Chapter 4: Anxiety Disorders

Overview

"Anxiety" by Mari Z. is licensed under CC BY-NC-ND 2.0.
“Anxiety” by Mari Z. is licensed under CC BY-NC-ND 2.0.

Anxiety disorders are those that are characterized by fear, worry, or excessive apprehension (APA, 2022). Disorders included in this section are generalized anxiety disorder, phobias, panic disorder, social anxiety disorder, separation anxiety disorder, and obsessive compulsive disorder.

 

Generalized Anxiety Disorder

Criteria to Diagnose: Generalized anxiety disorder involves excessive worry or apprehension about an array of things; the worry is usually coupled with restlessness, fatigue, lack of concentration, agitation, and sleep issues. Generally, it has to impair regular functioning for at least months or more. Generalized anxiety disorder affects roughly 2% of the US population (American Psychiatry Association, 2022).

prevalence of generalized anxiety disorder among US adults.
This chart shows the prevalence of generalized anxiety disorder among US adults from 2001-2003. Typically it affects women more than men and the age range of 30-44 more than other age brackets. Data regarding ethnicity of these individuals is not provided. (from NIMH)

Treatment, Medications, Therapies: Medications often used for this disorder are antidepressants, Buspirone (anti-anxiety medication), and benzodiazepenes. There are many alternative opportunities to help someone cope with generalized anxiety disorder (Mayo Clinic, 2017).

  • Lifestyle and home remedies include: exercise, sleeping well, relaxation techniques, healthy eating, avoid substances, and eliminate stimulants like nicotine and caffeine (Mayo Clinic, 2017).
    "Group Therapy" by Judy Robinson-Cox is licensed under CC BY-ND 2.0.
    “Group Therapy” by Judy Robinson-Cox is licensed under CC BY-ND 2.0.
  • Coping with this disorder also means adhering to the prescribed treatment plan, breaking vicious cycles and replacing them with virtuous cycles, and bolster plans with support from friends, family, and other supportive entities (Mayo Clinic, 2017).

Case Studies to Review:

Agoraphobia

"Agoraphobia, par Franck Vervial" by Franck Vervial is licensed under CC BY-NC-ND 2.0.
“Agoraphobia, par Franck Vervial” by Franck Vervial is licensed under CC BY-NC-ND 2.0.

Criteria to Diagnose: Phobias are excessive and persistent fears of an object or situation (OSC Rice University; APA, 2013). Agoraphobia is the extreme fear of being unable to escape a scenario without challenges or embarrassment. Agoraphobia is present for at least six months and impairs regular functioning. Those with agoraphobia typically avoid public transportation, enclosed spaces, open spaces, standing in lines/crowds, or being outside of their home environment. Left untreated, those with agoraphobia may not ever leave their home (American Psychiatric Association).

Typical Demographics: Specific phobias range between 8-12% of US adults, while Agoraphobia is present in roughly 1-3% of adolescents and adults.

Treatment, Medications, Therapies: Generally anti-depressants and anti-anxiety medications are prescribed to individuals with agoraphobia. There are also alternative medicines like kava that are being studied and have showed significant promise in reducing anxiety. It is important that the individual adheres to their treatment plan, including attempting to experience feared situations. There are calming techniques that can help as well.

In this video below, an agoraphobic person works through their anxiety riding in an elevator. This is a 360 degree video, so you can drag the video to see all the potential perspectives.

 

 

Case Studies:

Panic Disorder

Criteria to Diagnose: Individuals afflicted with a panic disorder experience frequent panic attacks, related to fears of more panic attacks, consequences of attacks, behavior related to attacks, or a combination of all these factors. Sometimes this is comorbid with agoraphobia (APA, 2022).

Panic Attacks Symptoms: Sense of impending doom; Fear of loss of control or death; Rapid heart rate; Sweating; Shaking; Shortness of breath; Chills; Hot Flashes; Nausea; Stomach Cramps; Chest Pain; Headaches; Dizziness; Numbness; Detachment from reality

Typical Demographics: Panic disorder affects 2-3% of the US population.

Treatment, Medications, Therapies: SSRIs, SNRIs, and benzodiazepenes are generally prescribed for this disorder. Other options include psychotherapy and life style changes to promote a less stressful environment and life.

Case Studies:

Social Anxiety Disorder

Review all of the following slides and video to learn more about Social Anxiety Disorder. To enlarge to full screen, select the double pointed arrow in the bottom right corner of the slides.

 

 

Separation Anxiety Disorder

Select each of the four hot spots below to learn more about this disorder. Select the icon in the upper right corner to enlarge it to full screen.

 

 

Obsessive Compulsive Disorder

"A little OCD" by justmakeit is licensed under CC BY-NC 2.0.
“A little OCD” by justmakeit is licensed under CC BY-NC 2.0.

Criteria to Diagnose: This disorder involves two significant components: the obsessions and the compulsions. Obsessions are recurring, intrusive thoughts that the individual cannot ignore. The compulsions are behaviors that aim to neutralize the intrusive thoughts. A common themes is related to cleanliness, contamination, etc. The compulsive behaviors must be excessive, unreasonable, and impair functioning. Diagnosis can occur when the compulsions and/or obsessions are consuming a minimum of an hour per day (American Psychiatric Association, 2022; APA, 2022).

Typical Demographics: This disorder affects roughly 2-3% of adults in the the U.S.. Symptoms generally start to show around 19 years old, but can occur at any age. Women are slightly more likely to have this disorder.

"Deep Brain Stimulation Illustration" by National Institutes of Health (NIH) is licensed under CC BY-NC 2.0.
“Deep Brain Stimulation Illustration” by National Institutes of Health (NIH) is licensed under CC BY-NC 2.0.

Treatment, Medications, Therapies: OCD is generally treated with either medication, psychotherapy or a combination of the two. Sometimes there are comorbities that would need to treated as well. Medications usually involve SSRIs; though it does take 8-12 weeks before the patients will experience a noticeable change (NIMH, 2022).

There is an alternative treatment option called Transcranial Magnetic Stimulation. This is FDA approved. For more information on brain stimulation therapies, check out this content from the National Institute of Mental Health.

Case Studies to Review:

Below is a 360 video, immersing the viewer into the world of an OCD person. You can move the video in any direction, as you like.

 

References:

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Psychopathology by Andrea Bearman and Jackie Delagrange is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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