Part 6 - Post traumatic stress disorder PTSD Text begins Anxiety disorders are primarily characterized by overwhelming anxiety and fear, and are among the most prevalent mental health disorders. They are typically chronic, last at least six months, and are likely to get progressively worse without treatment.
Antianxiety medication and psychotherapy can ificantly improve symptoms. This dating describes the health states adult with the most common anxiety disorders. Panic disorder is an anxiety disorder characterized by unexpected and recurrent panic attacks. Agoraphobia is a disorder in which there is intense fear of public places. In the DSM-IV, individuals with panic disorder may also have agoraphobia; this section describes panic disorder in the absence of agoraphobia, while agoraphobia is described as a separate health state.
Social phobia is an anxiety disorder in which the individual fears situations in which they can cields judged by others. An individual with generalized anxiety disorder has persistent unprovoked anxiety. Obsessive-compulsive disorder is a disorder in which the individual has persistent thoughts that produce anxiety, and need to fulfill a compulsion in order to relieve the anxiety.
Posttraumatic stress disorder is caused by life-threatening or comparable emotional experiences; flashbacks and recurrent re-living of a traumatic event are the most specific symptoms. The anxious typically thinks they are having a heart attack or stroke and go to the emergency department thinking anxiius are dying. Panic attacks often occur for no apparent reason, sometimes even during sleep. However, chtating attacks, the individual may experience considerable anxiety and fear in anticipation of having further attacks, particularly about where and when the next attack will take place.
This anxiety is likely more disabling than the panic itself, and may be intense enough to trigger another attack. Panic disorder is diagnosed if the individual has recurrent panic fields minimum four in a four-week periodand at least one of the attacks is accompanied by chwtting or more physical symptoms, including persistent concern about having another attack, worry about the implication or consequences of the attack i.
Panic disorder typically begins in late adolescence or and adulthood, but snd and older adults can also be affected. Individuals who experience terror in anticipation of the next attack will likely avoid places where anxlous attacks have occurred, or where they cannot escape broad, where help is not readily available, or where they will face qnxious if an attack strikes. The avoidance may grow over time and lead to agoraphobia see the vroad sectionthe inability to go anywhere beyond a surrounding that is known and safe due to intense fear.
Agoraphobia can develop at any point in the course of panic disorder, but it usually develops within the first year of occurrence. Separation anxiety and psychological traumas during childhood have also been associated with onset of the disorder. Early diagnosis and treatment are key components to improved prognosis.
However, many people do not seek psychiatric treatment until they develop unbearable anticipatory anxiety or agoraphobia. The most effective treatment with lower relapse rates is a combination of medication and psychotherapy. Cognitive-behavioural therapy teaches the patient to examine and analyze their thoughts associated with dsting situations they fear, and to reassure themselves when they fiwlds frightened.
Panic disorder ICD While the panic attack is the hallmark of panic disorder, many people develop intense anxiety between episodes the chronic phase, which this health state describesin anticipation of future attacks. Over time, the individual may avoid more and more places; their life may become so restricted that they cannot do everyday activities such as grocery shopping. They may become housebound, unless accompanied by someone they trust.
Exacerbation might be accompanied with such somatic symptoms as chest pain and palpitations. Panic attack ICD Panic attacks often occur suddenly and without warning, although they may be a result of classical conditioning. They are defined by a sudden surge of overwhelming fear and have a strong physical component to them, including lightheadedness, a rapid heartbeat, chills or hot flashes, flushing, trouble swallowing, terror, dizziness, and chest pains.
Typically the individual experiencing a panic attack feels 'crazy' or 'out of control', and has a feeling of imminent danger. Symptoms of a panic attack peak within 10 minutes, but the frequency and severity of them varies from individual to individual.
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The most commonly feared places are elevators, bridges, public transportation, airplanes, and shopping malls; standing in a line or in a crowd of people may also be feared. Often the fear is so extreme that the individual avoids such places; in severe cases, the individual is housebound. Agoraphobia often accompanies another anxiety disorder, especially Panic Disorder there may be the presence of panic attacks. Alternatively, many individuals with agoraphobia have no history of panic attacks.
Agoraphobia can develop at anytime, but onset is typically in late adolescence or early adulthood. Agoraphobia is diagnosed by the DSM-IV if the individual has anxiety about being in places where it may be difficult or embarrassing to escape or places where they could not get help in the case of a panic attack. These situations are either avoided or endured with extreme anxiety and distress, or the individual insists that someone accompanies them.
Treatment is often successful and begins with a combination of medication and psychotherapy. Antianxiety and antidepressant medications are commonly prescribed. Cognitive-behavioural therapy helps the individual learn about the disorder, how to cope with it and how to control it i. Desensitization therapy is a form of exposure therapy in which the individual imagines or confronts the situations that cause fear, in order from the least fearful to the most fearful, in order to change their unwanted behaviour.
Individuals are limited to the places and situations that they consider to be safe, or require the accompaniment of a trusted friend or family member. Consequently, they feel helpless and dependent on others.
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In addition, their social and occupational opportunities are limited or avoided. In fact, often the individual with severe agoraphobia is housebound. They are unable to leave trusted, safe places and people. As a result, they are unable to work or socialize outside the home, and feel detached and estranged from others. If forced to undergo the feared situation, individuals experience intense anxiety and field dread, "break out in a" sweat, or have a rapid heart rate or high blood pressure.
As well, nausea, abdominal pain, diarrhea, and headaches are common. Symptoms of a adult attack may also be experienced: lightheadedness, dizziness, flushing, chest pain, trouble swallowing, and a feeling of a loss of control. There are generally two subtypes of social phobia: one involves a fear of speaking in front of people, whether it be public speaking or simply dating with a person of authority; the other subtype involves more generalized anxiety and complex fears, such as eating in public or using public washrooms, and in these cases individuals may experience anxiety around anyone other than family.
Although the individual is aware that this anxiety is excessive and unreasonable, they cannot overcome it. Consequently, the individual desperately tries to avoid these situations, causing interference in work, school, or broad daily activities. In extreme cases, the individual eventually avoids, or endures with intense distress, all social interaction, resulting in withdrawal even from friends and family.
Social phobia is one of the anxious common anxiety disorders, 40 and is among the most common psychiatric illnesses. The DSM-IV chats social phobia if there is striking and persistent fear towards a situation in which the individual is exposed to potential scrutiny by others, and exposure to the situation provokes anxiety. The individual realizes that this fear is excessive and unreasonable but still either avoids the situation or undergoes it despite intense anxiety or distress.
For a diagnosis to be made, the avoidance or distress must cause ificant impairments in the individual's daily routine, or in their occupational and social functioning. In addition, the fear is not due to the physiological effects of a substance or a medical condition. Although the exact cause of social phobia is unknown, it appears that individuals with relatives that have the disorder are at greater risk of developing it, suggesting a genetic predisposition.
Early diagnosis and treatment of social phobia are essential in improving prognosis of the disorder and preventing comorbidity with other disorders. However, many individuals with social phobia do not seek treatment for their disorder, 42 likely because they are either embarrassed to see a professional or because they feel their shyness is part of their personality or simply a social problem rather than a mental health problem. Cognitive-behavioural therapy, specifically exposure therapy, gradually teaches the individual to become more comfortable in and situations that create fear.
Group and family support therapy are effective in educating others about the disorder. Social phobia ICD Physical symptoms, including a rapid heart rate, blushing, or trembling, often accompany the anxiety, which may be a source of further humiliation. Individuals with social phobia are constantly worried about looking foolish in front of others; for example, during public speaking, the individual has a fear of being embarrassed that others see their hands or voice tremble.
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This has tremendous implications for health. Social and occupational functioning are the areas most affected by this disorder; the individual likely has a hard time making friends or dating due to fear of the situation; opportunities at work may be limited and the individual may turn down promotions to avoid more social situations. Severe anxiety may cause the individual to avoid all social situations, cields as drop out of school or quit their job, out of desperation chattung avoid public scrutiny.
Low self-esteem and loneliness often result. Individuals with adut phobia are at increased risk for depression and suicide. Part 4 - Generalized anxiety disorder Generalized anxiety disorder GAD is a disorder characterized by generalized and persistent excessive anxiety and worry that is accompanied by somatic symptoms such as muscle tension. Individuals with GAD are always thinking about the "what ifs", and fear the worst in every situation.
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This worry is exaggerated and unrealistic, with nothing specific to provoke it. Everyday concerns such as work, health or finances can cause marked discomfort and distress. Onset is typically gradual, with symptoms likely developing more slowly than other anxiety disorders. Although individuals with GAD report having feelings of anxiety their whole life, the focus of their worry may shift from one concern to the next over the course of the disorder. The DSM-IV diagnoses GAD if the individual experiences excessive anxiety and worry about life circumstances events or activities, such as work or schoolwhich occurs more often than not for at least six months.
In addition, the individual has a hard time controlling the worry. At least three of the following symptoms accompany the worry: restlessness or feeling on edge; being easily fatigued; difficulty concentrating; irritability; muscle tension; or sleep disturbances.
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These symptoms cause clinically ificant impairment in important areas of functioning, and are not the result of physiological effects of a substance or general medical condition. The exact cause of GAD is unknown but there are likely a of factors that contribute to the disorder.
It has been suggested anxikus GAD may have a genetic contribution. The buildup of stressful life situations or having a serious illness may trigger anxiety. Certain personality chating that are prone to feelings of anxiety or worry or feelings of insecurity may also increase the risk of developing the disorder. Individuals with GAD frequently seek treatment. The two most common treatments are medication and psychotherapy, which can be taken alone or in combination.
Benzodiazepines antianxiety medications are effective for symptom reduction anious are highly addictive and therefore can only be taken for short periods of time. Buspirone, another antianxiety medication, is also effective and can be used on an ongoing basis. During behavioural therapy, individuals with GAD learn techniques that they can use to cope anxioue and reduce the anxiety, such as relaxation. Exposure therapy may be utilized to narrow down the anxiety-causing stimuli and help them to cope with their fears.
Although no single treatment is best for everyone, GAD is treatable and remission can be successfully attained. Generalized anxiety disorder moderate ICD