant feature. Many of the panic symptoms are present to a lesser degree. Instead of brief moments of intense anxiety, the person feels symptoms throughout most of the day. Although the specific manifestations of anxiety vary for each person, this chronic state of tension can affect 6 major systems of the body.

1. The cardiovascular system, anxiety increases the blood pressure, which causes tachycradia (rapid heartbeat), constriction of the blood vessels in the arms and legs, and dilation of the vessels surrounding the skeletal muscles. These changes produce symptoms of palpatations (an uncomfortable awareness of the heart rate), headaches, and cold fingers.

2. In the gastrointestinal system, anxiety leads to reduce salivary secretions, spasms within the esophagus (the hollow muscular tube leading from the nose and mouth to the stomach), causing spasms, diarrhea and/or constipation, and cramplike pains in the upper stomach.

3. In the respiratory system, anxiety leads to hyperventilation, or over breathing, which lowers the level of carbon dioxide in the blood, the symptoms of "air hunger", deep sighs, and pins and needles sensations.

4. In the genitourinary systems, the anxious person can experience the need for frequent urination. Men may have difficulty maintaining an erection during intercourse; women may have difficulty becoming sexually aroused or achieving orgasm.

5. In the musculoskeletal system, the muscles become tense. Involuntary trembling of the body, tension headaches, and other aches and pains may develop.

6. Through the changes in the central nervous system, the anxious person is generally more apprehensive, aroused, and vigilant, feeling "on edge", impaitent, or irritable. He/she may complain of poor concentration, insomnia, and fatigue.

There is often a fine line between the diagnosis of panic disorder and agoraphobia and that of generalized anxiety disorder. Three features distinguish them. First, the symptoms themselves: if an individual is chronically anxious (he/she weould be with generalized anxiety disorder) and also experience episodes of panic, then panic disorder and agorphobia will be the more likely diagnosis.

Second, defferent kinds of fearful thoughts are associated with the 2 problems. In most people with generalized anxiety disorder the worries are about the kinds of interactions they will have with others: "Will I fail in this work setting?" "Are they going to accept me?" "I'm afraid he's going to leave me." "What if they discover how little I know?" "I'll never perform ujp to their expectations." With panic disorder or agoraphobia, the imagined response of others is secondary to the fear of personal catastrophe or loss of control, and the person's internal statements and questions reflect this apprehension: "What if I faint [become hysterical, have a heart attack, cause a scene], and have people see me?" The panic-prone person focuses more on her/his ability to be in 100% control of all her/his physical and mental capacities. The anxious person focuses more on her/his ability to cope with the expectations and responses of thos around him/her.

POSSIBLE PHYSICAL SYMPTOMS DURING ANXIETY

Cardiovascular System

Tacycardia (rapid heartbeat)
Palpitations (uncomfortable awareness of the heart rate)
Headaches
Cold Fingers

Gastrointestinal System

Dry Mouth
Difficulty swallowing
Butterflies in the stomach
Gurgling sounds of gas in the intestines
Colon spasms
Diarrhea and/or constipation
Cramplike pains in the upper stomach

Respiratory System

Hyperventilation symptoms

Genitourinary System

Need for frequent urination
Difficulty maintaining an erection
Difficulty becoming sexually aroused or achieving orgasm (women)

Musculoskeletal System

Muscles tense
Involuntary trembling in the body
Tension headaches
Other aches and pains

Central Nervous System

Apprehensive, aroused, and vigilant
Feeling "on edge", impatient, or irritable
Poor concentration
Insomnia
Fatigue

The third difference has to do with the person's response to her/his fears. The anxious person thinks about withdrawing from the situations that increase her/his anxiety, and may procrastinate on performance tasks. The person with panic disorder or agoraphobia, on the other hand, is quick to use avoidance as a way to diminish discomfort. In a matter of days she/he will begin to identify the situations that are associated with the symptoms and determine how she/he can steer clear of them, immediately viewing avoidance as the single best solution to the problem.

by **Butterfly Faerie** » Wed May 17, 2006 4:26 pm

Symptoms Of Anxiety

nervousness/tension

sweating

rapid heartbeat

feeling unsafe

insomnia

trembling, twitching, or feeling shaky

fear of going crazy

fear of dying

choking sensation/lump in throat

irritability

dizziness/faintness

overeating

Chest pains/tightness

tingling/numbness sensation

nausea

numbness of lips, fingers, toes

frequent urination

trouble swallowing

restlessness or easily fatigued

dry mouth

clammy hands

hot flashes

difficulty concentrating

shortness of breath

smothering sensation

muscle aches, soreness or tension

fear of impending doom

feeling out of control/terror

guilt-filled memories

self-doubt and "what ifs"

diarreah, other abdominal distress

fear of doing something uncontrolled

sharp pain

weakness

fear of embarrasment or humiliation

self-medicating with drugs and/or alcohol

by **Butterfly Faerie** » Wed May 17, 2006 4:26 pm

Social Phobia

Social phobia is one of the more common anxiety disorders. It involves fear of embarrassment or humilitation in situations where you are exposed to the scrutiny of others or must perform. This fear is much stronger than the normal anxiety most nonphobic people experience in social or performance situations. Usually it's so strong that it causes you to avoid the situation altogether, although some people with social phobia endure social situations, albeit with considerable anxiety. Their concern is that they will say or do something that will cause others to judge them as being anxious, weak, "crazy", or stupid.

The most common social phobia is fear of public speaking. It is the most common of all phobias and affects performers, speakers, people whose jobs require them to make presentations, and students who have to speak in front of their class.

Other common social phobias include:

* Fear of blushing in public.

* Fear of being watched at work.

* Fear of choking on or spilling food while eating in public.

* Fear of using public toilets.

* Fear of crowds.

* Fear of taking examinations.

Sometimes social phobia is less specific and involves a generalized fear of any social or group situation where you feel that you might be watched or evaluated.

While social anxieties are common, you would be given a formal diagnosis of social phobia only if your avoidance interferes with work, social activities, or important relationships, and/or it causes you considerable distress.

As with agoraphobia, panic attacks can accompany social phobia, although the panic is related more to being embarrassed or humiliated than to being confined or trapped. Also the panic arises only in connection with a specific type of social situation.

Treatment for social phobia is often best carried out in a group setting.

by **Butterfly Faerie** » Wed May 17, 2006 4:27 pm

What is a panic attack?

A panic attack is a discreet period of intense fear or discomfort in which four (or more) symptoms develop abruptly and reach a peak within 10 minutes. The attacks are unexpected.

We who suffer from panic attacks have great concern about having having additional attacks, about the implications of the attack or its consequences (e.g., losing control, having a heart attack, going crazy, dying)

Because the physical symptoms of panic attacks are so intense, many people who suffer from the attacks feel that the next step must be death. They often end up in hospital emergency rooms and are usually sent home still wondering what was wrong!

We fear that the attack will last indefinitely, that we will never recover. In reality, most panic attacks peak within 10 minutes, and then subside. However, we feel so overwhelmed while in the midst of the attack that the few minutes it lasts seems to be forever. After, we ask this question, "Will it happen again?" That thought haunts us. It's a horrible experience.

We develop anticipatory anxiety, also known as FEAR of the FEAR. We fear not only the actual panic attack, but also anticipation of it. We think "What if it happens again?" The slightest physical symptom can set off waves of anticipation and cause FEAR of the FEAR.

Here are some fearful thoughts some people have during a panic attack:

• Fainting or collapsing in public

• Losing control of their body

• Becoming confused

• Having a heart attack or other physical illness

• Being trapped

• Causing a scene

• Going crazy

• Being unable to breathe

• Being unable to get home or to another "safe place"

Never forget there can be a recovery. Effective treatment can eliminate much of the disorder, but it may be susceptible to occasional temporary relapses when you experience stress.

by **Butterfly Faerie** » Wed May 17, 2006 4:28 pm

Anxiety Attacks

If you haven't been given a diagnosis of either panic attacks/anxiety or an anxiety disorder it is important you don't self diagnose. This must be done either by your doctor or by a medical specialist. It is very important to discuss your problem with your doctor.

After you have been evaluated throughly, your doctor will be able to tell you if your anxiety attacks are related to anxiety disorder or caused by another problem.

Many people who have anxiety attacks don't seek medical care because of embarrassment or fear of taking medications.

Anxiety disorder is the most common of all mental health problems and can start up in a number of different ways. If untreated it can lead to Panic attacks.

Anxiety attacks come up out of nowhere. If we have a anxiety attack in a certain place we may become afraid to go back to that place where we had the attacks. We start to avoid places where our attacks seem to have happened at. We go through great lengths to hide our symptoms hoping it can't be noticed by others.

by **Butterfly Faerie** » Wed May 17, 2006 4:28 pm

Agoraphobia

The actual fear is of being unable to escape, whether you're locked in a mass of people at a football game or stuck in an elevator or a dentist's chair. Many of us can't travel alone, particularly to new places, and many find it impossible to take public transportation.

Agoraphobia is often related to claustrophobia - feeling surrounded often makes us panic.

Sometimes it can happen after a prolonged illness where you had to be home or in a hospital, or it may come upon you with no warning at all.

It is the most severe form of all neuroses. Although it is the most commonly treated phobia, fewer people suffer from it than from other phobic disorders. Because they fear having a panic attack in a public place, true agoraphobics have great difficulty going outside of their homes.

Agoraphobia can range from mild to severe. In extreme situations, the sufferer ends up confined to just one room of their home or even to a "safe" chair or their bed.

We feel we can't hide the feeling inside of us any more and fear that what we are feeling at that point where we will be noticed by others. We worry, "What if I run across the room", that we would cry or do something foolish or embarrassing. We are afraid of the way we feel and where it could take us.

The thought of "Will it happen to me again?" haunts us. We become afraid of being afraid. It's such a horrible feeling to have and some of us become housebound. We lose our friends, our life, everything. Nothing in our life seems to be going well.

But there is good news. Agoraphobia can be treated with professional help.

by **Butterfly Faerie** » Wed May 17, 2006 4:29 pm

Obsessive-compulsive disorder (OCD) can be a debilitating disorder with the following two anxiety-related essential features:

Obsessions: undesirable, recurrent, disturbing thoughts
Compulsions: repetitive or ritualized behaviors

People with OCD experience unwanted obsessions, which cause anxiety. Severe anxiety produces feelings of dread, worry, fright, and apprehension (see generalized anxiety disorder GAD). Certain behaviors are performed compulsively in an attempt to lessen this anxiety. Although they realize their obsessions are excessive and their behavior is unreasonable, they feel powerless to control either. In fact, their symptoms can overwhelm them and result in severe impairment and dysfunction, which can begin at an early age.

Incidence and Prevalence

The National Institute for Mental Health reports that about 3% of people in the United States have OCD. Typical age of onset for boys is 6 to 15, while for women it is often later, between 20 and 30. Risk factors like genetic predisposition and environmental stress contribute to OCD. Also, OCD is more common among people of higher education, IQ, and socioeconomic status. Men and women, however, are affected equally. Though its course is chronic and usually lasts a lifetime, it is treatable with medication, behavioral therapy, and, in extremely rare cases, brain surgery.

Risk Factors

Risk factors for obsessive-compulsive disorder include the following:

Genetics
Postpartum periods
Environmental stressors

Although there is no clear genetic evidence, obsessive-compulsive disorder tends to run in families. A person with OCD has a 25% chance of having a blood relative who has it. Like other mental illnesses, it is more prevalent among identical twins than fraternal. There is a 70% chance that identical twins with share it, and a 50% chance for fraternal twins. Currently, researchers do not understand OCD’s genetic mechanisms, though they suspect multiple genes are involved.
Women with OCD may experience a worsening of symptoms during pregnancy and postpartum. A recent study suggests that fluctuating hormones may trigger symptoms during pregnancy. The same study reports OCD in 30% of women observed.

The arrival of a baby brings new responsibility, a new set of concerns, and changes in routine. While normal reaction to a newborn may include some anxiety, postpartum OCD features disturbing thoughts and excessive behavior regarding the baby’s well-being. The following obsessions and compulsions are common:

Obsession
Fear of contaminating the baby
Compulsion[
Repeatedly washing the baby
Obsession
Need for reassurances
Compulsion
Repetitively calling the physician
Obsession
Recurrent fear for the baby's safety
Compulsion
Incessantly checking the baby
Obsession
Recurrent thoughts of bad mothering
Compulsion
Incessantly checking the baby
Obsession
Recurrent thoughts of harming baby
Compulsion
Avoiding or neglecting the baby
Obsession
"Thoughts of disturbed order"
Compulsion
Ordering and rearranging baby's crib

These feelings and behaviors may occur immediately, but often begin 4 to 6 weeks after giving birth. Treatment is necessary to control symptoms and to ensure care of the baby.

Environmental stressors that can worsen OCD symptoms include the following:

Abuse
Changes in living situation
Illness
Occupational changes or problems
Relationship concerns
School-related problems

Causes

Biological factors involving brain structure and activation are associated with OCD. Abnormalities of the frontal lobes, basal ganglia, and cingulum are common in people with OCD. Basal ganglia are involved in routine behaviors, like grooming, and the frontal lobes in organizing behaviors and in planning. The cingulum consists of fibrous bands that assist in communicating the brain’s behavioral and emotional messages. Support for its role in OCD is the fact that surgical severing of the cingulum has relieved and even cured people with the disorder.

The Serotonin Hypothesis

An abnormally low level of serotonin is perhaps the most well-established link between the brain and OCD. Serotonin is a chemical neurotransmitter that transmits information from one nerve to another throughout the brain. It is released by one synapse(nerve ending), crosses a gap, and is picked up by another synapse. After a message is sent, enzymes in the brain clean serotonin out of the synapses. Drugs used to treat OCD, known as selective serotonin reuptake inhibitors (SSRIs), increase and sustain serotonin levels and reduce or eliminate symptoms.

by **Butterfly Faerie** » Wed May 17, 2006 4:29 pm

There are over 275 types of Specific Phobias that are listed according to some sources. In order to qualify for the diagnosis of a Specific Phobia, the person must have an excessive and unreasonable fear due to the presence or anticipation of a specific object or situation; exposure to the stimulus causes an anxiety response; the sufferer realizes that the fear is excessive or unreasonable; and, the avoidance of or distress due to the stimuli causes impairment in functioning.

(Isolated) Phobias

These are phobias restricted to highly specific situations such as proximity to particular animals, heights, thunder, darkness, flying, closed spaces, urinating or defecating in public toilets, eating certain foods, dentistry, the sight of blood or injury, and the fear of exposure to specific diseases. Although the triggering situation is discrete, contact with it can evoke panic as in agoraphobia or social phobias. Specific phobias usually arise in childhood or early adult life and can persist for decades if they remain untreated. The seriousness of the resulting handicap depends on how easy it is for the sufferer to avoid the phobic situation. Fear of the phobic situation tends not to fluctuate, in contrast to agoraphobia. Radiation sickness and venereal infections and, more recently, AIDS are common subjects of disease phobias.

Diagnostic Guidelines

All of the following should be fulfilled for a definite diagnosis:

the psychological or autonomic symptoms must be primary manifestations of anxiety, and not secondary to other symptoms such as delusion or obsessional thought;
the anxiety must be restricted to the presence of the particular phobic object or situation; and
the phobic situation is avoided whenever possible.

Includes:

acrophobia
animal phobias
claustrophobia
examination phobia
simple phobia

Differential Diagnosis

It is usual for there to be no other psychiatric symptoms, in contrast to agoraphobia and social phobias. Blood-injury phobias differ from others in leading to bradycardia and sometimes syncope, rather than tachycardia. Fears of specific diseases such as cancer, heart disease, or venereal infection should be classified under hypochondriacal disorder, unless they relate to specific situations where the disease might be acquired. If the conviction of disease reaches delusional intensity, the diagnosis should be delusional disorder. Individuals who are convinced that they have an abnormality or disfigurement of a specific bodily (often facial) part, which is not objectively noticed by others (sometimes termed dysmorphophobia), should be classified under hypochondriacal disorder or delusional disorder, depending upon the strength and persistence of their conviction.

Information Thread: Anxiety Disorders

Information Thread: Anxiety Disorders

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