[15.3] Anxiety, Depressive, and Obsessive-Compulsive Disorders

Question 1

Anxiety Disorders

Answer 1

• anxiety disorders: a category of disorders involving fear or nervousness that is excessive, irrational, and maladaptive
• people often cope with anxiety by limiting themselves to environments, activities, and people that make them feel safe and secure, and by developing rigid habits and ways of doing things so as to keep life predictable and under control
• but these patterns become imprisoning, stifling people’s growth and experience of life
• what separates anxiety disorders from other forms of anxiety is a combination of an unjustifiable degree, duration, and source of anxiety

Question 2

Generalized Anxiety Disorder

Answer 2

• generalized anxiety disorder (GAD): involves frequently elevated levels of anxiety, generally from the normal challenges and stresses of everyday life
• because the anxiety arises out of the ongoing situations and circumstances of life, people often have difficulty understanding their experience, and cannot identify specific reasons
• people with GAD often have unstable, irritable moods, experience difficulty concentrating, and have sleep problems
• a convergence of stresses, such as occurs during major life changes, commonly precede the onset of the disorder

Question 3

Panic Disorder

Answer 3

• panic disorder: an anxiety disorder marked by occasional episodes of sudden, very intense fear
• the key feature of this disorder is panic attacks—brief moments of extreme anxiety that include a rush of physical activity paired with frightening thoughts
• agoraphobia: an intense fear of having a panic attack in public; as a result of this fear, the individual may begin to avoid public settings and increasingly isolate himself or herself

Question 4

Specific Phobias

Answer 4

• phobia: a severe, irrational fear of a very specific object or situation
• specific phobia: an intense fear of a specific object, activity, or organism
• social phobias, which are very common, are a different category of phobias, related to inter-personal situations and relationships
• phobias can arise out of the patterns of anxiety that develop as children’s fears give rise to thoughts, emotions, physiological responses (e.g. arousal), and behavioural reactions (e.g. avoidance) that can, in turn, feed back to reinforce the fear
• for most people, as they develop cognitively and as they mature over time, their childhood fears subside
• for a subset of people, perhaps those who are genetically prone to a stronger fear response, some of these fears become stable patterns of emotion, thought, and behaviour, and transfer into adulthood; this is what becomes a phobia
• psychologists arguing from an evolutionary perspective believe that the human species has evolved to be biologically predisposed to develop certain fears (e.g. drowning), based on our evolutionary history

Question 5

Social Phobias

Answer 5

• social anxiety disorder: a very strong fear of being judged by others or being embarrassed or humiliated in public
• people who experience social anxiety deal with going out in public by developing familiar routines and retaining control over their ability to exit circumstances if their anxiety becomes too strong
• generally leads people to limit their social activities in favour of not exposing themselves to anxiety

Question 6

The Vicious Cycle of Anxiety Disorders

Answer 6

• one of the most dangerous aspects of anxiety disorders is that they tend to be self-perpetuating
• e.g. people with social anxiety disorder may avoid many social situations because they feel awkward and insecure and don’t want to embarrass themselves; as a result, they become even less confident about their ability to socially interact with people, making them even more likely to avoid social contact in the future
• avoiding or interrupting this vicious cycle is central to the treatment of anxiety disorders
• the most important part of psychological therapy for anxiety disorders is exposure: the person is repeatedly and in stages exposed to the object of his fear so that he can work past his emotional reactions

Question 7

Obsessive-Compulsive Disorder (OCD)

Answer 7

• obsessive-compulsive disorder (OCD): plagued by unwanted, inappropriate, and persistent thoughts (obsessions), and tend to engage in repetitive almost ritualistic behaviours (compulsions)
• obsessions take root and can last for a very long time, even many years; these thoughts tend to be distressing or generally inappropriate
• the compulsive behaviours that people with OCD engage in are ways of asserting control over their anxiety

Question 8

Mood Disorders: Major Depression and Bipolar Disorder

Answer 8

major depression: a mood disorder marked by prolonged periods of sadness, feelings of worthlessness and hopelessness, social withdrawal, and cognitive and physical sluggishness

• cognitive activities such as concentrating and making decisions are affected, while memories shift toward unpleasant and unhappy events
• other people start to notice, get annoyed, or have hurt feelings, which the depressed person likely knows, which then leads the depressed person to feel even worse about himself

bipolar disorder (formerly referred to as manic depression): characterized by extreme highs and lows in mood, motivation, and energy

• involves depression at one end and mania (an extremely energized, positive mood) at the other end
• during a manic state, individuals feel little concern about the potential consequences of their actions
• individuals can move from one end to the other at different rates; some people with bipolar disorder experience only a few manic episodes in their lives, whereas others go through several episodes each year

Question 9

Cognitive and Neurological Aspects of Depression

Answer 9

• pessimistic explanatory style: a set of habitual ways of explaining events to oneself which tend to be dysfunctional
• when something bad happens, such as the person failing to succeed at a task or a project, she makes internal, or personal attributions, for the event, blaming herself excessively for what happened
• depressed individuals also tend to make stable attributions: assuming that the situation is going to persist
• as they spiral into catastrophic ways of thinking, they make global attributions: expanding the impact of the negative event into other domains or into overall life

Question 10

Biological Aspects of Depression

Answer 10

• twin studies suggest an underlying genetic risk for developing major depression
• two primary regions of interest related to depression:
  
  • the limbic system, which is active in emotional responses and processing
  • and the dorsal (back) of the frontal cortex, which generally plays a role in controlling thoughts and concentrating
  • the overactive limbic system responds strongly to emotions and sends signals that lead to a decrease in frontal lobe activity, and the decrease in frontal lobe functioning reduces the ability to concentrate and control what one thinks about
• erotonin, dopamine, and norepinephrine all appear to be involved in depression
• individuals with depression are at higher risk for a variety of illnesses, as well as cardiovascular disease and higher risk of mortality in given time periods
• people who inherit “short” copies of a gene responsible for sero- tonin (5-HTT) activity are predisposed to depressive episodes in response to stress
  
  • they are also more prone to suicide attempts

Question 11

Sociocultural Influences on Mood Disorders

Answer 11

• socioeconomic and environmental factors leave some individuals more vulnerable to mood disorders
• poor neighbourhoods are associated with higher daily stress levels due to substandard housing and facilities, increased crime rates, and other difficulties
• they are also more vulnerable to stressors such as unemployment because they often lack connections, mentors, and job opportunities
• social ties tend not to be as strong; i.e. people may not know their neighbours very well and, therefore, take less interest in one another’s well-being

Question 12

Suicide

Answer 12

• suicide is the second leading cause of death in Canada
• it is four times more likely among males than among females, and two to three times more likely among Native Americans and European Americans than among individuals of other ethnicities
• the suicide rate for people 65 and older is nearly 60% higher than the rate for teens
• among people in their teens and early 20s, the most significant risk factors are: mood disorders, recent and extremely stressful life events, a family history of mood disorders, easy access to a lethal means of suicide, and the presence of these factors in conjunction with substance abuse
• for younger individuals, being the victim of bullying and ostracism is a risk factor, but it is a greater concern when youth are both the victims and the perpetrators of bullying