Anxiety

Anxiety and Related Disorders

Objectives

4 types of Anxiety Disorders

Symptomology and differences

Treatments available

Medication Specifics

Copyright 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

Anxiety Defined?

Anxiety Apprehension, uneasiness,

uncertainty, or dread from real or perceived
threat
Normal levels to debilitating

Normal anxiety Necessary for survival

Fear Reaction to specific danger

.

Levels of Anxiety

Mild anxiety

Moderate anxiety

Information input declines, focus narrows, selective

inattention occurs

Severe anxiety

Everyday living, environmental information processed

better

Focus is extremely limited, may focus on a single

facet or several disjointed ones

Panic

Extremely disturbed behavior, pacing, running,

hallucinations are possible
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Types of Anxiety Disorders

Panic Disorders

Social Anxiety Disorders

Overwhelming worry and self-consciousness about

everyday social situations

Specific Phobias

Sudden terror that strike suddenly and repeatedly

without warning

Intense fears of specific stimuli or situations

Generalized Anxiety Disorder

Excessive, Unrealistic worry and tension with little or

no provocation
.

Question 1
A parent is shopping with a 6-year-old child in the
Chesterfield mall. The parent suddenly realizes the
child is missing. Which level of anxiety would likely
result?
A.Mild
B.Moderate
C.Severe
D.Panic
Copyright 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

What do You think?

What behaviors might this parent be exhibiting

that would indicate panic-level anxiety?

Panic Disorders

Marked specifically with panic attacks

Symptoms can vary widely

Breath pattern changes, sweating, shaking,

pacing/running, not thinking clearly. Marked vital sign
changes.

Come out of the Blue

Extreme and overwhelming feelings of apprehension or

impending doom

Although specific triggers may exist, they usually come

on without warning

Fear of Fear

Patients often become so preoccupied with the next

attack, they cannot function in day to day activities
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Social Anxiety Disorders

Social Phobia (aka)

Anxiety is produced from Social Situations

Anxiety caused by; fear of speaking in public, saying

the wrong thing, looking foolish, dislike of eating or
drinking in public etc.

Avoidant behaviors

Patients often avoid these situations, even when

detrimental, to limit the anxiety.
When forced into these situations the may be able to
endure or might completely shut down

Phobias

Many Phobias Exist

Persistent, irrational fear of stimuli or situation

Anxiety can be overwhelming and crippling.

Functioning is extremely reduced

Etiology may be unknown or cause established

Death, Heights, Storms, Darkness, Germs etc.

Some are unknown others develop from an event

Thoughts of object vs Presence

Patient may be able to talk about or visualize cause,

but unable to bear the presence of the phobic item

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Generalized Anxiety Disorder (GAD)

Excessive Worry

Symptoms can vary widely

Often out of proportion to the actual cause

Restlessness, irritability, muscle tension, poor
concentration are common

Anxiety foci are many and varied

Inadequacy, job duties or performance, health

concerns
Family and support members grow weary of the
constant need for reassurance

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Defenses Against Anxiety

Defense mechanisms
Outlined by Freud and his Daughter Anna

Expanded upon by many others later

Automatic coping styles/skills
Protect people from anxiety
Maintain self-image by blocking
Feelings
Conflicts
Memories

Can be healthy or unhealthy

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Treatment Options

Promote Self Care

Counselling/Therapy

Performing ADLs, Refocus anxiety into tasks

Individual, specific or group

Medication Support

Antidepressants, antianxiety
SSRIs are first line Prozac, Lexapro and Zoloft
Anti-Anxiety medications should be considered short term

Nutritional Support

Good Nutrition and hydration to promote full body health

Sleep Support

Sleep hygiene and support, usually avoids specific sleep

medications
.

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Future Considerations

Other anxiety disorders

Highly Specific
Anorexia Nervosa, OCD

Situational Anxiety
Test days, family concerns

Substance-induced anxiety disorder

Cocaine, ephedrine, cold medicines, weight loss
supplements

Anxiety due to a medical condition

Respiratory distress, cardiac issues

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